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Another rehabilitation approach goes with the understanding that most pain killer addicts did not openly indulge in drugs to behave deviantly and/or get high, but to alleviate pain. This approach uses an intense focus on physical detox, along with individual therapy and a short-term, intensive treatment. This type of rehab program does not tend to emphasize the importance of total abstinence over the long term. Clinically speaking, it is often the case that someone who becomes addicted to pain killers becomes co-addicted to at least one other substances (alcohol is a good example). In the rare case that this does not occur, the above stated rehabilitation plan may prove successful. It must be noted, however, that addictive tendencies and behaviors can forever alter a person's chemical and thought-processes. If this is the case, a short rehab stint may not prove to be successful.
While pain killers have increased in terms of an addictive problem over the recent years, the number of overall cases of men and women addicted to pain killers is still relatively small compared to other substances (like alcohol, for example). If you are in chronic pain, the reality is that the pain can also lead to major depression and even substance abuse of another kind. It is not uncommon for those suffering chronic pain to become addicted to alcohol or other related substances when they are not treated. The recommendation is that if you are in chronic pain, but frightened that you will become addicted to pain killers:
Ever since the popular media stories about Rush Limbaugh's demise from oxycotin addiction, Americans have been more aware of this commonly prescribed pain killer. Oxycotin, as with all pain killers, is in the opioid family, and is often described as "prescription heroin." All opioids have a "downer" affect and, thus, pain killers not only alleviate the "pain," but also make the user quite relaxed and even laid back.
The problem with drugs like oxycotin is that once the "low euphoria" wears off, the pain and the stress related to both pain and other parts of life return. These normal feelings of anxiety, fear and stress become less tolerable to the user and he/she begins to seek a quick fix to comfort once again. It is not uncommon for men and women who develop oxycotin addiction to begin to seek out other drugs, such as alcohol, to enhance the feelings of content and/or relaxation they seek.
One sure sign of addiction to oxycotin, or any pain killer for that matter, is when the user begins to realize that he/she can no longer obtain the desired medication from his/her doctor and begins to seek out illegal drugs, or street pain killers. If he/she cannot obtain illegal pain killers, this may lead the now addicted user to seek out drugs like heroin to achieve a similar high.
Many people are confused by the fact that pain killers, which are often initially prescribed to alleviate discomfort or pain, can become addictive to the body. The most commonly addictive pain killers are the opioids (like morphine, codeine). To give you an idea of how addictive opioids are, heroin is a street drug version of an opioid.
While these pain killers do work to change the way that the body responds to pain, they also begin to achieve a feeling of lightness and/or euphoria in the user. If a person becomes attached to this euphoria (not hard to do with a body full of a pain and a life full of stress), then he/she will begin to take the medication over a long period of time and even begin to deny to him/herself that this is not the proper use of the medication.
After prolonged use of pain killers, the body chemistry is altered and a physiological dependency develops to the particular pain killer(s) being consumed. Once the body chemistry is altered, the person becomes in danger of major symptoms of physical and emotional withdrawal and in need of a reputable detox and recovery program.
Rehabilitation for pain killers is approached in several different ways. While some recovering addicts, as well as professionals in the field, view pain killer addiction as indistinct from any other chemical dependency, others disagree. Here we will focus on the camp that feels that total abstinence of all substances is necessary to achieve real recovery. This side of the recovery world feels that a short-term detoxification program should be coupled with a lifelong 12-step program. Individual and/or group therapy is often utilized in this treatment approach.
If this sort of recovery option seems "over the top" to you, be careful not to jump to early conclusions. The decision to embark on this kind of recovery program may be the only way if the pain killer addict in question was using any other substances simultaneously, or was using pain killers as an additional substance after already exhibiting a problem with multiple substances.
While it is sometimes the case that patients who have no history of chemical dependency are innocently prescribed pain killers and get a bad deal out of it, this is not always the case. Most long-term, hard core addicts use multiple substances. Even if pain killers are the number one or "drug of choice," this does not mean that cessation of only that group of drugs will lead to a sober life. In fact, it is likely that another drug will creep up as the addict culprit as soon as the pain killers are aborted.
Detox from OxyContin, Vicodin, or other opiate-related painkillers is similar to that from heroin or morphine, often manifesting unpleasant withdrawal symptoms such as shaking, fever, weakness, and nausea. Many people who try to stop using these drugs on their own find the symptoms so troublesome that they return to drug use.
Because these addictions often occur among people who have stable, supportive families, it is sometimes possible to detox from painkillers at home, without having to spend time in a hospital. In all cases, this process should be supervised by a physician, who may be able to prescribe medication to ease the withdrawal symptoms.
"Rapid detox" programs treat the patient in one or two days under anesthesia. These are not covered by insurance, and can pose risks to some patients. In addition, when they do work, they do not treat the addiction itself, leaving the patient to experience the same thought patterns and emotional needs that led to addiction in the first place.
Vicodin is the brand name for hydrocodone, a combination of codeine (an opiate) and acetaminophen (a common non-prescription painkiller). Like all opiates, it can be addictive, yet it is commonly prescribed for moderate pain conditions including headaches, arthritis, and chronic pain after injuries.
Some patients run into trouble when they heal from the original pain for which the drug was prescribed, then save leftover pills and self-prescribe them. Others require addictive levels of the drug to treat a legitimate medical condition, and don't get help from their physicians in weaning themselves off Vicodin afterward.
Because acetaminophen can cause liver damage, Vicodin addiction poses this risk as well as all the other risks associated with opiate abuse. Vicodin treatment may be managed by a physician on an outpatient basis, but severe cases will require standard opiate rehab.
While pain killer addiction is a real and recurring problem, it should be noted that there are some high risk factors that may indicate more susceptibility to the addictive tendencies with any substance of abuse. Those are as follows:
One of the treatment modalities for detox from heroin abuse is methadone maintenance. This use as part of the recovery process has proven very controversial over the years. Since oxycotin, a commonly prescribed and abused pain killer, has very similar affects on the body to heroin, methadone maintenance programs have become a more popular form of treatment for oxycotin detox.
Professionally speaking, it is generally the thinking that without total abstinence from use, one does not recover from drug addiction over the long term. While methadone maintenance can certainly make the process of withdrawal less traumatic over the short term, methadone use can easily lead to another chemical dependency and, yet, another need for treatment over time.
Addiction and addict thinking are inherently "impatient." Addicts become dependent on a quick fix both chemically and emotionally. The problem from a clinical perspective with feeding into this quick fix mentality, is that the addict thinking and behavioral manifestations, then, are not adequately addressed, and the addictive tendencies, thus, permeate the user for the long term.
While short-term detox, coupled with behavioral therapy and some form of 12-step treatment take a lot of effort and time, the results tend to be more fruitful and successful over the long run.
One problem with men and women who are not closely monitored in their use of pain killers (which generally occurs as part of the addiction cycle) are withdrawal symptoms that can be both uncomfortable and dangerous. Common symptoms of withdrawal from pain killers are:
Many painkiller addictions begin when the patient starts taking the drug not just for pain, but as self-medication for depression, anxiety, or fatigue.
Addiction is a disease of denial, and it may take an encounter with the law, or intervention by a concerned partner, family member, or medical professional, before the patient's harmful dependence on prescription drugs is recognized. Before the patient is ready for recovery, the addiction may threaten relationships and jobs as the patient focuses on getting more of the drug, to exclusion of other priorities. Some become unable to care for children or themselves.
In addition, because many people addicted to painkillers are responsible, middle-class adults, they frequently experience strong feelings of shame about their addiction. Effective therapy for a painkiller addiction should include treatment for any underlying depression or other emotional condition.
Darvocet is a legal drug, by prescription only. It contains both acetamenophin and a narcotic pain killer; it is used only for moderate to severe pain. In addition to relieving pain, one of Darvocet's side effects is drowsiness and euphoria. Cocaine is an illegal substance and is a very powerful and dangerous stimulant drug. If you combine the two, the results will be very unpleasant. Imagine driving in your car and slamming on the brakes as hard as you can (Darvocet) and at the same time slamming down the accelerator (cocaine). Your car will receive mixed signals and it will be severely damaged. Similarly, if you combine a stimulant drug with a sedative drug, your body won't know how to react and could very possibly just shut down. Possession of Darvocet without a prescription is a crime, as is possession of cocaine. Combining the two could be a death sentence.
Pain killer addiction, while still a severe problem, tends to be researched or discussed less frequently than addiction(s) to alcohol and other "street" drugs. Pain killers are often used to treat persons who have been unexpectedly overcome with severe pain and who require some alleviation of this pain for normal or even functional living. Just because these drugs are administered "legally," however, the addiction problem as a result can be just as severe and life threatening as addiction to any other chemical substance. And just like one becomes physiologically and mentally dependent on alcohol and heroin, the same occurs when one experiences addiction to pain killers.
The problem with pain killers is twofold: they are legally distributed to several million Americans each year and they are very addictive by nature. Such common pain killers as Vicodin and even Oxycontin have become among numerous prescription narcotics to adversely affect otherwise non-drug using men and women. While the use, as already stated, generally starts as a response to an unplanned and uncontrolled stimulus (pain, in this case), the addiction then manifests as a chemical dependency develops over time. At this point, more and more amounts of the pain killer(s) are taken to alleviate pain. And in some cases, the pain can become psychosomatic, just so that the now addicted person can find an "excuse" to continue or justify indulgence.
Addiction to painkillers can occur after a patient begins treatment for a legitimate, painful condition. Addiction can occur in people who already abuse illegal drugs, but is often likely among law-abiding, ordinary people whose arrest for forging a prescription may be their first encounter with the law.
The line between addiction and treatment is sometimes hard to distinguish, leading to problems when doctors either underprescribe medication for pain because they fear addiction, or overprescribe out of a lack of understanding of addiction and tolerance.
Prescription drug addictions are also common among medical professionals and hospital workers, who have access to the drugs in the course of their work.
The first effect of painkillers is, of course, to prevent patients from experiencing pain. Some people who had been in severe pain are so delighted to feel "normal" again that they may ignore signs of dependency and increasing tolerance, taking more and more of the drug.
However, in opium-derived painkillers such as oxycodone (OxyContin) and hydrocodone (Vicodin), the physical effects will mimic those of heroin or other opiates. The addiction itself is the primary physical effect, and the person may continue to function in society while engaged in an ever-increasing pattern of drug-seeking.
Painkillers also pose risks of liver damage and deadly overdose. With some drugs (notably Darvon and Darvocet, which are chemically related to methadone), an overdose is as little as four times the standard therapeutic dose.
"Pain killers" is a term used to refer to prescription narcotics that are used to treat chronic and/or severe pain. Pain killers are similar to alcohol in that they repress the user's central nervous system. Some examples of pain killers commonly prescribed are Codeine, Methadone, Morphine, Percodan, Vicodin and Percocet. These kinds of medications can be prescribed for anything from severe back pain to a bad case of shingles to cancer.
The major problem with the frequent distribution and use of pain killers, however, is that they are highly addictive substances and can often lead people with non-addictive pasts to acquire addictive tendencies. If you are in chronic pain, but have a history of addictive substance use, it is highly recommended that you notify your primary health care physician and/or specialist prior to being prescribed any of the above. That way you can make an informed decision about the possible side effects of use, as well as receive information about any alternative forms of medication/treatment to alleviate pain. At the very least, it is crucial for anyone taking pain killers to have their intake monitored with scrutiny by the distributing physician.
If you use opiate narcotics for chronic pain on a long-term basis, you probably will become addicted to them; this is an automatic response by your body to any addictive substance. This kind of addiction is called "iatrogenic addiction," meaning that your addiction is the result of a legitimate medical treatment. It doesn't mean you're a "junkie." Many medical problems create chronic, severe pain, and sometimes the only way to ease this debilitating pain is through the use of prescription pain killers. If your doctor recommends that you use opiate medications for pain, he/she will carefully monitor your use of the drugs. You must NEVER take more medication than prescribed. If you still need help managing your pain, let your doctor know; a solution will be found.
Painkillers can be addictive on their own, but addiction is often associated with the simultaneous use of the drugs with alcohol.
The makers of OxyContin, Vicodin, and other painkillers warn patients not to consume alcohol while taking the drug, and the vast majority of patients do. Those who ignore the advice, knowingly or unknowingly, risk physical collapse and death. Even before such symptoms set in, the combination can cause unpredictable behavior and disturbing symptoms such as vomiting.
Some people begin drinking alcohol while taking painkillers as a way to deal with increased pain. If you are taking painkillers and feel like you "need" a beer or a glass of wine, stop and call your doctor to see if your medication needs to be changed.
Private treatment centers for oxycodone treatment and rehab from other painkiller addictions can provide an extensive range of therapies to manage withdrawal symptoms and cravings, while building up the life skills needed to manage without the addictive drug.
Individual attention is key in private treatment, which often takes place in a small facility. Counselors work with the patient on such skills as recognizing cravings, finding appropriate ways to deal with physical pain, and establishing drug-free ways to deal with stress, fatigue, depression, and anxiety.
OxyContin is the brand name for oxycodone, a powerful painkiller frequently prescribed for a variety of problems. It is an opium derivative and is available in milder forms as Percodan and Percocet.
After its approval by the FDA in 1995, OxyContin was heavily marketed as safe and nonaddictive. Today, it is increasingly connected to addiction and even deaths. In some cases, heroin addicts who are unable to get their drug turn to OxyContin as a substitute. In others, patients prescribed OxyContin for legitimate physical problems become dependent on the drug.
A high incidence of OxyContin-related crimes has caused some pharmacies to remove it from their shelves.
Prescription painkillers are an important part of today's medical arsenal, and relieve untold suffering every day. Unfortunately, some of the most effective painkillers can also be addictive.
If you are taking medication prescribed by a professional for a genuine ailment, and you are following the prescription instructions, you may develop a dependency on the drug, but you do not have an addiction. Fear of addiction can lead to undertreatment of legitimate illnesses and unnecessary suffering.
If you feel you need more and more of the drug, if you are taking it after your physical illness has healed, and if you are lying to doctors or pharmacists to get it, you should seek treatment.
|Jennifer Mathes, Ph.D.|