When a patient develops an opioid dependency, they feel trapped between their fear of suffering from pain, the increasing need for it and the doctor’s reluctance to continue prescribing.
All sorts of things happen when patients end up in this situation and many start doing things they never thought they would do, such us going ‘doctor shopping’, buying opioids online and living a double life. All whilst trying to keep it secret from their family and doctor. Some end up in more extreme situations like forging scripts or buying illicit opioids from the street.
Here, in this article, Dr Oscar D’Agnone, Medical Director of The OAD Clinic in London, shares the signs of opioid dependency and how cases of painkiller addiction are treated in his practice.
How can opioid dependency affect someone mentally?
The emotional impact of all this is very important because patients feel ashamed of their behaviour but they can’t help it. Their self-esteem is very low and they lack confidence. However, they also become very defensive when doctors or family members try to discuss these problems.
What are the signs of an addiction to painkillers such as opioids?
Opioid-dependent patients are very vulnerable and they are also exposed to physical consequences of opioid chronic-use such as the risk of overdosing when taking uncontrolled high doses or mixing with alcohol or other sedatives.
Symptoms like nausea, chronic constipation, dyspepsia, sexual dysfunction, fatigue, depression, cardiac alterations (QT prolongation), osteoporosis, and others are also frequently present. Patients and families feel trapped like there is no way out, but there is.
How are cases of opioid dependence treated at The OAD Clinic?
Opioid-dependent patients have to receive specialised treatment by a team of addiction and pain specialists.
At The OAD (Opioid Analgesic Dependence) Clinic, our team is led by Dr D’Agnone and Dr Arun Bhaskar, President of the British Pain Society. The patient’s pain and root cause need to be assessed.
The need for opioid painkillers, or any painkiller at all, has to be reviewed since, in many cases, the underlying condition has been removed and only opioid dependence and addiction remains.
If that is the case an Opioid Substitute Treatment (OST) has to be started to prevent withdrawals once the opioid the patient has been using has been removed.
Today we have oral medications like buprenorphine, that can replace the main opioid the patient has been taking and can be easily reduced without causing discomfort.
We even have monthly injections (Buvidal) that only require the subcutaneous administration of a very small amount (1ml approximately) of buprenorphine every four weeks. This is a very simple, straight forward and convenient intervention that prevents the patient from taking medication on a daily basis.
In the meantime, other non-opioid painkillers or analgesic procedures can be prescribed to manage pain, if needed.
Like in most of the other cases of opioid dependence, psychotherapeutic interventions are needed to deal with the emotional damage chronic opioid use has produced.
Can treatment help patients to fully recover?
From our experience, we know that there is light at the end of the tunnel and hundreds of patients can tell their recovery story.
Worried that you or your loved one is struggling with an addiction to painkillers? Get in touch with Dr D’Agnone’s clinic now for further advice on what to do and how the clinic’s recovery program can help.