Opioids: Use, Misuse, and Abuse

Opioids: Use, Misuse, and Abuse

The use of opioids to help ease and treat situational or chronic pain has become increasingly controversial. This is mainly due to the prevalence of misuse and abuse of opioids that has taken our society by storm.

While opioids are not new to the market, they seem to be easier to get than ever before and can sometimes be overprescribed. According to Andrew Rosenblum,  Lisa A. Marsch, Herman Joseph, and Russell K. Portenoy, in their article titled, "Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions," "Concerns related to effectiveness, safety, and abuse liability have evolved over decades, sometimes driving a more restrictive perspective and sometimes leading to a greater willingness to endorse this treatment." While they still remain one of the most effective options for pain management, the role opioids can play in addiction has resulted in conflicting opinions about this treatment option.

When it comes to opioids and many other medications, you have people who use the drugs appropriately, those who misuse the drugs, and others who abuse them. It is important to understand how these terms are defined and where the line is drawn between each.

Opioid Use

The use of opioids refers to taking the medication as intended. This implies the correct dosage at the correct frequency for the correct duration. Anything outside of these parameters can be considered misuse.

Taking extra care to read and understand the instructions for the prescription is incredibly important when it comes to these medications. If something is unclear, it's important to ask your provider. Opioids are known as controlled substances for a reason. If not taken exactly as intended, there is the risk of developing an addiction even after one occasion of misuse.

Opioid Misuse

Misuse can be mild. Occasional misuse of medications can certainly occur. Skipping a dose by accident or even taking your next dose a little early or a little later by mistake can happen. Depending on the medication, this can have minimal effects or significant ones. This can be a one-time error, or it can be more frequent. Sometimes, misuse can quickly evolve from an honest mistake to a recurring habit.

Misuse refers to failing to take the medication exactly as prescribed. This could also include taking more than the recommended dose or even less than what is prescribed. Misuse could also refer to taking the medication for longer than needed or failing to take the medication for the length of time prescribed.

Taking medication not prescribed to you or allowing someone else to take your medication is also an example of misuse. Concerning opioids, this can be extremely dangerous. Strength and dosage are individualized for the intended patient to target a specific ailment. Anyone taking the medication other than how it's prescribed is misusing the drug.

Opioid Abuse

Abuse of opioids refers to taking the medication for reasons other than its intended use or in excess amounts. The key difference between misuse and abuse is the intent of the user. Misuse still involves taking the drug as a form of treatment, while abuse implies taking the drug to obtain a certain feeling.

Opioids are known to be highly addictive. In addition to reducing pain, they release endorphins and activate reward centers in the brain, producing a false sense of ease and well-being. This is the feeling most abusers are seeking.

Abuse often occurs after being prescribed the medication for a well-intended reason. The prescription ends, and perhaps the pain still exists. Sometimes, the desire to feel the effects of the drug influence seeking out more even after the pain has subsided.

Tips for Avoiding Misuse and Abuse

By following the prescription exactly and being aware of the risks and side effects, opioids can serve as an effective treatment for certain conditions. Some tips for avoiding misuse and abuse include:

  • Make a plan with your provider
  • Know the alternative options
  • Take the medication exactly as prescribed
  • Report any side effects or symptoms immediately
  • Do not share or sell your medication under any circumstances
  • Ensure proper and secure storage at all times
  • Properly dispose of any unused medication following FDA guidance

Opioid misuse and abuse is a huge problem in today's society, with incidents of overdose and opioid-related deaths continuing to increase. As described by Phillips JK, Ford MA, and Bonnie RJ in their book, Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use, "Current national trends indicate that each year more people die of overdoses—the majority of which involve opioid drugs—than died in the entirety of the Vietnam War, the Korean War, or any armed conflict since the end of World War II." These statistics are tragic. Understanding the risks of taking these medications and knowing what constitutes appropriate use, misuse, and abuse is critical. If you or a loved one is struggling with opioid addiction, it's time to seek help.

The use of opioids is and will continue to be a controversial topic. With their known risks and addictive tendencies, it is understandable that this would be the case. We face an opioid crisis in today's society, with more and more people falling victim to the hold it can have on their lives. It is critical to take the medications as prescribed to ensure no misuse or abuse of the drug. Even with the best of intentions, it can be possible to form an addiction to these substances, which can escalate quickly. Enlightened Solutions offers a variety of treatment options for addiction, and conducts a full assessment upon intake to ensure the most individualized and best quality of care possible. Let us help you take back control of your life. If you or someone you care about is struggling with addiction, give Enlightened Solutions a call today at (833) 801-LIVE.


prescription drug abuse

The Problem of Prescription Drug Abuse

Prescription drug abuse and misuse have increased over the past several years. According to a research report published by the National Institute of Drug Abuse (NIDA), the past 15 years have seen increased visits to emergency rooms as a result of prescription medication abuse, deaths from overdoses of these drugs, and an increase in the number of people seeking treatment for prescription drug use disorders.

The NIDA research report, published in June 2020, discusses the widespread nature of prescription drug abuse. In 2017, it was estimated that 18 million people had misused prescription drugs at least once. Among 12th-grade students, prescription drug abuse is ranked fourth behind alcohol, marijuana, and tobacco. Also, young people who misuse prescription drugs are more likely to use street drugs.

Prescription Drugs Most Frequently Misused

The types of prescription drugs most often abused are opioids, central nervous system (CNS) depressants, and stimulants.

Opioids are medications used to treat pain by acting on opioid receptors along the spinal column and in the brain. These drugs also control pain by affecting areas of the brain that control emotion. Drugs of this nature include Vicodin, OxyContin, Percocet, morphine, codeine, and fentanyl. Opioids are also used in medications for coughs (codeine) and severe diarrhea (Lomotil).

In addition to inhibiting the transmission of pain signals, opioids also cause drowsiness, mental confusion, and reduced respiration. Opioids also activate the brain’s reward centers, which can cause euphoria, particularly when taken in amounts higher than prescribed. If opioids are snorted or injected, there is an increased risk of medical issues.

As opioids react with the brain’s reward center, there is a chance of developing a dependence or addiction even if they are taken as prescribed. Since opioids interact with the part of the brainstem that controls breathing, an overdose can be fatal. According to the NIDA, opioid overdose deaths were five times higher in 2016 than in 1999.

CNS depressants are also frequently abused. These drugs include benzodiazepines, prescribed primarily for anxiety; barbiturates, used during surgical procedures and for seizure disorders; and non-benzodiazepines (also called hypnotics), prescribed for insomnia. Benzodiazepines include Xanax, Valium, and Klonopin; barbiturates include Luminal and Nembutal; and hypnotics used for insomnia include Ambien, Lunesta, and Sonata.

As a class, CNS depressants have a calming effect and induce drowsiness. These medications can be addictive. Withdrawal from benzodiazepines can be problematic, and barbiturate withdrawal without medical supervision can be life-threatening.

Stimulants are also abused. Stimulants are prescribed for attention-deficit hyperactivity disorder (ADHD), narcolepsy, and occasionally for depression that isn’t responding to conventional treatment. Stimulants, including Adderall, Ritalin, and Concerta, increase wakefulness, motivation, learning, and memory. If misused, stimulants can lead to hostility, paranoia, psychoses, seizures, irregular heartbeat, and cardiovascular failure.

Symptoms of Prescription Drug Abuse

Symptoms of prescription drug abuse vary depending on the drug being misused. Signs of opioid abuse include drowsiness, confusion, and poor coordination. Symptoms of CNS depressant abuse are low concentration, memory problems, and slurred speech. Anxiety, agitation, and reduced appetite are symptoms of stimulant abuse.

Why Is Prescription Drug Abuse So Prevalent?

Experts at Enlightened Solutions, a drug and alcohol treatment center located in New Jersey, state that there are several reasons for the increased addiction to prescription drugs. As these drugs are only available by prescription, many people assume that these medications are less harmful than street drugs and therefore safe. Additionally, the advertising campaigns done for these medications can lead to the belief that these drugs are safe.

Although these drugs are only available by prescription, they are readily available. Prescription medications are stolen by people either for their own use or to sell. In some instances, people are willing to share prescriptions with family members and friends. Also, some people “doctor shop” or visit multiple doctors for the same complaint to obtain multiple prescriptions for their drug of choice and have them filled at different pharmacies.

Treatment for Prescription Drug Addiction

Treatment for prescription drug abuse is available and often includes detox with medical supervision and therapy. The method of therapy used for prescription drug abuse is often cognitive-behavioral therapy (CBT). In CBT, people learn to change unhealthy patterns of thinking and behaviors. During contingency management, another therapy method, patients are rewarded for positive behavioral change. In therapy, patients will explore the underlying painful issues in their lives or past traumas which made them more prone to developing an addiction to these drugs. They will work to develop healthy coping skills and resolve past issues.

Prescription drug abuse and misuse are serious and growing problems that can range from taking a family member’s leftover Percocet for a headache to grinding up Adderall tablets and snorting the powder. At Enlightened Solutions, we provide treatment for prescription drug abuse. We are licensed to treat co-occurring disorders, so in addition to substance abuse, we also treat the mental health issues that frequently accompany addiction. One of the treatment modalities we offer is cognitive-behavioral therapy (CBT), which is useful in treating prescription drug abuse. We provide a range of holistic therapeutic methods, including art and music therapy, equine-assisted therapy, yoga and meditation, and family constellation therapy. We also offer traditional psychotherapy and support groups rooted in the 12-Step philosophy. We are located near New Jersey’s southern shore, and we offer each client an individualized treatment plan. If you are struggling with an addiction to prescription medication or are concerned that someone close to you may be, please call us at (833) 801-5483 for more information and help.

 


Angels Pitcher’s Death From Lethal Combination of Opioids, Alcohol, and Fentanyl

Angels Pitcher’s Death From Lethal Combination of Opioids, Alcohol, and Fentanyl

There is always a chance that your addiction can kill you if you do not get help for it. Combining two or more drugs together can increase those chances. Angels pitcher, Tyler Skaggs, died recently from opioid, alcohol, and fentanyl overdose which can teach us just how grave and lethal the combination can be if you do not get help. 

Tyler Skaggs

Tyler Skaggs was a popular player of the Angels and one of their most reliable pitchers of the season. He suffered a lot of injuries last season such as his elbow. He worked with mobility coach Sarah Howard in Los Angeles and renowned strength coach Eric Cressey. This year, Skaggs experienced soreness in the forearm after experimenting with a new pitch during Spring training and missed a start. He also injured his ankle in an April game against the Chicago Cubs. 

Finding Tyler Skaggs

Angels pitcher Tyler Skaggs died in his hotel room on July 1st with opioids, fentanyl, and alcohol in his system. The Angels were staying at a hotel in Southlake ahead of a four-game series against the Texas Rangers. Skaggs’ body was found the day after the team arrived at 2:18 pm when a teammate was concerned about Skaggs not returning his calls or texts about meeting him for lunch. 

Drugs Found in Tyler Skaggs

Fentanyl was one of the drugs found in Skaggs’ system. It is a powerful synthetic opioid that works like morphine but 50-100 times more powerful. If you take this drug in uncontrolled concentrations or if your opioid tolerance is not tolerant of long-term use, you are more likely to have breathing suppression, as well as death, occur to you. There were 3.8 nanograms per millimeter of fentanyl in Skaggs’ system which is a huge amount. There were levels of over 100 in his system.

There were also 38 nanograms per millimeter of the prescription-strength painkiller oxycodone which is prohibited by Major League Baseball’s Joint Drug Prevention and Treatment Program since it is considered a “drug of abuse” on the federal Drug Enforcement Administration list. There was a blood alcohol level of 0.122%. Having 0.08% is considered legally impaired. 

Mysteries Surrounding Tyler Skaggs’ Death

It was said that the cause of Skaggs’ death was a mixture of alcohol, fentanyl, and oxycodone intoxication “with terminal aspiration of gastric contents.” This means that Skaggs choked on his own vomit while under the influence. His death was ruled as an accident and was found in his bed fully clothed with no signs of trauma. His family believes that an employee of the Angels team had something to do with his death. They released a statement of how heartbroken they were to learn that Skaggs died of a combination of these drugs and how out of character it was of him for someone trying to make it as a major league baseball player. The family believes that an employee of the Angels supplied these drugs to Skaggs.

Attorney Rusty Hardin

Rusty Hardin is a renowned criminal defense attorney who has represented athletes like Roger Clemens who was accused of lying before Congress over alleged steroid use. Hardin is determined to provide answers to Skaggs’ wife and family about what happened and how it happened. He wants to know how he acquired those drugs and if others are responsible for what happened. It is unfortunately too early to speculate if there are grounds for legal action.

After Tyler Skaggs’ Death

Players paid tribute to Skaggs by etching his initials and jersey number onto their hats and into the dirt on the mounds. Teammate Andrew Heaney threw Skaggs’ signature curveball when opening his first start. Angels player Mike Trout and Tommy La Stella wore Skaggs’ number underneath their last names and others wore No. 45 patches. In the first home game after Skaggs’ death, the Angels wore No. 45 jerseys with the name Skaggs on the back during the July 12th game against Seattle. Skaggs’ mother, Debbie, threw a strike for the ceremonial first pitch after a 45-second moment of silence. When the game was over, the players arranged their jerseys on the ground and said a prayer for Skaggs and the jerseys were left there.

Hundreds paid tribute to Skaggs at a memorial service at the St. Monica Catholic Church in Santa Monica. He was thought of as a passionate and caring man. Skaggs’ wife spoke of their love and family members and friends shared their goofiest and heartwarming memories with him. 

What We Can Learn From Tyler Skaggs’ Death

Tyler Skaggs’ was a major league baseball player that had a hidden addiction. Family members and teammates had no idea that he was struggling with addiction and were shocked at the discovery. Unfortunately, Skaggs did not seek out help which led to his untimely demise. The circumstances around Skaggs’ death does not change the man he was when he was alive or how talented he was. Because there is a big stigma surrounding addiction, especially in the sports community, not enough players get the help they need. If you are struggling with addiction or know someone who is, no matter what profession they are in, it is important to make sure they receive the tools they need to continue to live. Tyler Skaggs’ death should teach everyone how common addiction and overdoses are as well as how lethal the combination is of alcohol, oxycodone, and fentanyl.

Located on the shore of Southern New Jersey, Enlightened Solutions is a recovery center that uses evidence-based therapies and holistic healing to treat addiction and mental illness. With the opportunity to learn about therapies that are keyed in to healing the human spirit and learning about new stress-reducing techniques centered around a 12 step network, you will ensure a lasting recovery. For more information, please call us at 833-801-LIVE as we are open 24 hours a day, 7 days a week.


Is Everyone Who Takes Opioids At Risk For Addiction?

Two cars are in a serious accident. The drivers of both cars are rushed to the hospital with severe injuries. As immediately as possible after routine procedure, both patients are administered either an oral or intravenous dose of morphine to relieve the pain. Analgesic and relaxing, their pain subsides and they likely fall asleep. Both patients need surgery to heal internal wounds or close up exposed ones. For the pain which will result afterwards, the doctor informs them, they will be prescribed a prescription painkiller. Likely they will receive something like Hydrocodone, Oxycotin, Dilaudid, or Percocet. Each of these medications are morphine based, designating them as opioids. While they are in the hospital, their intravenous pain medications and oral pain medications will be monitored. Upon discharge, they will each receive specific instructions on taking pain medication and rehabilitating their body at home. One patient goes on to heal fine and doesn’t take another opioid medication until there is another serious issue with pain. The other patient will heal from their original injury but may not heal from their pain. In the process, they’ll develop an addiction to opioid painkillers. In the wake of the opioid epidemic sweeping the nation, thousands of family members want to know the answer to one simple question: why?

New research published in the journal JAMA Surgery sought to answer this question. Though the number seems small, the amount of overdose deaths which could result has drastic implications- six percent of people who receive opioid painkillers for post-surgery rehabilitation continue using their prescription medication for at least three months post-procedure. Researchers found that the type of surgery or severity of the pain had little to do with the likelihood of using the prescription painkillers outside of their recommended expiration. The issue, researchers discovered, is a lack of screening for high risk factors which would contribute to the likelihood of substance abuse. Researchers called this “addressable patient-level” risk factors. Live Science reported on the findings. Increased risk for opioid abuse post-surgery had the highest percentages among patients who:

  • Smoked cigarettes
  • Drank alcohol
  • Had pre-existing substance abuse problems
  • Had anxiety
  • Were previously chronic pain patients

Opioid addiction can happen without a patient’s knowing that they are predisposed to developing a chemical dependency problem. Thousands of American have faced this problem in recent years, which has greatly contributed to the ongoing crisis with opioid painkillers, synthetic opioid painkillers including fentanyl, and a turn to heroin.