You may hear about someone’s opioid addiction and think, “That can’t happen to me.”
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But given the right circumstances, it can happen to almost everyone, says pain management specialist Teresa Dews, MD. Her answers to the questions below explain why, and offer tips on reducing your risk.
Why are opioids prescribed at all?
Opioids are prescribed to relieve painful medical conditions or to facilitate recovery from surgery or injury. For example, you may fall and fracture a hip, break a bone, have sickle cell anemia, or undergo a gallbladder operation.
Opioids are best for managing pain after surgery or acute injury — but not in high doses and only for a limited period of time. Many other medications can be prescribed in conjunction with or in lieu of opioids.
How can you tell you’re becoming addicted?
So many factors contribute to opioid addiction: what you’re taking them for, your family history, your genetic predisposition, your biology, and stress you’re under, and additional triggers that encourage you to seek release with substances.
Many people find it hard to tell they have a problem with opioids. But here are some clues:
- You’re not taking medications as prescribed. You’re supposed to take medications every six hours, but you take them every three hours.
- You alter the way you take your medication. You mix prescription medications with over-the-counter meds or take them with alcohol to boost their effect. Cutting or grinding them to mix and inject, smoking and inhaling them are obvious signs of abuse.
- You run out of medication early. This may mean you’re taking your pills too often (or that someone is taking them from you).
- You’re preoccupied with your medication. You stare at the clock, waiting for the time you can take another pill. Unfortunately, these medications can take over your life.
- Your family is concerned about your medication use. Loved ones can spot behavioral and personality changes that an addicted person can’t: mood changes, anxiety and less-than-kind behavior when medications are unavailable. There may be fire associated with that smoke.
If you have a problem, can you wean yourself from opioids?
Yes, and many people do. However, if you are able to wean yourself off opioids, you’ve probably become tolerant but not addicted.
If you are addicted, part of the problem is loss of control. Let’s step back for a moment. All of our brains are hardwired to seek pleasure. If you watch sports, read, or listen to music to make yourself feel better, no harm done.
But something different happens when opioids activate your brain’s pleasure center. Drugs short-circuit feedback from your rational brain that tells the addicted part of your brain, “Think about the consequences.”
You have to be able to recognize that you’re having difficulties, that addiction is a medical condition, and that you need help. But you can’t.
What steps can you take to avoid opioid addiction?
If your doctor says, “I’m going to give you something for pain,” ask if it’s a narcotic. You should find out what the medication is, what it’s used for, and what its side effects are. Too many patients are not assertive about asking questions.
If you feel your pain is minimal, opioids are probably not necessary. For example, if you have oral surgery, applying cold to the area or taking an anti-inflammatory like naproxen may be sufficient.
Or perhaps the dentist anticipates intense pain for one day and moderate pain for five. Then you’d only need five opioid pills to manage the strong pain.
Having a huge amount of pain medication left after you’ve healed from trauma or surgery probably means too much was prescribed.
Does anything increase your risk of addiction?
Pain medications offer equal opportunity for abuse. However, certain factors increase your risk. These include being in chronic pain, having a history of substance abuse (like a drinking problem in college), being addicted to cigarettes or alcohol, and being younger and male.
Where can you turn for help?
If you’re having a problem with your medication, be sure to tell your primary care physician or prescribing doctor.
If you think a family member may have a problem, be sure to tell their physician. Patients who are addicted to opioids can give doctors all the right answers. So it’s helpful to hear a family member say, “I’m sorry, Mom is taking twice the amount of pain medication you prescribed, or Mom is using alcohol to boost its effect.”
The doctor can steer patients and families to the right resources: chemical dependency experts, community resources, addiction treatment centers, your state’s toll-free hotline for help with substance abuse.
Any final words?
No one ever wants to become addicted to any substance. Yet addiction, including to alcohol and nicotine, affects 12 to 20 percent of the population. Many people think that others get addicted on purpose or that addiction is a character flaw, but it isn’t. Addiction is a neurobiological disease that affects different people to different degrees.