How to Take Prescription Pain Relievers Without Addiction
Prescription pain relievers sound pretty intimidating from the headlines. Some people who take them switch to heroin, and some die from overdose. The problem is so serious that the FDA has installed abuse warning labels in the form of black boxes . But at the same time, these drugs are common and useful pain relievers.
We are talking about opioids – drugs that act in the same parts of the brain as opium. Heroin and morphine are both opioids, but they are also the main ingredients in prescription drugs like Vicodin and OxyContin . These drugs seem to relieve pain and, in some cases, can cause feelings of euphoria. For many, they are indispensable tools for pain relief from surgery, trauma, or for people with chronic pain in their daily lives.
Yes, prescription drug addiction is a real problem
In 2014, the latest year for which data are available, nearly 2 million people abused or were addicted to prescription opioids . And prescription drugs are directly responsible for half of opioid overdose deaths. According to the Centers for Disease Control and Prevention , we are in the midst of an “opioid overdose epidemic,” which includes both prescription drugs and street drugs.
The popularity of these street drugs is partly due to prescription opioids: for those addicted to painkillers, heroin is more readily available and cheaper . According to the Office of Substance Abuse and Mental Health Services , 79% of heroin users have previously taken pain relievers for entertainment.
But if you ask another question, it doesn’t sound so bad: only 3.4% of people who abuse painkillers end up switching to heroin. And of course, not everyone who gets the prescription gets addicted. Prescribers wrote 259 million opioid scripts in 2012, and most of them are likely to have been treated responsibly.
To avoid addiction, don’t try to skimp on pain relievers.
It may seem like the opposite, but it’s true: if you can handle it and only take the pills when you are in severe pain, you are more likely to become addicted.
This is for two reasons. First, you teach your brain that taking the pill is really nice: you have a lot of pain, you take the pill, you feel better. Another problem is that when you are already sick, it takes more medication to fight the pain than if you were taking it all the time.
According to Ginny DiClementi , a clinical psychologist who works with patients with pain, the best and safest way to take opioids is to take them exactly as prescribed: if it is given every four hours, you look at your watch (or set up an app to check the connection). you ) and take the tablets exactly four hours later. This allows you to “get ahead of your pain” and never get to the place where you are desperate for the drug.
Patients are unlikely to become addicted to pain relievers when they use them to relieve short-term, serious pain, such as pain from injury or surgery, according to Dr. DiClementi. The problem here is not how you use drugs when you are in pain; this is what you do with your medications when you recover.
Throw away old expired tablets
Raise your hand if you have half a bottle of Vicodin in your medicine cabinet. You are not alone – I have two of them. (One was my recipe, the other was my dog.)
But you shouldn’t save them. It is fairly safe to take opioids when you need them for pain. Taking them when you don’t have major problems starts the problem. Here’s Dr. Dicklementi again, describing in The Conversation how people end up becoming addicted by accident :
Here is a typical example: a patient who was prescribed Vicodin after back surgery may need fewer pills after a while to cope with pain, but he was afraid to tell the doctor (“What if the pain comes back?”), So the prescriptions continued. … By the time of complete recovery, the patient already had a supply of pills. One day after work, this patient came home with a headache from a busy day. The medicine cabinet contained the remainder of Vicodin. Took a couple of pills, and the patient felt relief not only from the headache, but also from the stress of the day. The next time it was easier to take the pills, until the patient soon became addicted and looked for more. This patient, like many other drug addicts, did not intend to abuse the drug.
When you are not in severe pain, you may be better able to notice the euphoric effect (rather than just appreciate the pain relief). For this reason, Dr. DiClementi encourages people to get rid of their pill stocks. Mix them in the trash, the less appetizing the better – she suggests cat litter – to hide them and keep divers away from the dumpsters. You can also ask about returning unused drugs to the pharmacy or keep track of drug take-back activities in your area.
I know, I know, it sounds like a waste. But it’s better to give up pills than to take them when you don’t need them.
Trust your doctor
You are not alone in trying to use opioids safely: your prescribing doctor must also monitor you.
The CDC has just released new prescribing guidelines for opioids that place greater responsibility on providers. Rather than vaguely suggesting that your doctor should discuss options with you, the new rules specify when, why, and how to prescribe opioids to prevent addiction.
For example, with new guidelines, you’re less likely to build up stock. Prescribers are now advised to prescribe the lowest dosage and shortest course of pain relievers you may need — in many cases, the cost is three days. If you think you need more, discuss it with your doctor, but keep in mind that after the first few days, you may be fine with something like ibuprofen .
With long courses of treatment, your doctor should now check you from time to time to assess whether the benefits still outweigh the risks to you and your situation. In other words, don’t expect her to churn out replenishments.
If you have chronic pain, prescribing solutions becomes more difficult. Opioids may not work very well for chronic pain , but if they seem to be effective , you may not be interested in switching to something else.
However, according to Dr. Dicklementi, it is worth trying other treatments, not just drugs. She mentions massage and hot tubs as several strategies that work for some people (although noting that they are not always effective for everyone). An implanted electrical device can interfere with the transmission of pain signals . Hypnosis can divert your attention away from pain. Psychological approaches work: mindfulness-based stress reduction and cognitive behavioral therapy have been shown to be effective in recent research .
This does not mean that all the pain is in your head. “Psychological doesn’t mean imaginary or feigned,” DiClementi says. Our experience of pain is determined by what is happening in our brain. Chronic pain is not only related to the mind or body, but both together.
Many pain management options vary greatly in cost and effectiveness. To help navigate these, talk to your doctor or ask for a referral to a pain specialist . Talking honestly is the right way to go, whether you are trying to avoid opioids or feel you need them and want to take them safely.