Have you suddenly found yourself trapped in a vicious addictive cycle with pain meds? Perhaps they were prescribed for you after an injury, or maybe you simply tried them out of curiosity, but at some point they took over your life. If so, you are not alone. 5.2 million people reported abusing prescription pain relievers in November of 2012, an increase from 4.7 million in 2005. Now is the time to free yourself, and the information to follow will help you do it.
First, it’s critical to learn how addiction occurs, as well as to become familiar with the various kinds of treatment and support available to you. If you’re scared at the prospect of quitting, consider it a healthy sign, because that shows your recognition that these drugs are a real problem for you, and one you cannot solve alone. But rest assured that opioid addiction is a challenge you can overcome with strong motivation, the right information, and the right help tailored for you.
So how does addiction to meds like OxyContin and Vicodin actually happen? Opioids, which is an opiate manufactured synthetically, as opposed a drug like heroin derived from the poppy flower, stimulate the same brain circuits associated with appetite and sex drive. These receptor sites respond to the neurotransmitter dopamine, which creates feelings of euphoria. As your brain persists in seeking this state over and over again, you eventually come to feel as though you need your painkillers for survival. Slowly, you can’t think of anything else.
Because painkillers stimulate intense dopamine surges, the response of your brain is to reduce dopamine activity to maintain balance. The more your natural response to dopamine is diminished, the more you are forced to use the painkiller to recapture the euphoria. Ultimately, your dopamine system becomes so irregular that you are reduced to needing the pills only to avoid severe withdrawal symptoms. These symptoms resemble the flu, such as severe body aches and pains and insomnia. Once this occurs, you will probably find yourself willing to do just about anything to get your drugs.
The causes of dependence go beyond repeated use however, with the most important factor being a genetic predisposition to addiction. If alcoholism runs in your family, for example, you are at significantly greater risk of having addictive tendencies towards drinking and drugs. Socioeconomic status, a history of abuse of other drugs, chronic pain, long standing high levels of stress, a peer group which uses drugs, or untreated mood disorders and ADHD are also powerful factors which can leave an individual vulnerable to develop a prescription drug addiction. People who have Attention Deficit Disorder with Hyperactivity/Impulsivity (ADHD), for example, already experience chronically low levels of dopamine; they may actually feel “normal” on prescription painkillers because of elevated dopamine, and are therefore at much higher risk to become addicted.
It is likely you are addicted to painkillers, if you are taking more than the dosage prescribed, feel sick if you try to skip them for a day, spend an inordinate amount of time preoccupied with getting your next dose, or your doctor is no longer prescribing them but you are buying them on the street. The consequences are mounting, starting with urges to take pills that distract you at work or school, and the fact that you are spending money budgeted for other things to buy your drugs. Slowly your motivation seems to be directed towards getting and using drugs, and you get a ticket because you were too preoccupied to get that tail light fixed. Your grades slip, and your boyfriend complains because you never want to have sex anymore. You find that you’d rather get high at home than go out with your friends, or only spend time with friends who use. If any of these are true, it’s time to face facts and get help.
You may feel afraid to tell a family member because you don’t want to disappoint them. However, if you’re a teenager or twenty-something and still a student, it can be tough to get the help you need without using at least some of your parents’ resources, even if it’s only their insurance (if you are still covered under your their policy). It may be easier to start with a sister or brother if you’re close, a good friend or mentor you trust, and work up to telling your family. It’s a good idea to have a basic plan already mapped out before you sit down with them so nobody panics. I would not suggest discussing it with the physician prescribing your painkillers if that’s where you are getting them; this will likely lead to an immediate termination of the prescription, triggering withdrawal, which could debilitate you in the problem solving process.
There are many different treatment options out there for a painkiller addiction. Speaking with an experienced counselor and/or treatment professional can help you decide which is the best for you, and whether or not you need to consider inpatient, outpatient, or residential treatment. Treatment is individualized for each person. An experienced professional that specializes in addiction treatment can help you on your path to recovery by choosing one or more of the treatment options that are available to you.
Suboxone (or Subutex, which is similar, but not identical) is an opioid medication often used in detox to keep withdrawal symptoms at a minimum. It is also used as a relapse prevention drug after discharge from rehab/residential because relapse rates can be daunting. While it is designed to stimulate enough dopamine action to control withdrawal, it does not release enough opioid effect to get you high. Suboxone also blocks opiate receptors in a way that you also cannot get high from painkillers while taking it. You will simply feel no effect. The downside of Suboxone is that it is a lower level narcotic in it’s own right and can have some nasty withdrawal symptoms and negative side effects such as reduced sex drive and irritability. The upside is that it vastly increases your chances for staying clean if taken for a substantial period of time (approximately two years is recommended) at slowly decreasing dosages.
You may feel overwhelmed by the prospect of going to rehab or lots of NA meetings and having a sponsor check in with you daily. The process does involve giving up a certain amount of personal control, which will likely be scary. The addiction voice inside your head will try to tell you that you can succeed without formal treatment or 12 Step Recovery, because it wants you to fail. At least some of your using friends will likely support you in your doomed independent efforts because their addictions don’t want you to succeed, necessitating that they will have to confront their own demons
This one never works. No matter how long you’ve been clean. End of story. That means they should be used only in a case of extreme medical necessity like post-surgery. If this ever occurs, someone trusted should be dispensing the medication and keeping it somewhere safe and inaccessible to you between doses. While it is not necessary to be a purist and deny yourself Novacaine when having a root canal, there is no reason to get a painkiller script at the local immediate care center for a sinus infection. When in doubt, ask someone you trust like your sponsor or therapist.
Our understanding of addiction and who is at risk continues to advance fairly rapidly, as do available treatment options. Sometimes it takes a few attempts to get clean for good, but every setback brings with it new recovery lessons. Whether that means dealing with your sleep disorder arising from post-acute withdrawal, or recognizing that your girlfriend or boyfriend is holding you back in the process rather than supporting you, rise to the challenge of any trigger or setback, and stay on track to success.
Whatever path you take to recovery from painkiller addiction, the most critical factors are your honest self-admission that it has become a serious problem in your life, the willingness to do WIT (Whatever It Takes) to take to overcome the challenge for good, and the right help and support to get you there. Good luck and good health on your journey back to the life you were meant to live.
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