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Painkiller abuse reaching epidemic levels in U.S.

According to the Centers for Disease Control and Prevention, the total number of painkillers prescribed in a single year could medicate every adult living in the U.S. around the clock.

Every 19 minutes, someone dies from a prescription painkiller overdose. In fact, the number of painkiller overdose deaths now exceeds the number of deaths from heroin and cocaine combined.

"It's a huge problem in our country right now, basically an epidemic, people taking narcotic pain killers," says Dr. Ryan Shelton, a physician with Mecklenburg Medical Group based in Charlotte, North Carolina.  

While millions take narcotic painkillers like Oxycontin, Vicodin and Hydrocodone safely every day, there are millions more who abuse these medications.  

Most abusers dabble with higher and higher doses, or inject them to get a feeling of euphoria that can be deadly.  

Ingesting multiple narcotic painkillers along with other drugs or alcohol depresses the central nervous system and slows down an individual's ability to breathe. Sometimes, the combination of the two can stop a person's breathing altogether.

The scary side effects of misuse and overdose can make anyone wary of taking them at all.

However, Dr. Shelton says there is no reason for anyone to endure pain as long as they follow their physician's prescription plan for taking these drugs. 

"It's really important to not change, to not self-adjust your dose," says Shelton. "Take it just as directed and just for the short amount of time that it was prescribed."

Painkiller prescriptions are intended to provide relief as a short-term plan, and they should start with a low dose.

The long-term solution should be treating the cause of the pain and not medicating it.

"The addiction potential really comes in over a long period of time," Shelton says. 

Individuals who take pain pills for several weeks or months and also have a family history of personality addictive behavior could be setting the stage for a pain pill problem.

In many cases, abusers develop 'cravings' for a pain pill high, and they will sneak extra doses or visit several physicians to obtain multiple prescriptions of the same drug. 

"If you really do need long-term pain medication, you may need to see a specialist," Shelton warns.

Over time, tolerance to prescription painkillers is overcome by adjusting the type and dose, and that's only a job for a trained professional.

If you are prescribed painkillers, don't be surprised if a professional asks you to sign a 'treatment agreement' or a 'pain contract.' These documents explain the risks and rules of the prescription and the appropriate way the drug should be taken. 

Sometimes, a physician requires a patient to refill a pain medication prescription from a single pharmacy, or the patient has to pass a drug test before having the prescription refilled.

The idea is to keep both the patient and doctor accountable to one another. 

For your personal accountability at home, take away the temptation.

"Once your issue causing the pain is over, the pain medication needs to be disposed of," Shelton says. 

Narcotic painkillers are powerful, and ignoring the risk of addiction or the steps to take these prescriptions safely has left far too many dead wrong.

Doctors say people can become dependent on painkillers without becoming addicted, and it's important to know the difference.

Dependency happens when someone becomes tolerant to a medication, or experiences withdrawal symptoms without it.

Addiction is classified as a chronic disease where use is compulsive and self-destructive.

Your doctor can give you the best advice on your risks.

Copyright 2013 America Now. All rights reserved.

Additional Information

The following information is from WebMD.com regarding prescription painkiller addiction (Source: <http://www.webmd.com/pain-management/features/prescription-painkiller-addiction-7-myths).

  • Addiction is classified as a chronic disease defined by compulsive use, whereas dependence (tolerance and withdrawal) is different. Dependence can happen without being addicted.
  • Warning signs of addiction: raising your dose without consulting a doctor, going to several doctors to get prescriptions without telling them about the ones you have, evidence that the drugs are causing problems in your life and you keep taking them.
  • Don't bear the pain. Undertreating pain can cause suffering.
  • Pain pill addiction isn't about willpower or moral failure, it's a chronic disease and some people are more genetically vulnerable.
  • The main risk factor for addiction is genetic predisposition.
  • Know your family history.
  • Don't share prescription pain pills and don't leave them where people can find them.

Dr. Sanjay Gupta from CNN discusses addition to pain pills (Source: http://thechart.blogs.cnn.com/2012/02/22/dr-gupta-in-depth-the-truth-about-presciption-addiction/).

  • Every 19 minutes someone dies because of misuse of prescription medications (take too much, forget or ignore warnings, take it with alcohol).
  • 1.9 million Americans hooked on prescription pain medications alone.
  • Painkillers can depress the central nervous system, slowing down breathing and the brain stem's responsiveness to CO2. People simply stop breathing in some cases of abuse. Combined with alcohol (another depressant) these medications are particularly dangerous.
  • Addiction is a brain disease. Dependence on drugs and alcohol can change the brain chemistry, altering pain/pleasure centers.
  • Millions use prescription pain medication safely but about 30,000 die every year from abuse.

The following information is from WebMd.com and explains that all painkillers are not the same (Source: http://www.webmd.com/pain-management/painkillers-and-addiction-narcotic-abuse).

  • Opiods (opiates or narcotics) are pain relievers made from opium. Morphine and codeine are two natural products of opium. Synthetic modifications of morphine produce heroin, hydropmorphone, Percocet, OxyContin, Vicodin, Lorcet, hydrocodone, Demerol, Methadone, and fentanyl
  • Opiods can give an intoxicating high when injected or swallowed in high doses, making narcotic abuse one of the most common forms of drug abuse in the U.S.
  • Addiction is when the person has a dependence but also displays psychological effects (compulsive behavior to get the drug, cravings, continued use despite consequences).
  • Symptoms of narcotic abuse: inability to feel pain, sedation, euphoria, show breathing, small pupils, nausea, itching, constipation, slurred speech.
  • Withdrawal symptoms include: anxiety, irritability, craving, rapid breathing, runny nose, salivation, gooseflesh, nasal stuffiness, muscle aches, vomiting, cramping, diarrhea, sweating, confusion, enlarged pupils, tremors, loss of appetite.
  • Taking opiods for extended periods of time may require taking higher doses to ease pain due to tolerance.
  • Addiction occurs when the narcotic becomes compulsive and self-destructive, or when its used for something other than pain relief.

The following statistics are from the Centers for Disease Control and Prevention (Source: http://www.cdc.gov/vitalsigns/MethadoneOverdoses/index.html and http://www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html)

  • Prescription painkiller overdoses (opioid or narcotic pain relievers: Vicodin, OxyContin, methadone, etc.) killed more than 15,500 people in 2009.
  • More than 30% of painkiller deaths involve methadone.
  • The number of overdose painkiller deaths is now greater than deaths from heroin and cocaine combined.
  • In 2010, about 12 million Americans reported nonmedical use of prescription painkillers.
  • Enough prescription painkillers were prescribed in 2010 to medicate every American adult around the clock for a month.
  • Many more men than women die of overdoses, with middle-aged adults having the highest overdose rates.

The following information regarding pain contracts are from the L.A. Times (Source: http://articles.latimes.com/2011/apr/06/health/la-he-pain-contracts-20110406).

  • Chronic pain (lasts for months) afflicts more than a quarter of adults Americans.
  • Opioids are highly effective yet very dangerous and addictive.
  • Respiratory depression: taking too many slows breathing and may cause it to stop.
  • Overusage can be triggered by the euphoria.
  • Some doctors ask patients to sign a "pain contract" or "opioid treatment agreement."
  • These documents explain the rules of taking the drug safely, discourage taking too much, mixing or sharing.
  • May require a patient to submit blood or urine drug tests, fill their prescriptions at a single pharmacy or refuse pain medication from any other doctor.
  • If the rules aren't followed, the doctor may drop them from the practice.
  • Some critics argue that these agreements invade patient privacy and damage trust.
  • Because of a few high-profile prosecutions of doctors running "pill mills," the contracts have become increasingly popular as a way to protect themselves.
  • Others say agreements can serve as an educational tool.