Prescription Opioid Series: Part 1 - Warning Signs of Abuse & Addiction

It is now well published that addiction to prescription drugs is a rising and increasingly troublesome trend. A startling reality of this epidemic is that a large number of people surrounding us are covertly dealing with an opioid addiction and we may not even recognize it.  According to the Centers for Disease Control and Prevention (CDC), as many as 1 in 4 people who receive prescription opioids long-term for non-cancer pain struggle with addiction. According to the 2010 National Survey on Drug Use and Health (NSDUH), 2.4 million Americans used prescription drugs non-medically for the first time within the previous year. Even though the number of people seeking treatment has increased, overdose deaths from prescription painkillers have quadrupled from 1999 to 2010, and tripled since 2010. Prescription drug overdose has surpassed motor vehicle accidents as the number one cause of death and emergency room visits. Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids (CDC).

Common prescription drugs include Fentanyl, Hydrocodone (often combined with acetaminophen and prescribed as Vicodin or Lortab), Oxycodone (OxyContin, Percocet, Endocet, Percodan, Roxicet), Morphine (Kadian, Avinza), and Codeine (often given for severe coughs). Other Opioids, often prescribed to chronic pain patients, include Methadone, Fentanyl, Meperidine, Pentazocine, and Tramadol.

Prescription painkillers reduce pain signals from the brain to the body. Most people begin taking prescription opioids for good reasons, such as alleviating physical pain. But often, addiction starts with a shift in the patient’s emotional status. Opioids can produce a euphoric high and extreme relaxation, which serve as the key building blocks of addiction. In an attempt to treat the pain and enhance these pleasurable feelings, individuals begin taking higher doses of the medicine, increasing their level of tolerance and the amount needed to produce the initial effect that occurred—leading to physical dependence and often physical or psychological addiction. Once a person has become addicted to painkillers, when the drug wears off they begin to experience withdrawal symptoms that create physical pain, making it very difficult to stop taking the medication and end the cycle.

So what are some of the early warning signs of prescription opioid addiction to look for when meeting with clients, conducting home inspections, and or conducting workplace visits? Signs and symptoms of addiction vary by the type of drug the individual is using; however, there are certain clues you can spot right away that could alert you to a potential issue.  Here are some examples that may help you identify prescription opioid abuse within your client base:

It doesn’t take long for withdrawal symptoms to appear if an addict stops using for a period of time; many addicts frequently experience withdrawal symptoms between doses and on days where they might not be able to obtain any drugs. Withdrawal symptoms can mimic the flu and include a headache, nausea and vomiting, diarrhea, chills, sweating, fatigue, severe anxiety, and the inability to sleep. If your clients often claim to be sick, or suddenly coming down with the flu, but then quickly feel better, they may be addicted to opioids.

If you want to get objective data to verify your suspicions, order a drug test that includes a panel to specifically test for prescription drugs. In part two of this series, we will address how to successfully monitor opioid prescription use.  For more information on opioid abuse, please contact your laboratory or email us.