America is in the grip of an opiate crisis that is being driven by prescription painkiller over-prescription and abuse. The fact that many people are starting an addiction journey after first taking highly potent opiate drugs prescribed by doctors is exacerbating the epidemic. Many are of the opinion that medications recommended to them by physicians are somehow “safe” and without risk of dependency of addiction whereas this is clearly not the case.
Prescription opioids were introduced by pharmaceutical firms in the mid-1980s and have been used to treat chronic health conditions such as cancer in the years since. Researchers tracing the origins of the opiate epidemic have identified that it has occurred in three waves, as follows:
The First Wave
Deaths related to opiate drug abuse first began to show a sharp increase in 1991 as a result of widespread prescribing of potent painkillers since they were introduced a few years prior. The reason physicians were more “gung-ho” about prescribing opiate meds was that pharmaceutical firms and medical societies were claiming at the time that the potential for dependency and addiction was very low. It was also at this time that opiate drugs were being prescribed for pain conditions other than cancer which increased the number of people exposed to the risk of addiction. By 1999, more than 85% of people using opiates were taking them for non-cancer related pain.
The Second Wave
Just over a decade later, there was another spike in opiate-related deaths which was due to peoples’ abuse of heroin. This was linked to prescription opiates at the time as many people developing a tolerance to their meds turned to cheaper and more widely available heroin to help them manage pain. Between 2002 and 2014, deaths caused by heroin overdose increased by a staggering 286% as more people switched from prescribed opiate drugs to the illegal alternative. The main problem people face when they start using heroin is that it is not manufactured in the same clinical environments as prescribed medications. The consequences of heroin abuse are much more detrimental to physical health mainly because the most common method of using is with an injection which exposes individuals to risk of HIV/AIDS, hepatitis B and C and several other types of infection.
The Third Wave
The latest wave of the opiate epidemic started in 2013 with increasing deaths related to synthetic opiates found in drugs like fentanyl. The sharpest rise in fatal opiate overdose was in 2016 when more than 20,000 individuals died as a consequence of fentanyl and related medications. This spike in fatal overdose has been attributed to the illegal manufacture of fentanyl-type substances which has replaced the practice of diverting the medical version.
How Addiction to Opiate Painkillers Develops
An opiate is a type of drug that works by altering brain chemistry to created pleasurable effects. The natural form is an extract of the opium poppy which has been widely used to combat pain for centuries. In this natural form, the substance is known as heroin. The way it works is to flood the reward center of the brain with dopamine so that the user becomes unaware of the pain they are in. Opiate or opioid-based painkillers contain a synthetic version of heroin, which works in the same way.
People are usually prescribed opiate-based painkillers to combat the painful symptoms of chronic conditions either as a result of serious illness (cancer) or the trauma of an accident or injury. Any chronic condition is classified as such because it is likely to take a few weeks, months or even years to fully heal from. This means that individuals prescribed opiate painkillers are likely to take their meds for a prolonged period of time, which increases their exposure to dependency.
Opiate drugs are incredibly potent and fast-acting and it doesn’t take long before a person develops tolerance to their effects. What this means is that they will need a higher dose of the drug in order to get the same effects. Because we now understand that opiates are highly addictive, physicians are much less likely to increase dosage than in the past. For people managing chronic pain conditions, this is a very vulnerable time as their symptoms are likely to get worse unless they use more opiates to combat them.
In order to manage pain in the absence of a prescription for a sufficiently high dose to do the job, many people turn to the street alternative. Some may first try “doctor shopping” or asking friends to obtain prescriptions on their behalf, but because heroin is widely and cheaply available it is often not long before they switch to the illegal alternative. Once a person finds themselves experiencing opiate withdrawal when not using or cravings that are too overwhelming to resist, they are very likely to have an opiate addiction.
How Prescription Painkiller Dependence and Addiction is Treated
At Elevate Addiction Services in San Francisco, we believe in the holistic approach to healing people of addiction issues. Many of our patients find their bodies adjust much better to sobriety when holistic therapies are used to treat them through opiate withdrawal and rehab rather than more prescription medications. However, a person is not cured of their addiction once they have completed detox or opiate withdrawal and there is much work to be done to ensure they don’t relapse in recovery.
Opiate addiction is marked by a compulsion to use that has nothing to do with conscious choice. Research shows that when holistic treatments are combined with counseling and behavioral therapies, people have enhanced chances of achieving long-term recovery. The principal advantage of the holistic approach to rehab is that it identifies the root causes of addiction and seeks to address them.
People who have been in the grips of substance abuse for some time are very likely to be suffering from physical, emotional and psychological imbalances. Holistic addiction therapy redresses these balances and empowers patients to create a healthier lifestyle for themselves that is drug-free. Holistic practices such as meditation, massage therapy, and yoga also introduce people managing painful conditions to other ways of dealing with their symptoms. Although the route to recovery from prescription drug abuse is strewn with challenges, Elevate patients draw confidence from the fact that they are fully supported at every step of the way.
