No one swallowing doctor-prescribed painkillers does so with the intention of getting addicted. We take them, for example, to ease post-surgery pain or deal with pain related to diseases, such as cancer, back pain, generalised body pain, abdominal pain, headache, arthritis. Still, for some people with particular nature and certain risk factors who use these medications for good initial reasons the risk of addiction exists.
The fact that painkillers work well with little effort makes them the first choice for pain management for many people. Rather than exploring other ways of managing pain, which take effort and may not eliminate pain to the same extent as the painkillers, people reach for the pill bottle each time pain relief is required. The ease of use and effectiveness it brings may lead some to reach for the drugs more often than is safe or necessary.
Although there are many other effective forms of pain management, our medication-oriented culture promotes the use of medications as the first approach used for pain management. Physicians prescribe these painkillers rather than refer to pain clinics. Even when people are desperate to try non-drug alternatives for pain relief, they often have a much harder time accessing these alternatives than they do getting a prescription for painkillers typically only after dependence has developed.
This leaves people with few alternatives for managing their pain, other than the drugs, further fuelling the addiction that has developed.
Opioids, in particular, have a side effect of euphoria. This is similar to the pleasure felt when you have been successful or after intense physical excitement, but it requires no such effort to attain. As people who are in pain have typically suffered an unpleasant experience that caused the pain be it an accident or over-exertion the pleasurable effects of these painkillers can seem like a delightful surprise. Seeking repeated experiences of pleasure through the addictive behaviour or substance is one of the hallmarks of addiction.
Becoming addicted to pain medication is a disease. Taking the painkillers causes a change in one’s brain chemistry that is not under the individual’s control. It is absolutely not anyone’s fault. Addiction is a chemical, physical disease, one that requires expert medical treatment in a safe, humane environment.
Sudden discontinuation of opiates, “going cold turkey”, is associated with intense withdrawal symptoms, which although rarely life threatening, can be severe and prolonged, lasting up to two to three weeks. Opiate withdrawal is characterized by severe discomfort, including diarrheal, abdominal pain and cramping, vomiting, runny nose, eye tearing, yawning, sweating, agitation, restlessness, twitching and tremors, back and bone pain, and intense craving for the drug.
It is important to note that there is a difference between being dependent on narcotics and being addicted. Many people can become dependent even in a relatively short postoperative course of narcotic medications. In such cases, withdrawal symptoms are to be expected, but the vast majority of people can tolerate the withdrawal symptoms if they know that it is normal and not dangerous to feel anxious, flushed, etc. as the body withdraws from the pain medication. A few patients may need a medication such as clonidine, which helps block the sympathetic overdrive that makes them feel these symptoms. In these shorter lived problems, the symptoms should resolve in days and not weeks. People also need to know that they are not addicted but have only become dependent on the drugs. However, for people who are addicted to narcotic pain medications, a detoxification program is often needed.
The above write up is published on our site courtesy of Dr. Maureen Ona-Igbru.
Dr Maureen is a medical doctor with many years in practice and has an undying passion for dissemination of health knowledge to the public. One striking feature that cuts across all her articles is the ability to present a complex medical condition in an easy to understand manner for the readers.
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