Pain Killers, also known as opioids, are commonly prescribed because of
their pain relieving properties. Many studies have shown that properly
managed medical use of pain killer compounds is safe and rarely causes
addiction. Taken exactly as prescribed, opioids can be used to manage
pain effectively.
Among the compounds that fall within this
class—sometimes referred to as narcotics—are morphine, codeine, and
related medications. Morphine is often used before or after surgery to
alleviate severe pain. Codeine is used for milder pain. Opioids act by
attaching to specific proteins called opioids receptors, which are
found in the brain, spinal cord, and gastrointestinal tract. When these
compounds attach to certain opioids receptors in the brain and spinal
cord, they can effectively change the way a person experiences pain. In
addition, opioids medications can affect regions of the brain that
mediate what we perceive as pleasure, resulting in the initial euphoria
that many opioids produce.
Chronic use of pain killers can
result in tolerance to the medications so that higher doses must be
taken to obtain the same initial effects. Long-term use also can lead
to physical addiction—the body adapts to the presence of the substance
and withdrawal symptoms occur if use is reduced abruptly. Individuals
taking prescribed pain killer medications should not only be given
these medications under appropriate medical supervision, but also
should be medically supervised when stopping use in order to reduce or
avoid withdrawal symptoms. Symptoms of withdrawal can include
restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold
flashes with goose bumps (“cold turkey”), and involuntary leg
movements.Individuals who become addicted to pain killers can be
treated. Options for effectively treating pain killer addiction to
prescription opioids are drawn from research on treating heroin
addiction.
Prolonged use of these drugs eventually changes the
brain in fundamental and long-lasting ways, explaining why people
cannot just quit on their own, and why treatment is essential. In
effect, drugs of abuse take over the brain's normal pleasure and
motivational systems, moving drug use to the highest priority in the
individual's motivational hierarchy, thereby overriding all other
motivations and drives. These brain changes, then, are responsible for
the compulsion to seek and use drugs that we have come to define as
addiction. This is likely the state people are in when they are
reportedly "doctor shopping," feigning illnesses, and stealing from
pharmacies to obtain the drug.
Fortunately, we have a number of
effective options to treat pain killer addiction to prescription
opioids and to help manage the sometime severe withdrawal syndrome that
accompanies sudden cessation of drug use. These options are drawn from
experience and clinical research regarding the treatment of heroin
addiction. They include medications, such as methadone and LAAM
(levo-alpha-acetyl-methadol), and behavioral counseling approaches.
Typically,
the patient is medically detoxified before any treatment approach is
begun. Although detoxification in itself is not a treatment for pain
killer addiction, it can help relieve withdrawal symptoms while the
patient adjusts to being drug free. Once the patient completes
detoxification, the treatment provider must then work with the patient
to determine which course of treatment would best suit the needs of the
patient.
