Prince’s death brings focus on prescription drug addiction

May 06, 2016 | by David Lott, M.D.
Categories: Healthy Driven Minds

Since the news of Prince’s death broke, I’ve been following the story pretty closely. I like Prince’s music and listened to it a lot growing up — “When Doves Cry” is my favorite song of his. So I’ve had a personal interest in the story.

With multiple news reports saying Prince’s death may have been related to an addiction to prescription painkillers, I’ve had a professional interest as well. News media outlets like the Minneapolis Star Tribune, near Prince’s Minnesota home, have reported Prince died just before he was to have met with a doctor to get help for his addiction.

I’m not involved with Prince’s case, and I don’t want to jump to any conclusions. But I do want to take the opportunity to talk about the subject of addiction — particularly addiction to prescription drugs.

Princecrop

Photo via ABC News 

Ending the stigma of addiction

Hearing that Prince may have sought help for an addiction problem just before his death, sadly, is a situation I understand all too well. The stigma of addiction leads people to not get the help they need before it becomes an emergency.

Some people don’t understand how serious the problem of addiction is — particularly as it relates to opioid use disorder. Opioid overdoses are much more deadly than most other drugs. The number of people who have died from overdosing on prescription painkillers has more than quadrupled since 1999, according to testimony given to the U.S. Senate by the National Institute on Drug Abuse.

If any good can come out of this tragic situation with Prince, I hope we can have a conversation as a country about ending this stigma. Addiction is a disease, and it’s one we have the tools to treat.

We shouldn’t judge our loved ones, friends, neighbors, co-workers, or even celebrities for needing help to beat addiction. It can happen to any one of us. And it can start with a simple prescription. We need to recognize there is a stigma and to understand the desire for confidentiality among people who need help. Maybe they know they need help, but they’re just afraid to get it.

The risks and signs of opioid use disorder

The technical term for an addiction to drugs such as prescription painkillers, heroin and other similar substances (opiates) is opioid use disorder. According to data from the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2014 nearly 2 million people had an opioid use disorder relating to the use of prescription painkillers.

Prescription drugs in general are the third most common drug related to dependence or abuse, behind only alcohol and marijuana. And painkillers are by far the most commonly abused prescription drugs.

Two of the most commonly abused prescription painkillers are hydrocodone and oxycodone.

Addiction to prescription painkillers is different than most forms of drug addiction in that the addicted patient often starts on the drug under a doctor’s orders. The patient may have had a surgical procedure or a car accident and is in a lot of pain, so the doctor prescribes an opioid painkiller to help. This is a legitimate use of the medication, as no other pain relievers are as effective as opioids.

But anyone taking opioids needs to be cautious, as these medications can lead to a lot of problems — like addiction — if they’re taken long term. Conditions that cause chronic pain (pain that comes back frequently or stays for a long period of time) are particularly risky to treat with prescription painkillers. Increasing the time you take the medication provides more opportunity to become addicted.

Many news reports have cited a passage from the book “Unbroken Brain,” which says in part: “If you do not have a past history of addiction and are in your 40s and getting pain treatment with opioids, your odds of becoming newly addicted are low.”

Your risk of addiction can depend on many factors including:

  • Genetics (family history of addiction increases your risk)
  • How long you take medication
  • How much medication you take
  • Past history of substance use problems

Still, so we don’t know everything there is to know about the risk yet. I believe the risk of addiction is greater than researchers originally thought.

If you have a loved one taking opioid painkillers, keep an eye out to make sure he or she takes the medication as directed. Some warning signs to watch out for include:

  • Appearing drowsy or intoxicated
  • Depression
  • Irritability
  • Not performing well at work or school (or just not attending at all)
  • Running out of medication too early (e.g., a prescription was supposed to last one month but the medicine is gone after two weeks)

People who are closer to the addicted patient will likely notice these signs sooner than casual acquaintances. It is possible, however, that a patient could hide these symptoms successfully for a long time.

How we treat prescription drug abuse in our community

Of course, if someone has overdosed, call 911 immediately. When it’s not an overdose situation, patients can go to one of our assessment and referral centers. Staff members can evaluate the patient’s needs immediately, 24 hours a day, seven days a week.

Patients’ needs can vary tremendously when prescription painkillers are involved. Some patients may be physically or medically unstable and need care from the nearby emergency room. Other patients may need structured care as part of our inpatient unit, where we can provide therapy in a hospital setting.

From there, we can recommend follow-up treatment, based on the patient’s needs and what he or she is willing to do. The recommendations can include:

  • Support groups, such as Narcotics Anonymous and Smart Recovery
  • Outpatient therapy
  • Evening programs (for patients who are more stable and maintaining jobs or school)
  • Day programs (for people who need more structure but who can go home at night)
  • Residential treatment program (for patients who need even more structure by living on-site during treatment)

Opioid use disorder is unique in addiction treatment in that there are several highly effective medications to treat the problem. When a patient is addicted to opioids, we always evaluate whether medications would be a good part of the patient’s overall treatment plan.

One of the main types of medications we use to treat opioid use disorder is buprenorphine (also known as Suboxone ®). Many doctors haven’t completed the necessary training to prescribe this medication to patients. Fortunately for patients in our area, all of the on-call doctors at Linden Oaks have completed this training and can prescribe buprenorphine when indicated.

We also have access to emergency naloxone treatment (sometimes referred to as the “save shot”). Naloxone saves a lot of lives because it can reverse an opioid overdose very effectively. Linden Oaks now gives naloxone information and prescriptions to many at-risk patients and their families to have at home. Some reports have indicated Prince received such an injection to treat a suspected opioid overdose when his plane made an emergency stop on April 15 in Moline, Illinois.

Don’t wait. Get the addiction help you need now.

We’ve seen more opioid overdose deaths in the Naperville area in recent years. It’s an alarming trend, and a lot of those cases have involved prescription opioids, including some that started out with the patient receiving painkilling medication legitimately under a doctor’s orders.

Young patients — teens and children — may start down the path to addiction by taking other people’s prescription painkillers to get high. Once they’re addicted, they may actually switch to heroin or other drugs.

If you need help for addiction, there is care available in our area, and it’s available right now — don’t wait until it’s too late.

If your family needs help to deal with addiction, fill out this assessment form online, and one of our team members will contact you. You can also call us at (630) 305-5027.

Take a free Addiction Aware screening to assess your risk.

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