“It has become increasingly clear that opioids carry substantial risk but only uncertain benefits – especially compared with other treatments for chronic pain. We lose sight of the fact that the prescription opioids are just as addictive as heroin.” ~ Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention Last year, the Centers for Disease Control and Prevention called the abuse of prescription opioid pain medications and “epidemic”, and that epidemic doesn’t seem to be going away completely anytime soon. In fact, when you consider how rampant prescription drug abuse actually is – including both opioids and benzodiazepines –you may change the way you think about what’s in your medicine cabinet.
How Big Is the Problem of Prescription Drug Abuse, REALLY?
According to the CDC, drug overdose deaths are increasing at alarming rates. Take a look at the most recent federal statistics:
- Since 2000, the death rate due to opioid overdoses has increased by 200%. In other words, it has tripled.
- Over a one-year time frame, 2000-2013, the overall opioid death rate increased by 14%, including:
- Opioid pain relievers—9%
- Synthetic opioids—80%
- In 2014, over 60% of all drug overdoses involved some type of opioid
- There has been a 15-year increase in prescription opioid pain reliever overdose deaths.
- In 2014, a record number of people died because of opioid overdoses – 28,647.
- From 2001 to 2014, there was a fivefold increase in the number of deaths due to benzodiazepines.
- In real numbers, that means that 7945 people died in 2014 because of benzodiazepine overdoses.
The heroin death rate is included in the statistics because as new legislation makes it increasingly difficult to obtain prescription opioids, more and more people are switching to cheaper and easier-to-obtain heroin.
Why Are Prescription Opioids so Addictive?
The first thing to keep in mind is that prescription opioid painkillers don’t actually “fix” or “cure” pain. They mask that pain by affecting signals in the brain. It all starts in the brain. However, by that same mechanism, they can also produce feelings of euphoria, self-confidence, and freedom from worry and stress. Over time, regular usage of prescription opioid painkillers affects physical and chemical changes within the brain, in essence, “training” your brain that the opioids are necessary for normal functioning, and therefore, pleasurable. In other words, the longer, stronger, and more frequent your opioid use is, the longer, stronger, and more frequently your brain will say your opioid use needs to be. That is the definition of “tolerance” – an ever-increasing need to use greater and greater amounts of the drug in order to achieve the same pleasurable effect. In fact, when the drug is discontinued – or even delayed –a chronic opioid user will begin to experience unpleasant withdrawal symptoms within a matter of hours, including:
- Joint pain
- Muscle cramps
- Nausea and vomiting
- Excessive sweating
- Uncontrollable shaking
- Chills and fever
The symptoms are the body’s way of signaling that it needs the expected drug – it has become physically dependent upon the opioid, and it will be difficult, if not impossible, to function normally without the drug until a person is free from that dependency. Physical dependence leading to addiction can easily occur when opioid medication is taken long-term. Interestingly, opioid medicines were never intended for long-term use as a means to treat chronic pain. Up until just under a generation ago, prescription opioids were only given to treat immediate, or acute, pain over the short term. Recognizing this, the Food and Drug Administration just passed new guidelines recommending that doctors only dispense prescription opioids as a last resort, and even then, at the lowest dosage and for the shortest duration possible.
What Are the Most-Commonly-Abused Prescription Opioid Painkillers?
There are a number of prescription opioid painkillers that carry a high potential for abuse – to varying degrees, depending upon the dosage and the method of ingestion:
- Hydrocodone–Usually prescribed under the brand names Vicodin, Lortab, or Lorcet, hydrocodone is typically given in tablet form for severe pain requiring round-the-clock relief. It can also be dispensed in liquid form as a cough suppressant. 99% of the world’s supply is used in the US. Oral hydrocodone is basically equivalent to the same amount of morphine.
- Oxycodone–Most commonly prescribed under the brand name OxyContin, is intended specifically to help with acute pain, or in some cases, the management of severe cancer pain. Oxycodone is about 50% stronger than hydrocodone and morphine.
- Fentanyl–Marketed under a wide variety of brand names, the synthetic opioid fentanyl is mainly used to treat transitory acute pain. It has been determined that fentanyl is up to 100 times stronger than morphine and up to 50 times stronger than heroin.
- Codeine–Codeine is the world’s most-commonly-taken opiate, and it is typically used to treat mild pain or persistent cough. As a drug of abuse, codeine cough syrup is often consumed recreationally. Codeine is only about one-tenth as potent as morphine.
Why Are Benzos so Addictive?
Originally introduced in the 1960s, benzodiazepines have proven to be effective treatments for insomnia, anxiety disorders, and alcohol withdrawal. For vulnerable individuals, however, “benzos” carry a higher-than-normal abuse potential. Other drugs of abuse are addictive because they precipitate dopamine surges in the reward areas of the brain, thereby “training” the person to continue the action of using a particular substance. This is not exactly the case with benzodiazepines. In a 2012 study conducted by researchers at the University of Geneva, it was determined that benzodiazepines achieve the same effect by “calming” inhibitory neurons that prevent excess dopamine production. Dr. Roger Sorensen of the National Institute on Drug Abuse’s Functional Neuroscience Research Branch, says, “This is the first demonstration that acute benzodiazepine use can increase dopamine release, supporting its addictive potential.” When a benzodiazepine medication has been taken over the long-term or chronically abused, the withdrawal symptoms can be severe – including seizures that can be life-threatening. For this reason, benzodiazepines and alcohol are the only two abused substances that ABSOLUTELY must always only be discontinued under the supervision of a trained medical staff.
What are the Most-Commonly-Abused Benzodiazepines?
Because of the large number of disorders that they treat, benzodiazepines are popular among physicians, and that popularity is growing. Within the last 20 years:
- The number of adults with benzo prescriptions grew by more than 67%, from 8.1 million to 13.5 million people.
- The percentage of people with benzo prescriptions jumped from 4% to 6%.
- The amount of benzodiazepine medication distributed increased threefold.
These increases mean that more people are being exposed to higher dosages of medications that are considered to be highly addictive. This accounts for why benzodiazepines are one of the most common prescription drugs that are abused recreationally.
- Xanax –Xanax is the trade name of the generic drug alprazolam, and most often, it is used to treat anxiety or panic disorders. Among abusers, it is typically used with illicit drugs to enhance and prolong their intoxicating effect.
- Valium– Valium is the trade name of the drug diazepam, and it is typically used for short-term anxiety relief, seizure disorders, and symptoms of alcohol withdrawal. Individuals with a history of alcohol abuse or certain psychological disorders are at a heightened risk of abuse.
- Klonopin –Klonopin is the brand name of the generic drug clonazepam, which is used to treat seizures, panic disorder, and movement disorders. Klonopin is frequently abused by cocaine or meth users to combat stimulant-induced anxiety.
In addition to being popular drugs of abuse, both opiates and benzodiazepines present a great danger of fatal overdose, especially when combined with alcohol or each other. If you or someone you know potentially has a problem with prescription drugs – whether benzodiazepines, opiates, or some other medication – then it is imperative that you get the proper help and support immediately. Northpoint Recovery can offer you that assistance, by offering evidence-based, multi-layered addiction recovery treatment that attacks the disease on several levels – physical, mental, emotional, nutritional, and spiritual. Northpoint Recovery’s experienced clinic staff can give you the tools to craft your own future – a future where serenity, sanity, and sobriety have been restored. SOURCES: https://www.foxnews.com/health/2016/02/29/benzodiazepine-prescriptions-overdose-deaths-on-rise-in-us.html https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687085/ https://en.m.wikipedia.org/wiki/Equianalgesic https://www.drugabuse.gov/news-events/nida-notes/2012/04/well-known-mechanism-underlies-benzodiazepines-addictive-properties https://www.genengnews.com/insight-and-intelligence/top-17-abused-prescription-drugs-of-2013/77899961/ https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm https://mobile.nytimes.com/2016/03/16/health/cdc-opioid-guidelines.html?referer=