As Senior Clinical Director of Substance Abuse Services at UPMC Health Plan, Dr. Daley PhD, knows how devastating misuse of pain or anxiety medications can be to both the individual and their loved ones. He carefully answered some common questions to help anyone struggling and fight back against the stigma of addiction.
Watch Dr. Daley and Dr. Glance discuss many common questions surrounding prescription drug misuse and addiction:
Why should we be concerned about prescription drug misuse and addiction?
Most of us have a family member, friend, or colleague who misuses or is addicted to pain medications, sedatives, tranquilizers, or stimulant drugs. These problems can occur as a result of taking a medication prescribed by a physician to treat a medical or psychiatric condition. Some people transfer their addiction to a prescribed medication to an illicit street drug. Others start by misusing another person’s prescription drugs, then get hooked after taking an addictive drug for several years. Some people become addicted because they are prescribed addictive drugs for long-term use that become hard to give up when a health care professional suggests this.
How common is prescription drug misuse and addiction?
According to a recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA), 119 million people in the U.S. used pain pills, sedatives, tranquilizers or stimulant drugs during the past year. This high number represents over 44% of the population ages 12 or older.
While most people use these medications responsibly for their medical or psychiatric conditions, about 10% misuse these drugs, and nearly 2 million develop an addiction. Some who misuse or become addicted to opioids also use alcohol or other drugs. Taking a combination of substances raises the risk of a potential drug overdose or other negative outcomes. For some people, the use of illicit and dangerous drugs started with their use of prescription opioids.
As a result of high rates of drug misuse and addiction, deaths from overdose have increased nearly fourfold in the past decade. This led to well over 50,000 deaths in the U.S. in 2015. Pennsylvania has one of the top rates of drug overdoses in the U.S. as a result of this drug epidemic. Overdose deaths increased in Allegheny County by 44% in 2016. The number of overdose deaths in the U.S. now exceeds that from vehicle accidents. And, each person who dies from an overdose leaves behind family members and others who often suffer from their loss.
What is meant by prescription drug misuse, and what are the signs?
Drug misuse is the intentional or unintentional use of one of these medications not prescribed to the user. Almost half of people who misuse or become addicted to prescription drugs receive, borrow, buy, or steal these drugs from family or friends.
Some of the more common signs of misuse include:
- Taking more medications than prescribed
- Getting prescriptions for the same drug from more than one physician
- Doctor shopping to get the drugs the person wants
- Lying about drug use and telling the prescriber that the symptoms the drugs are intended to treat are much worse
- Saying that the prescription was lost
- Mixing alcohol or other medications, which increases the risk of negative effects.
Why are the physical signs of a drug addiction?
There are two physical signs of addiction to prescription drugs:
- The first is experiencing withdrawal symptoms when the amount of the drug taken is reduced or stopped completely. Symptoms of withdrawal from opioid drugs can last up to a week or longer. These may include yawning, sweating, coughing, runny nose, sneezing, goosebumps, muscle and joint pain, diarrhea, nausea, vomiting, anxiety, irritability, and strong drug cravings. While uncomfortable, withdrawal from opioids is not life threatening as is withdrawal from alcohol or tranquilizers, which can cause seizures and be fatal.
- The other physical sign of addiction is an increase in tolerance to the drug where more is needed to achieve the desired effect. One of the dangers of using any of these drugs long-term is that a tolerance can develop requiring higher doses of the drug, which in turn can make it more difficult to stop using.
What are the mental and behavioral signs of addiction?
Compulsion or a strong desire or craving to use drugs despite their negative effects is the hallmark of addiction. Related to this is obsession, or intense mental focus on getting the drug. Drugs become far too important and may become the central focus of the person’s life.
Other signs of addiction include being unable to stop once drugs are taken, using greater quantities than intended, or continuing drug use despite the fact that medical, psychological, family or other problems are caused or worsened by this use. The person with an addiction often does not take care of responsibilities at home or work.
What type of help is available for these problems and is treatment effective?
Medical treatment for an addiction may include detoxification from addictive drugs in a supervised medical setting (hospital, rehabilitation program, outpatient clinic). The person is tapered off addictive drugs and managed by a medical team to help stabilize their condition, then connect them to ongoing treatment. One of the most effective treatments for individuals with an opioid addiction is medication-assisted-treatment combined with counseling. Methadone (taken daily), buprenorphine (daily pills or extended release shot given monthly), and buprenorphine combined with naloxone are available.
Short and long-term residential programs (several weeks to months), partial hospital (5-7 days per week), intensive outpatient (2-4 days per week) and outpatient (individual, group and/or family counseling) are also available to help anyone with a drug problem. Treatment programs aim to get the person to accept their drug problem, stop misusing or using drugs, and learn ways to meet the challenges of recovery. Common challenges include managing drug cravings, resisting social pressures to use drugs, getting the family involved, finding alternative ways to manage stress or problems, catching early signs of potential relapse, and developing a recovery support system so that recovery becomes a “we” and not an “I” process.
Treatment for addiction can be very effective. The key is sticking with treatment and not dropping out too early. People who actively engage in mutual support programs such as Narcotics Anonymous (NA) often do better than those who do not use these programs. Mutual support programs such as Nar-Anon are also available to help family members or friends affected by a loved one’s addiction.
For more information:
UPMC Health Plan Special Program Assistance (SPA) 1-855-772-8762
Behavioral health case management and telephone coaching for members with substance problems.
PA Get Help Now 1-800-662-4357
This helpline and website provides information about local resources for substance use disorders.