September is ‘Addiction Recovery Month’ and, globally, medics are highlighting how people can, unwittingly, become addicted to prescription medicines.
Medication for severe or chronic pain, especially opioids, is potentially-addictive, as are some anti-depressants, especially when used over a long time, without proper medical supervision.
No one is immune to painkiller misuse or addiction, according to Dr Conor Hearty, a consultant in pain medicine and anaesthesiology at the National Orthopaedic Hospital Cappagh.
“There is a need to monitor, not just over-the-counter medicines, but also high-strength prescription painkillers, which can be overused. While they effectively tackle severe pain, the problem is that some people can become dependent on opioids, and struggle with withdrawal.”
One-third of the population will experience chronic or severe pain at some stage, and about one-fifth of all prescriptions for pain medication in Ireland are opioid-based.
In the UK, a proactive drive among health professionals saw opioid prescriptions reduced by almost half a million in the last four years.
Painkiller addiction, or ‘opioid use disorder’ (OUD), was declared a national health crisis in the U.S., two years ago, when numbers with OUD reached 3 million people. Netflix dramas like Dopesick and Painkiller vividly told the story of America’s opioid epidemic unfolding.
Morphine and codeine are two natural opioids, while lab-made versions include Fentanyl and Oxycodone. Tackling the overprescribing of opioids is important, while also ensuring patients have effective alternatives, Dr Hearty maintains.
“Pain management programmes work well in some situations. Patients are supported with their long-term pain, by focusing on physical and mental health therapies to reduce reliance on pharmaceuticals, such as exercise, physiotherapy, hypnosis, and other alternative therapy.
It is also important to maintain patient access to opioids, under medical supervision, the pain management expert says.
“At the National Orthopaedic Hospital Cappagh, for example, we use opioids for various needs. This includes anaesthesia and post-surgery pain relief, to the chronic pain of joint deterioration, or pain caused by cancer or infection. This is essential pain-relief; so, for medics, the focus is on maintaining access for patients who need it, while helping prevent harm or misuse.”
Waiting lists for hospital consultations and treatment are also problematic, as patients waiting to be seen are often put on pain meds in the meantime. Some people self-medicate for pain too, or take prescription drugs from others, which is incredibly risky, health experts warn.
Using more of a drug, than prescribed, or using it for longer than intended, while being unable to control or cut down its use, is the crux of addiction.
Unpleasant withdrawal symptoms, when someone is addicted, include flu-like symptoms, tremors, sweating, confusion, vomiting or diarrhoea.
Patients should immediately talk to their prescriber, pharmacist, or health professional, if they feel their prescription medicines or OTC drugs are becoming problematic, experts warn.
An opiate ‘high’ is transient, and those with a painkiller addiction will cease to experience it, as they build up a drug tolerance, according to Dr Conor Hearty, consultant in pain medicine.
“A GP can refer the patient to a professional in addiction medicine. Addiction damages the individual physically and cognitively, and an addict will need help with distressing and painful withdrawal symptoms, if they try to cut down when physically dependent.”
Other important advice for ‘Addiction Recovery Month’, covering the safe management of medicines in the home, includes;