Trapped in the cycle of addiction

Opiate drug addicts don’t have to struggle along

By Brad Clark

Addiction to opiate pain medication is one of the most common, fastest growing and deadliest substance use disorder issues in the United States. This “quiet epidemic” has caught the attention of several presidential candidates, who are incorporating policies on substance abuse into their campaign. If you have a family member or friend who is an opiate addict, here’s what you need to know regarding opiate addiction and how recovery is possible.

Opiates are powerful pain relieving substances that are derived from the opium poppy and include synthetic variations of these substances.  Some of the more commonly abused prescription opiate medications are: Oxycodone (Oxycotin, Percodan, Percocet), Hydrocodone (Vicodin, Lortab, Lorcet, Norco) Morphine (Duramorph, Roxanol), Methadone (Dolophine, Methadose), Meperidine (Demerol), Hydromorphone (Darvocet), Codeine, Oxymorphone (Opana) and Fentanyl (Actiq, Duragesic, Sublimaze).

Addiction begins with chronic pain treatment

When working with individuals who are addicted to opiates it is quite common to hear that they were first prescribed opiate pain medication for relief from chronic pain issues such as back or neck problems or for pain relief following an injury or surgery. While opiates are effective when used short term to manage acute severe pain, a growing body of research suggests that opiates are not an effective long-term solution for chronic pain issues. The human body quickly builds up tolerance to opiates, which means more of the substance has to be used to get the desired effect and thus opiate medications have a high risk of addiction potential.

Another problem experienced by many who use opiate based medications for relief from chronic pain issues is that while under the influence of the medication and numb to their pain the person does too much physical activity and exacerbates the original problem leading to even greater pain issues long term.

In response to the current epidemic of opiate addiction we are seeing an increased emphasis within the pain management field on non-pharmacological coping skills and strategies to manage chronic pain issues, more use of non-narcotic/non-addictive pain medications (such as Gabapentin and Cymbalta) and an emphasis on identifying appropriate physical limitations to adapt one’s lifestyle to their medical condition.

In addition to numbing physical pain, many who become addicted to opiates also report the opiates provide emotional numbing as well. Consequently, many opiate addicts come to rely upon the opiates as a primary means of dealing with not only physical pain but also emotional pain. Then as healthy coping skills are not utilized to assist in managing a person’s emotions, they tend to atrophy leaving the addicted individual feeling like using opiates is the only option to cope with negative feelings.

Faking symptoms, doctor shopping, street drugs

Once addicted to opiates it is not uncommon to see individuals resorting to faking pain symptoms, “doctor shopping”—seeing multiple doctors for the same issue—or buying opiate medications off the street. On the streets a single pill may sell for up to $40 or $50 so opiate addictions can get extremely expensive very fast. As a result of the high cost of opiate mediations on the street, a new generation of heroin addicts has been created that have discovered it is cheaper to switch to the black market injectable. In a 2012 Denver Post article on the growing problem the city is facing with homeless heroin addicts it was stated that a single dose shot of heroin typically cost $15.

Once an individual switches from opiate pain medications to heroin use a new set of fatal risks is encountered. The purity of heroin on the streets varies greatly, but in general it is much more potent than the heroin of decades gone by. This variation in purity increases the risk of accidental overdose when users get heroin that is more pure than they are used to. An additional risk associated with IV use of heroin is that of acquiring an infectious disease such as HIV or Hepatitis C if needles are shared and not properly cleaned.

Many individuals who are addicted to opiates stay locked into the cycle of using for fear of going through the withdrawal. Without getting help, the withdrawal process can be unpleasant to say the least and is often described as “a really bad flu” with symptoms which can include: abdominal cramps, agitation and anxiety, joint pain, sweating, diarrhea, dilated pupils, change in vital symptoms, irritability, insomnia, teary eyes, muscle spasms, hair standing up on skin, runny nose, rapid breathing and frequent yawning. There are however medications which can be used to assist in managing and taking the edge off of withdrawal symptoms, as well as medications which can assist with the cravings to use.

Sharing the struggle

Individuals with substance use disorder issues frequently struggle alone in silence feeling trapped in a vicious cycle. Feelings of guilt, shame and remorse drive the need to use substances to numb the emotional pain. While under the influence, individuals make poor decisions which often lead to regrettable behaviors and then when the effects of the substances wear off the feelings of guilt, shame and remorse are ever more intense and lead to the next use of substances.

There is, however, a solution—a way out of the vicious cycle of addiction. Despite addicts’ thoughts that no one can possibly understand what they are going through, there are actually many trained professional substance use disorder professionals who know and understand exactly what they are going through and ways to help them break the cycle of addiction and live a healthy and meaningful life. The first step is to reach out for the help that exists along a continuum of care that ranges from outpatient to inpatient treatment. A trained substance abuse counselor can conduct an assessment to determine if a substance use disorder issue exists and determine the appropriate level of care to address the issue.

Brad Clark is licensed specialist clinical social worker and licensed clinical addictions counselor. He is the director of the Addictions Treatment Center at Prairie View, a faith-based behavioral and mental health service provider based in Newton, Kan.