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Prescription Painkiller Overdose Rates Rising: What is the Link to Mental Health?

By HERWriter
 
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A recent report from the Centers for Disease Control and Prevention stated that binge drinking is on the rise for U.S. adults, and now prescription painkiller overdoses appear to be at an epidemic level.

The CDC report on prescription painkiller overdoses revealed some surprising statistics over the past few years, showing a clear problem with abuse of painkillers. In fact, “the number of overdose deaths is now greater than those of deaths from heroin and cocaine combined,” according to the report.

The report added that the amount of pills sold to doctors’ offices, pharmacies and hospitals quadrupled from 1999 to 2010, and some states are having issues with doctors freely giving out pills.

Easy access to painkillers can be an issue. According to the report, “in 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.”

Compared to 1999, the number of prescription painkiller overdoses is phenomenal. Almost 15,000 people in 2008 in the United States were killed by overdosing versus the 4,000 killed in 1999.

Prescription painkiller misuse could lead to addiction, abuse and even death in the case of overdosing, and this health issue can be linked to mental health as well.

In fact, according to the Diagnostic and Statistical Manual of Mental Disorders, abuse of prescription painkillers can actually be considered a mental disorder in some cases. There is a substance dependence disorder and different opioid use disorders that some people can develop.

Dr. Mark Kraus, an addiction medicine specialist and diplomat of the American Board of Addiction Medicine, said in an email that it is uncertain why the rates of prescription painkiller overdose are rising in the United States.

However, people who do have issues with misusing or abusing prescription painkillers do have resources available to them. For example, there are medications like Suboxone Film, counseling and even websites like www.TurnToHelp.com for patients to turn to in order to overcome dependence.

Kraus added that mental health disorders are common with prescription painkiller abuse, and that more awareness needs to be drawn overall to the issues of overdose and abuse.

“There is a high incidence of psychiatric disorders paired with those facing this problem of addiction,” he said.

Lisa Lannon, the co-founder of Journey Healing Centers, which is an alcohol and drug treatment center with headquarters in Scottsdale, said in an email that easy access to painkillers, coupled with the addictive nature of opiates, could be a reason for high overdose rates.

“Overdose rates for prescription painkillers have skyrocketed in the U.S. because it is a lot easier to get pills today,” Lannon said. “Pain tolerance goes up the longer a person uses opiate-based pain pills, so they take more to either alleviate the pain or to get high. It becomes a game of roulette, and makes overdosing rates go up.”

Pills are an easy solution to pain instead of finding the root of the problem and treating that.

“People want an easy fix for pain. Once painkiller meds alleviate the pain, sometimes the cause or finding alternate treatment methods becomes overlooked,” Lannon said. “And because of pain pill tolerance, the number of pills being used goes up, resulting in addiction. Pain pills are an opiate-based medication, which is addictive (like heroin) so when they are looking to get a high or disconnect from life, abusing pain pills are another way to go.”

Even if pain pills are used in the correct way to begin with, tolerance to the medication increases and more pills are needed to get results, eventually leading to addiction in some cases.

Lannon has some suggestions for reducing the amount of overdoses, including a better tracking system.

“Some solutions for reducing pain pill abuse include a better management system by pharmacies, more doctor training on addiction and having doctors offer alternatives,” she said. “Having a tracking system on the number of refills or prescriptions someone gets for pain pills can assist if someone is starting to show signs of an addiction problem.”

For people who are currently addicted to or abusing prescription painkillers, she suggests making that decision to break the addiction and to get support from family members and friends.

“The first step towards becoming free of painkillers is for that individual to want to be free of addiction,” Lannon said. “It also helps to have family members and friends have caring conversations and support them in getting help. Loved ones can reassure them that they are not bad, did nothing wrong, and just made a mistake or got caught in a cycle that they couldn't stop.”

She said there is also a negative mental health aspect to prescription painkiller abuse.

“Opiate pain pills block the emotional receptors in the brain, which on a mental health aspect can cause a person to not get emotional or show feelings,” Lannon said. “Prescription drug abuse can cause anxiety, paranoia, as well as become a way to escape reality and not deal effectively with what may be going on in a person’s life.”

Family members can suffer when one member is addicted, which sometimes leads to depression, anger and worrying, she said.

Dr. Fernando Branco, the medical director of Rosomoff Rehabilitation Center and Brucker Biofeedback Center at Miami Jewish Health Systems, said that misuse of painkillers can lead to multiple consequences.

“Abuse is a consequence of uncontrolled use by the patient, doctors and society in general,” Branco said. “The patient will develop physical dependency (withdrawal symptoms) and tolerance (higher and higher dosages with time) even if no abuse is present. Often what is considered abuse or better described ‘Addiction’ is the natural consequence of using [narcotics] beyond acute injuries.”

Mental and physical health side effects can vary depending on the individual.

“Narcotic are depressants of the central nervous system,” Branco said. “Consequently, depression/anxiety is quite common. Judgment is affected by narcotic use. [Patients] add more and more medications, even [when] they know it is not the best path. The overwhelming majority of overdoses are unintended.”

Jeff Wolfsberg, a drug education specialist, added in an email that there are even more mental health effects from abusing painkillers.

“The side effects of abusing pain killers is difficulty concentrating, memory difficulties, depression, insomnia, cravings, headaches, and more,” he said. “Often, the person entering recovery has done a lot of damage to professional, social, and family relationships that will require mending.”

Andrew Spanswick, the founder and CEO of KLEAN Treatment Center in California, said in an email that in the case of addiction to prescription painkillers, a “medical detox” is needed for treatment.

“I would recommend a residential treatment program for a minimum of 30 days, followed by outpatient therapy coupled with a 12-step program,” Spanswick said.

He added that people with mental health issues to begin with can be drawn to painkillers.

“In almost every case, people who abuse prescription painkillers are using them to cope with some problem in their lives,” Spanswick said. “These addicts never learned proper coping mechanisms to deal with their feelings and emotions, and try to mask the pain they feel with painkillers.”

Sources:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder: Fourth Edition: Text Revision. Arlington, VA: American Psychiatric Association, 2000.

Centers for Disease Control and Prevention. Prescription painkiller overdoses in the US. Web. Jan. 31, 2012.
http://www.cdc.gov/vitalsigns/PainkillerOverdoses

Kraus, Mark. Email interview. Jan. 31, 2012.
Lannon, Lisa. Email interview. Jan. 31, 2012.
Branco, Fernando. Email interview. Jan. 31, 2012.
Wolfsberg, Jeff. Email interview. Jan. 31, 2012.
Spanswick, Andrew. Email interview. Jan. 31, 2012.

Reviewed February 1, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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