So, No One Understands Your Pain Pill Addiction?

How about the Deputy Commander of  United States Special Forces?

US Army Photo

In going public about his drug dependency during interviews with USA TODAY, [Lt. Gen.] Fridovich, 59, echoes the findings of an Army surgeon general task force last year that said doctors too often rely on handing out addictive narcotics to quell pain.

An internal Army investigation report released Tuesday revealed that 25% to 35% of about 10,000 soldiers assigned to special units for the wounded, ill or injured are addicted to or dependent on drugs, according to their nurses and case managers. Doctors in those care units told investigators they need training in other ways to manage pain besides only using narcotics.  READ MORE…USAToday.com
If a three-star general can admit a problem and get help, so can you!

Vivitrol Approved To Treat Opiate Addiction

Vivitrol, a long-acting formulation of naltrexone given by injection once a month, was approved by the FDA to treat alcohol dependence in 2006. The FDA has now approved Vivitrol to treat and prevent relapse after patients with opioid addiction have undergone detoxification.


A Guide To The Safe Use Of Pain Medication – FDA

Addiction to pain medication is the fastest-growing segment of the addiction field.  There are a variety of reasons, ranging from doctors who do not understand the potential of addiction, to drug companies who underplay the dangers of their products, to unscrupulous doctors and importers who provide a smörgåsbord of drugs to their “patients” on demand.

The Food and Drug Administration has published an excellent rundown on the safe use of pain medication, from aspirin to opioid drugs.  We recommend it highly.

A Guide To The Safe Use Of Pain Medication

Opiate Overdose Due To Reduced Tolerance

In practically all cases, opiates kill by respiratory depression: when we OD, the part of the brain that controls breathing shuts down, and we “forget” to breathe.  This causes death by hypoxia — suffocation. I was reading again today about another addict who overdosed and died because she misjudged her tolerance for Oxycontin after leaving detox and relapsing.

Our tolerance to the respiratory depression of opiates rises rapidly.  It doesn't take long before a frequent user can tolerate doses as much as 10 times higher than those that would kill a non-tolerant person.  This is true of all opioid drugs: heroin, methadone, hydrocodone, oxycodone, and so forth.  When we detox completely or partially, through maintenance use, cold turkey, or in a clinical setting, our tolerance drops rapidly.  We become far less tolerant to the fatal effects of the drug than we were while using regularly. If we manage to stay clean for a while our tolerance drops even more.

I leave detox or treatment, I hit some meetings, I do the right things for a while. Then I start to slide back into my old ways, hanging with the wrong people, around the wrong places, and doing the wrong things.  Since I don't have any real support staying clean, I'm a sitting duck when post-acute withdrawal hits, and I start jonesing for my drugs.  So I go out and score. Maybe I know a little about reduced tolerance, so I decide to start slow…but not slowly enough.  Or maybe a buddy decides to give me a little extra taste.  Or maybe I get a hot shot.  Or maybe I just go nuts.

Maybe I nod off, stop breathing, and don't wake up.

This could literally be the most valuable information of your life.  Remember it.  Reduced tolerance is the number-one cause of overdoses.

PAWS Can Smack You Upside The Head If You’re Not Ready For It

You can hang around recovery groups for a long time without hearing people mention PAWS, or Post Acute Withdrawal Syndrome.  That's too bad, because it is one of the major causes (if not the major cause) of relapse in the first couple of years. Without getting into a lot of detail here, let's talk about PAWS for a little bit.

Addiction occurs because physical changes take place in our brains when we use drugs.  They cause us not only to crave greater amounts of drugs, but also to need the presence of the drug to keep from getting sick (withdrawal). The symptoms of withdrawal vary, depending on the drug, but they are generally comprised of feelings and physical symptoms that are more-or-less the opposite of those caused by the drugs themselves.

These symptoms begin within a few hours of quitting the drug, and last for several days to about three weeks, depending on the specific drug or drugs that were used. Taken together, they make up acute withdrawal. That's what we deal with in detox.

Post Acute Withdrawal occurs after the acute phase and can last for up to two years, off and on, in “waves.” Why so long? Well, we exposed our brains to drugs for a long time, and it took quite a while for our brains to become completely used to them. Doesn't it make sense that it takes our brains quite some time to recover?

The difficulty is that we addicts have taught ourselves that it's not OK to be uncomfortable. We know just how to deal with unwanted emotions and physical discomfort: we use drugs. The discomfort of PAWS can lead us to make some bad decisions, because much of it occurs in parts of the brain where we can't just “think” it away. That's why “Just Say No”…Just Doesn't Work, and it's the reason for a lot of relapses.

It's also the reason that long-term maintenance with Methadone or Suboxone is problematic.  Since the addiction is constantly fed, and since physical recovery never really begins, we still have months of PAWS to deal with when we finally do try to get off the maintenance.  Without proper support, we may find that to be more than we can handle.

PAWS is best dealt with by getting plenty of rest, eating well, watching our intake of sweets, taking a couple of multivitamins a day, exercising, going to meetings, and hanging out with our supports. It doesn't have to be the end of our sobriety, especially if we know it's coming and are prepared to accept it and get through to the other side.

If you're interested, you'll find more information about Post Acute Withdrawal Syndrome here.

Binge Use of Alcohol and Drugs

Getting drunk or high on an intermittent basis — perhaps every weekend —  is known as binge using. There is are indications that people who binge drink stand a considerably greater chance of becoming alcoholics, especially young people, who are still forming neural connections in their brains.  Many authorities believe that this applies to certain drugs as well, especially “uppers” and opiates.  The human brain is not fully mature until about age 22.

Binge use does not mean that we are addicted but, if consistent, it is a danger signal both immediate and for the future.

The big question is whether we need to use during the week in order to be comfortable.  This is known as maintenance use, and it enables alcoholics and other addicts to get through the week while functioning normally, “busting loose” on the weekends.

Only you can decide if you are an addict, but if alcohol or other drugs are causing problems in your life and you still feel that you have to find excuses to use them, or that you “deserve” to, then you definitely have cause for concern.

“…3 to 4 Oxys a day…Is that a lot?”

“I just found out that  my spouse has been snorting Oxycotin for approximately 1 year. He says he has been doing 3 to 4 80 mg pills a day for 5 months. What kind of help does he need?  Is that a lot?”

That is a lot of Oxy. Your spouse is addicted and needs professional help. It is extremely difficult to detox and remain abstinent from any opiate drug on one’s own.

The best course of treatment would be clinical detox, followed by inpatient treatment and then aftercare — along with a 12-step program such as NA for support. This is the course that is most likely to work. If you do not have insurance to cover detox and treatment, check with your local mental health society for resources in your area. As a last resort, short-term detox with Suboxone and support from Narcotics Anonymous is an option.  Avoid methadone treatment; it only switches one addiction for another, and it is more difficult to get off methadone than oxycodone.

You must also understand that the problem will only get worse with time. Promises to “quit after the holidays, after (whatever)” mean nothing. The only meaningful action your spouse can take is to get help. Period. Everything else is blowing smoke to protect his addiction.

For yourself: Nar-Anon* or Alanon, to learn more about the disease of addiction and how to keep from being further enveloped in the madness. You must take care of yourself before you can take care of anyone else.