Ask Dr. Pat · Health

Overcoming Opiod Addiction

Dr. Megan Riddle, M.D., Ph.D. MS, a fellow in consult liaison psychiatry at the University of Washington, will discuss opioid addiction.

Dear Susan:

What you described is consistent with what we call a substance use disorder. Individuals dealing with this disorder find that using substances causes significant problems in their lives. They become both physically and psychologically dependent on these medications to make it through the day. When the patient is suffering acute pain, such as directly after surgery, opioids can offer much-needed relief. However, in cases of chronic pain, using these medications for an extended period of time can lead to problems. Symptoms of an opioid use disorder include many of the features you described, such as taking more opioids than you intend to, craving the drugs, being unable to cut down, spending excessive time obtaining and using the medications, signs of tolerance—like needing a higher dose to get the same effect—and having symptoms of withdrawal when you cut down. A key part of this disorder is that it can lead to trouble in your work and personal life, to the point that you are unable to function as you would want to. Unfortunately, your problem is all too common among those who are taking prescribed chronic opioids. Some studies have found the rates of substance abuse as high as 1 in 4 among those on long-term opioids.

The consequences can be dire. Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015. As you learned,  after detox and rehab, support from recovery groups, health care professionals, friends and family, can make all the difference. These are people who have helped you navigate the darker times and celebrated your successes. It is so rewarding to hear your story: one that has a happy ending as you continue the path to the healthier, more fulfilling life you deserve.

Megan Riddle, M.D./Ph.D.

 

References

Passik SD, Kirsh KL, Casper D. Addiction-related assessment tools and pain management: instruments for screening, treatment planning, and monitoring compliance. Pain Med. 2008;9(suppl S2):S145–S166.

Brown RL, Rounds, LA. Conjoint screening questionnaires for alcohol and other drug abuse: criterion validity in a primary care practice. Wisconsin Medical Journal. 1995:94(3) 135-140.

American Psychiatric Association (2013): Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.

National Institute of Neurological Disorders and Stroke (2003): Low Back Pain Fact Sheet.

Strain. E (2014): Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis. http://www.uptodate.com/contents/opioid-use-disorder-epidemiology-pharmacology-clinical-manifestations-course-screening-assessment-and-diagnosis In: Saxon AJ, editor.

Tompkins DA, Campbell CM (2011): Opioid-induced hyperalgesia: clinically relevant or extraneous research phenomenon? Current pain and headache reports. 15:129-136.

Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. Jones, CM; McAninch, JK. “Emergency department visits and overdose deaths from combined use of opioids and benzodiazepines.” Am J Prev Med 2015; 49 (4):493-501.

Start the conversation

This site uses Akismet to reduce spam. Learn how your comment data is processed.