I Am Addicted 2

Pain is one of the most common reasons people seek medical treatment. Doctors can prescribe several different drugs to relieve pain. The most potent pain-relieving drugs are narcotics.

In the United States, narcotics are widely prescribed to treat painful   conditions. Narcotics are often prescribed in conjunction with other less   potent drugs (such as nonsteroidal antiinflammatory medications) or as a pill   that has a combination of a narcotic with either acetaminophen (for example, Tylenol) or aspirin (Arthritis Pain, Aspergum Cherry, Aspergum Orginal, Aspir-Low, Aspirin Lite Coat, Aspirin Low Strength, Bayer Aspirin, Bayer Aspirin Regimen, Bayer Childrens Aspirin, Bufferin, Bufferin Arthritis Strength, Easprin, Ecotrin, Empirin, Fasprin, Genacote, Halfprin, Norwich Aspirin, St. Joseph Aspirin, St. Joseph Aspirin Adult Chewable, Stanback Analgesic, Tri-Buffered Aspirin, Zorprin).   Acetaminophen is also commonly found in many different products   that are available as over-the-counter (OTC) medications. With the public often   using OTC products that contain acetaminophen as well as prescription narcotics   that might also have acetaminophen, the U.S. Food and Drug Administration (FDA)   has become concerned about dangerous interactions from combining these   medications. There is not just the potential for narcotic abuse but the concern   that patients are accidentally ingesting too much acetaminophen from combining   these products with the potential for severe liver damage or even death.

The use of prescription pain relievers without a doctor’s prescription only   for the experience or the feeling it causes is often called “nonmedical” use.   Narcotic use is considered abuse when people use narcotics to seek feelings of   well-being apart from the narcotic’s pain-relief applications.

The U.S. Substance Abuse and Mental Health Services (SAMHSA) report that   after marijuana, nonmedical use of painkillers is the second most common form of   illicit drug use in the United States. According to SAMHSA, 21% of people age 12   and older (5.2 million individuals) reported using prescription pain relievers   nonmedically in 2007. The U.S. Drug Enforcement Agency suggests that the number   of people abusing any prescription drugs is even higher at 7 million   individuals.

SAMHSA’s Drug Abuse Warning Network reported that approximately 324,000   emergency department visits in 2006 involved the nonmedical use of pain   relievers (this includes both prescription and over-the-counter pain   medications). According to the U.S. Department of Health and Human Services, there   were an estimated 90,232 emergency department visits related to narcotic   analgesic abuse in 2001.

• Morphine (Avinza, Kadian, Morphine IR, MS Contin, MSIR, Oramorph SR, Roxanol) and codeine are natural derivatives of the opium poppy. Related   medications that are semisynthetic include drugs such as heroin, oxycodone   (Percocet, Percodan, OxyContin), and hydrocodone and acetaminophen (Vicodin). Synthetic   medications in this class include drugs such as methadone (Diskets, Dolophine, Methadose), meperidine (Demerol),   and fentanyl. All medications in this group are called opiates or narcotics.   Some chemicals, called endorphins, occur naturally in the body and produce a   morphine-like effect.
• The most commonly abused illicit narcotic is heroin, but   all prescription narcotics have the potential for abuse. In 2008, the Florida   Medical Examiners Commission noted that prescription opioid painkillers (such as   Vicodin, Percocet, and OxyContin) caused more deaths than illicit substances   such as heroin.

Narcotics have many useful pain-relieving applications in   medicine. They are used not only to relieve pain for people with chronic   diseases such as cancer but also to relieve acute pain after operations.   Doctors may also prescribe narcotics for painful acute conditions, such as   corneal abrasions, kidney stones, and broken bones.

When people use narcotics   exclusively to control pain, it is unlikely that they become addicted or   dependent on them. A patient is given a dosage of opioids strong enough to   reduce their awareness of pain but not normally potent enough to produce a   euphoric state.

Adequate pain control is the goal for the medical use of   narcotics. Thus, patients or health-care professionals should not allow fear of   addiction to interfere with using narcotics for effective pain relief.

The difference between opioid abuse, dependence, and addiction

There is somewhat of a continuum between opioid abuse, opioid dependence, and   addiction. Individuals who use narcotics to the extent that they start to   interfere with the person’s ability to do routine activities or fulfill regular   responsibilities at home, at school, or at work would be considered to be   abusing opioids. Other signs that individuals are abusing opioids include   maladaptive behaviors that impact adversely on relationships, worsening of   interpersonal problems, or frequent involvement with legal problems related to   opioid use.

Individuals who have opioid dependence often will manifest some of the following   symptoms.

• Ingestion of larger and larger amounts of opioids or for longer periods of   time than intended
• Desire or compulsion to take the drug with significant amount of time spent   trying to obtain opioids
• Withdrawal symptoms if the drug is stopped or the amount taken is reduced
• The need for increased amounts of drug to achieve the original effects   (tolerance)
• Social, recreational, occupational, or pleasurable activities are neglected
• Persistent use of narcotics even when evidence that is harmful to their body,   mood, thinking, or actions
• Addiction is elevated narcotic abuse that becomes a craving, with   compulsive need to use opioids and often self-destructive behavior