Feb 08 Newsletter/Why Don't They Just Quit?

Technology is wonderful-up to a point. The medical and pharmaceutical industries have made huge advances to help those suffering from all sorts of diseases. Most of these advances are genuine lifesavers.

Americans are enjoying longer and higher quality lives-so much so, that we have come to expect many things as normal (diseases cured, symptoms gone and less pain for those suffering the debilitating affects of certain health problems).

Much Too Popular
One class of drugs-opiate painkillers, has become much too popular. These meds will not only relieve physical pain but will also give the user a pleasant euphoric effect at the same time. For a significant and growing number if people this euphoric state of mind is becoming more and more difficult to let go of (similar to the popularity of Valium in the 70's-which by the way, has been recently increasing as well).

So how and why is this happening? How do pain meds cause even more pain? Let me start by saying that these drugs are very necessary for genuine pain-such as pain experienced after a surgery, broken bones, dental work and more. When used as prescribed, for short periods of time these drugs make life manageable. In some very rare cases they may be appropriate for extended periods of time-especially when a person has a terminal disease. A very small percentage of people fall into this category. Thank God for these medications.

The majority of people who take these medications do not fall in this group. Here is where the problem starts. Rarely does anyone start out to become dependent on opiate pain meds. It happens slowly without being noticed. This is an insidious process. Usually, there comes a time when a person's physical pain is gone. With regular use of painkilling drugs, the central nervous system has come to expect the drug and the sedative affect it produces-as normal.

Withdrawal
When a person stops using the drug, the body revolts. This is called withdrawal. It's normal. Much less extreme, but nonetheless similar, a heavy coffee drinker who suddenly quits drinking coffee altogether will experience headaches for a few days. This is because their central nervous system has become accustomed to regular jolts of caffeine throughout the day. Withdrawal from caffeine is usually short-lived and not too difficult. Stopping opiate pain meds is similar, but much, much more intense. The withdrawal symptoms are often very painful-so much so that the person will start to think that their pain is not really gone and they must get and take more pain meds.

A Vicious Cycle
Not only is the body expecting this drug, but a person who is taking pain medication is also building a tolerance to it. Their body is requiring more, sometimes lots more-to feel better. This is a vicious cycle that feeds on itself and only gets worse over time. The person taking theses drugs will also become much more sensitive to all pain-as the normal ability to handle mild pain with over-the-counter medications is now diminished.

I've recently watched this problem arise close to home, as a family member needed surgery. He had been regularly taking large amounts of pain meds for back pain. While in the hospital for knee-replacement surgery, he found that he required a much larger dosage of pain meds than a normal person would need. After he was given the maximum safe dosage-excruciating pain still persisted. One feels helpless in these situations.

To ensure that this doesn't happen, pain meds really should only be used when truly needed. Otherwise, when the time comes that a person genuinely needs them-these pain-relieving drugs may not work at all.

How large is this problem really? In 2007 there were a total of 3.7 billion prescriptions written in the United States. 182 million were for pain meds*! I have double-checked these numbers because I thought they couldn't be correct. Pain meds are second only to prescriptions written for lowering cholesterol (192 million prescriptions). Anti-depressant prescriptions came in third with 158 million.

If you subtract people aged 21 and under from these numbers-that leaves 230 million adults. According to these calculations, over 15 million people are taking opiate pain medications every day. This is 5% of the entire adult population.

Do all these people need opiate pain medication every day? The only way to know for sure is to quit, go through withdrawal and see how you feel after a few months-drug-free. More and more people are unwilling to go through this process. Today, addiction to opiate pain medications is one of the main reasons people are checking into rehab centers.

So how does one avoid becoming dependant on pain medications? And once a person has become dependant on them, how do they learn to safely quit?

Read more about this topic--chapter 27, Why Don't They JUST QUIT?

* IMS Health Services (2007 Research Statistics)