Americans are hooked on opiates. The mushrooming rate of addiction to these doctor-prescribed painkilling drugs (also referred to as “narcotics” or by the more medical term “opioids”) now constitutes an alarming epidemic. That realization in turn has generated calls in recent months for a stronger concerted national response to the runaway crisis. And the stats about death from overdose help tell the story. Between the years 1999 and 2014, opiate-related deaths rose dramatically, multiplying more than threefold.
Prescription Opiate Addiction and Heroin – Stats on the Deadly Epidemic
What many don’t know is that far more people—nearly twice as many—die from prescription opiates than from the illicit opiate heroin. And, for every one death from prescription opiate abuse, there are another 10 treatment admissions, 32 emergency department visits for misuse or abuse, 130 people who abuse or are dependent, and 825 non-medical users, according to the Centers for Disease Control.
One scary byproduct of America’s prescription opiate epidemic has indeed been the more recent phenomenon of a dramatic surge in heroin-related deaths. Today far more Americans die from drug overdoses than from car accidents, and opiates (including heroin) account for 61 percent—almost two out of three—of these deaths. The last time America saw an epidemic of this proportion was in the 1990s, when death rates from AIDS persuaded lawmakers that the country was facing a “national health crisis.”
Meanwhile, roughly one in six Americans over the age of 12 now admits to having used an opiate drug for recreational purposes at some point in their life.
Oxycodone and Hydrocodone Addiction – Risks and Dangers
As the two most widely prescribed painkiller medications on the market today, the drugs oxycodone and hydrocodone are also the two biggest contributors to the opiate addiction crisis.
Oxycodone is the active ingredient in the familiar name-brand painkiller medications Oxycontin and Percocet, but it goes by lesser-known trade names, too, like Percodan, Endodan, Roxiprin, Endocet and Roxicet.
Hydrocodone is the main agent that, in combination with other chemicals like acetaminophen, makes the popular brand name Vicodin what it is. Hydrocodone also shows up under less familiar trade names, including Anexsia, Dicodid, Hycodan, Hycomine, Lorcet, Lortab, Norco and Tussionex.
Because these drugs are doctor-prescribed, many people assume they’re safe to take. What many users don’t realize until they end up in treatment for an opiate dependency is that the only real difference between oxycodone and heroin, or between hydrocodone and heroin, is that one substance is legal and the other is not.
In reality, just one 80 milligram pill of Oxycontin can provide the same addictive high as a $10 bag of heroin, depending on the purity (and in turn potency) of that heroin. The difference is one of these highs is coming from a drug dealer and the other is coming from the pharmacy. The two substances are otherwise essentially identical according to chemical composition and pain-relieving properties, and thus equally addictive. They produce the same euphoric high that for many users serves as an escape from not just physical pain but painful emotions.
Other Opiate Addictions: Morphine, Fentanyl and Codeine
The drugs morphine, fentanyl and codeine are in the same opiate family as oxycodone and hydrocodone, and thus also prone to abuse. These drugs work similarly to relieve pain, by binding to key opioid receptors in the brain that control both one’s perceptions of pain and their emotions. That binding action sends a big surge of dopamine through the brain’s pleasure and reward circuit. The result is a sensation of deep relaxation and euphoria.
In contrast to morphine and fentanyl that require a doctor’s prescription, codeine is available over the counter in certain cough and cold syrups. This “over-the-counter opium,” as it has been called, hails from the same source as heroin.
How Addiction to Opiates Often Starts – and Why It’s So Hard to Quit
For at least one in four people addicted to opiates, that addiction started with a doctor’s prescription for a genuine medical condition requiring the alleviation of pain. The article that helped earn Huffington Post journalist Jason Cherkis a Pulitzer Prize features the tragic story of 25-year-old Patrick Cagey, whose addiction to opiates began sometime after a high school wrestling injury, for example. (Cagey died from a heroin overdose in August 2013.) Variations of the same storyline proliferate in America. An athletic injury or surgery, or another medical condition requiring chronic pain management, are often the precursor to doctor-prescribed medications to relieve pain, and, in turn, to opiate abuse and dependency.
And the same way that opiate addiction often starts is also the reason opiate addiction is often so hard to end. As soon as opiates leave the system, symptoms of withdrawal set in. Those symptoms, which can often include muscle and bone pain, are often uncomfortable. They are also easy to mistake for the same old pain from a past injury or diagnosis requiring chronic pain management (for which one received that initial prescription in the first place). The cycle of feeling compelled to take more and more pills to dull the pain thus perpetuates itself, often without the awareness that now the pain being dulled is actually just the pain of opiate withdrawal, nothing more. (“Non-medical use of opiates” is one way to describe this phenomenon.)
Here detox and treatment can offer life-saving assistance, by helping clients comfortably manage opiate withdrawal so that they can determine whether the pain they are still experiencing after an old injury is from withdrawal itself or from a bona fide medical condition.
9 out of 10 times that pain is related to opiate withdrawal, according to the addiction professionals who oversee detox.
When someone comes to realize that the pains associated with their drug withdrawal were only masquerading as pain from a previous medical diagnosis, that “aha” moment is often a breakthrough toward recovery. In cases where chronic pain remains a legitimate medical issue, addiction-certified medical professionals can also prescribe non-narcotic painkilling medicines as a safer alternative to opiates. In each case, professionally supervised detox and treatment extend a life preserver to those caught in the deadly grip of opiate drugs.
Short- and Long-Term Side Effects of Opiate Addiction
What are the short- and long-term side effects of opiate addiction?
Short-term side effects can include:
- Slowed breathing
In addition to muscle and bone pain, the long-term side effects of opiates can include the following:
- Cold flashes with goose bumps
- Physical dependency requiring more and more pills to alleviate pain
Warning Signs of Opiate Addiction – Getting Help
Knowing the warning signs of an opiate addiction can be a first step in getting help and preventing another opiate overdose death. Today those struggling with opiate addiction need to know that there is hope, and that medication-assisted treatment in the form of Suboxone (also known as buprenorphine) is helping more and more people find freedom from opiates. The following signs can indicate a need to seek immediate opiate treatment:
- Ongoing use of painkillers long after the original medical condition has improved
- Increasing usage and growing tolerance to the drug
- Great expenditures of time on trips to the doctor and to new doctors in order to fill opiate prescriptions
- Personality changes
- Social withdrawal from family and friends
- A decline in personal hygiene and appearance
- Changes to daily eating and sleeping habits
- A neglect of family and work responsibilities (calling in sick to school or work more often, for example)
- Hypersensitivity to normal sights, sounds and emotions
- Hallucinations and blackouts
- Defensiveness about one’s drug use