Pain is one of the most common symptoms doctors have to deal with in their patients every day. Pain is usually a sign that something is wrong in our bodies and works an alarm in that sense. But as we know, turning off the alarm doesn’t put down the fire.
The underlying medical disease or condition is the root of the problem and is the primary target of any medical treatment. Sometimes, however, the underlying condition cannot be completely resolved or takes a long time to treat, meaning that the pain remains.
Dr Oscar D’Agnone is a highly-experienced psychiatrist when it comes to treating patients with an addiction to painkillers. In this article, he explains which conditions opioids are prescribed to treat, how people might become dependent on them and why it’s difficult to stop using them for chronic pain.
What types of conditions can opioids be prescribed to treat?
Chronic lower back pain, arthritis, headaches (migraine), post-surgical pain, multiple sclerosis, fibromyalgia, shingles, neuropathy (nerve damage, trapped nerve) are the most usual causes of chronic pain.
Improvements in our quality of life, like easy access to clean water, food, quick access to healthcare interventions, new medications and treatments (including vaccines, new drugs, surgical procedures, diagnostic procedures, new cancer treatments), retirement plans, and many other things that we take for granted, have extended the life expectancy in developed countries.
One of the consequences is that as we live longer, chronic pain is becoming a more frequent problem because elderly people are prone to suffer from some of the above-mentioned conditions.
How do people become addicted to painkillers?
Over the last years, many patients have been prescribed mild and hard opioids (Morphine, Hydrocodone, Oxycontin, Vicodin, Codeine, Tramadol and others) to deal with acute pain resulting from these conditions. As the pain became chronic and well-controlled by these opioids, however, patients are reluctant to stop them or change to other painkillers.
Why do people find it difficult to stop taking opioids?
There are two main reasons for patients reluctance to stop or change the opioid painkiller: first is because it has been effective in controlling pain, and second, because they have an effect reducing anxiety and producing some sort of sedation and wellbeing sensation.
However, there are big drawbacks when using opioids for longer periods than initially agreed with your doctor, or when used in higher doses than prescribed.
How long does it take to become dependent on opioids?
Whether prescribed or not, it doesn’t take long to become dependent on opioids.
Dependence is a normal physical consequence of using opioids and is characterised by two clinical syndromes: opioid withdrawal and opioid tolerance.
It means that if opioids are suddenly stopped, the patient will suffer symptoms like restlessness, anxiety, persistent insomnia, sweating, nausea, vomit, backaches, runny nose, hot or cold flashes, goosebumps, diarrhoea, and other flu-like symptoms. Doctors call these symptoms opioid withdrawal, but they are usually known as going “cold turkey”.
Tolerance means that over time the patients will have to progressively increase their opioid dose in order to achieve similar effects they had when they started in far lower doses.
This is the reason these days that a pain specialist only prescribes opioids for acute pain and for a limited period of time.
If you are concerned about your own opioid dependency, or that of a loved one’s, do not hesitate to book an appointment to see Dr D’Agnone now at his clinic for professional help.