Drug Abuse

Pain management has come under fire in recent years, to the detriment of some who truly could not function or participate in the basic activities of daily living without the help of prescription drugs. High-profile stories of drug addiction and overdose, such as the celebrity stories of Michael Jackson and Anna Nicole Smith, have shone a harsh light on how some doctors prescribe powerful prescription drugs. The backlash effect makes doctors more reluctant to treat pain aggressively, even when it is warranted.

There are doctors who prescribe opiates without regard for the long-term effects. Pain clinics in Florida are the most obvious problem. Known as “pill mills,” these clinics have proliferated to the point that people travel to Florida from out of state, knowing that for a few hundred dollars they can get the prescriptions they want. As opiate deaths have risen in Florida, calls to regulate these “pain clinics” have become more urgent.

When do we cross a line, however, from simply protecting people from too much pain medication and consequent addiction to preventing people with real pain from being able to function?

The first question we need to examine is, “What is pain management?”  The first thing to remember is that it is pain management, not pain eradication. If you have severe pain that makes you unable to function normally, that needs to be brought down to a manageable level. However, some injuries may always cause a certain level of pain. It is when a person tries to eradicate pain completely that they are at most risk of addiction.

The goal of pain management cannot necessarily be to eradicate pain completely because you have to balance the reduction of pain with the ability to still function with a clear mind. This means that pain management is a highly involved process, not simply getting someone to write prescriptions. It may involve special daily exercises, physical therapy, yoga, Pilates, acupuncture, meditation, cognitive behavioral therapy, and other therapeutic modalities.  People who manage long-term back pain faithfully do their prescribed daily stretches each morning and each night year after year. Those who slack off on those exercises have to rely more on pain pills to get through the day.

Prescription opiates have surpassed illegal drugs as a leading cause of emergency room admissions, bringing the issue of proper prescribing of these controlled substances to the forefront. Those who take opiates for extended periods of time with no intention of becoming dependent on them can become accidental addicts. Their doctor may begin to question how much they are taking. Their prescriptions may run out too early in the month. They may start doctor shopping to get multiple prescriptions or, if truly desperate, forge prescriptions or steal from friends’ medicine cabinets.

Opiates are some of the most addictive substances available and their abuse has increased dramatically in the last two decades. Dr. David Sack, an addiction psychiatrist and CEO of Promises Treatment Centers, explains, “Prescription opiates are very similar to heroin and morphine in how they work in the nervous system, and they produce an intense sense of relaxation and euphoria that is very attractive.  Between 1990 and 2000, four times as many people started abusing prescription narcotics because they were more available, they were more widely prescribed, and there were fewer restrictions on them,” Dr. David Sack, addiction psychiatrist says.

Dr. Sack says part of the problem is that patients will sometimes lie to doctors to get their prescriptions.   He says an early warning sign for doctors is when patients start to call in early for their refills.

Education is of key importance when helping patients cope with chronic pain. Patients must understand the impact of opiates on the nervous system and the consequences of combining different medications. Doctors need to understand how to monitor pain and their patients’ compliance with complementary therapies, as well as understand the early warning signs of addiction. The more knowledge each party has the less likely the patient with truly debilitating pain will suffer pain needlessly and the less likely the doctor will be fueling a dangerous addiction.

Prescription Drug Abuse: Prescription Addiction Rehab

Prescription drug abuse cuts across all age groups and economic classes; often times sneaking up on people and taking over their lives.

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