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Prescription Drug Addiction

Prescription Drug Addiction

The current opioid crisis has brought much needed attention not only to the dangers associated with the use of street drugs like heroin but also the surprisingly significant damages resulting from the misuse of prescription medications. And the problem is a big one. According to the Substance Abuse and Mental Health Services Administration (SAMSHA), for example, prescription meds are abused more often than any other drug, with the exceptions of alcohol and marijuana. Additionally, SAMSHA’s 2014 National Survey on Drug Use and Health found that around 15 million people in the U.S. aged 12 and up had used prescription meds for a non-medical purpose within the last year.

The news isn’t all bad, however. If you or someone you love is struggling with a prescription drug addiction – an opioid, sedative or stimulant – you can take some comfort in knowing that that there is plenty that can be done about it. As the National Institute on Drug Abuse encouragingly states, “Years of research have shown the substance use disorders are brain disorders that can be treated effectively.” And that’s the key: treatment. This guide provides you with important information about prescription drug addiction and it’s treatment, as well as useful advice on what you can do to help someone you love with a prescription meds abuse issue get the help they need.

Expert

David Brooks
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The current opioid crisis has brought much needed attention not only to the dangers associated with the use of street drugs like heroin but also the surprisingly significant damages resulting from the misuse of prescription medications. And the problem is a big one. According to the Substance Abuse and Mental Health Services Administration (SAMSHA), for example, prescription meds are abused more often than any other drug, with the exceptions of alcohol and marijuana. Additionally, SAMSHA’s 2014 National Survey on Drug Use and Health found that around 15 million people in the U.S. aged 12 and up had used prescription meds for a non-medical purpose within the last year.

The news isn’t all bad, however. If you or someone you love is struggling with a prescription drug addiction – an opioid, sedative or stimulant – you can take some comfort in knowing that that there is plenty that can be done about it. As the National Institute on Drug Abuse encouragingly states, “Years of research have shown the substance use disorders are brain disorders that can be treated effectively.” And that’s the key: treatment. This guide provides you with important information about prescription drug addiction and it’s treatment, as well as useful advice on what you can do to help someone you love with a prescription meds abuse issue get the help they need.

Signs of Prescription Drug Abuse

As you might imagine, the signs of prescription drug addiction depend a lot on the specific drug in question. What are prescription drugs considered addictive? Here is a look at the most common types of prescriptions meds abused, and their corresponding signs and symptoms of abuse:

Prescription opioids are powerful and effective painkillers commonly used in short-term situations, such as recovery from surgery, and for longer-term pain relief for patients suffering from serious and terminal diseases, such as cancer. Like their illicit street counterparts, prescription opioids are highly addictive, with dependence typically coupled with tolerance. Opioids are among the most frequently abused forms of prescription medications, both in the U.S. and around the world.

Common forms of prescription opioids include: hydrocodone (Vicodin, Lorcet, Norco, Lortab); oxycodone (Oxycontin, Oceta); codeine (often used in prescription cough medications); hydromorphone (Dilaudid); fentanyl (Fentora, Duragesic, Lazanda, Actiq, Sublimaze); and Meperidine (Demerol). In addition, illicitly-manufactured fentanyl of questionable quality has recently appeared on the street drug scene.

  • Abnormal sleep habits (sleeping more or less than normal)
  • Anxiety, depression, mood swings, irritability
  • Bruises or track marks (for IV users)
  • Constipation, diarrhea
  • Drowsiness, nodding off
  • Dry skin, infected skin, constant itching and scratching
  • Nausea, vomiting
  • Euphoria
  • Flu-like symptoms
  • Impeded coordination
  • Lowered blood pressure
  • Mental confusion
  • Slurred speech

How to Help Someone Struggling with Prescription Drug Abuse

Helping a friend or family member with a drug abuse problem can be hugely frustrating, is often heartbreaking, and will certainly be difficult. In most cases, the biggest hurdle is simply getting the addict to accept the help being offered. This section covers a number of important topics about what friends and family can do to best help loved ones in overcoming their prescription drug addictions.

If you are wondering if someone you know may be suffering from prescription drug abuse, start by taking inventory of the signs of addiction listed above. There are also a number of signs that are common to the habitual use of drugs regardless of the specific substance. Some are obvious, such as selling, stealing or forging prescriptions, or “doctor shopping,” which means seeking the multiple prescriptions for the same drug from more than one doctor. Other signs include poor performance at work or school, changes in physical appearance (lack of basic grooming or dirty, disheveled clothes), increased secrecy and lying, and defensiveness when asked about substance abuse or even “How are you doing?”

Which brings up an important point: Sometimes the best way to determine if a person is abusing drugs is to simply ask. The answer may likely be a self-defensive denial, but it’s also possible that the user has reached a point where they are ready to admit their problem. The point is, don’t be afraid to ask, as long as the question is posed from a place of concern and support.

Prescription drug addiction is an actual disease with its own unique set of characteristics. Among the biggest are denial and resistance. So, broaching the subject of addiction with the person of concern can be tricky, and require sensitivity and some amount of thoughtful preparation. Here are a few suggestions to help when speaking with someone about a drug abuse problem:

  • Resolve any conflicts you may have personally about getting involved before talking to your loved one: Some people are apprehensive about speaking to someone regarding a substance abuse problem. Concerns include damaging a friendship or bringing up issues that are none of their business. Consider this: drug addiction can lead to permanent injury and death. The fact is that talking about substance abuse will likely not ruin a relationship, but if it did, isn’t the possibility of saving a life worth the risk?
  • Be ready with some real, solid objective information: That means doing a little self-education on drug addiction generally and the substance in question specifically. The more you know and the clearer you are on the problem and potential solutions, the more likely the person will be willing to listen.
  • Don’t be judgmental: Focus on the person’s behavior and its consequences, not the bad choices he or she made that caused the problem. Offer support and encouragement to get help.
  • Let your friend know you’ll be there to help throughout the recovery process: Your loved one is going to need your help and support both during and after treatment. Be sure to let him or her know that you plan to be there for the long haul.
  • If you’re still not sure what to say, consult with a professional before talking to your friend: Try calling a local treatment center or 12-step program. You’ll likely receive some very useful advice on what to say your loved one, and how best to say it.

An intervention is a process of confronting an addict about his or her drug use in a face-to-face meeting. There are two basic types of interventions: informal and formal. An informal intervention refers to a brief meeting, usually unplanned, between an addict and one or more friends or family members to discuss the issues surrounding the addiction. The purpose of an informal intervention is to get the addict to recognize that he/she has a problem, and provide encouragement for the addict to seek help.

A formal intervention is one that is planned in advance, typically attended by a larger group friends and family members, with the clear intention of getting the addict to act immediately on his/her addiction by going directly into treatment. The major feature of a formal intervention is the participation of a professional interventionist who provides a structure to the intervention process, and directs the intervention’s participants to share their concerns with the addict. A formal intervention is commonly done when all other attempts to get the addict to stop using have failed.

Another important way to help a friend with a prescription addiction problem is to take on the task of seeking out the treatment and support options available. Doing so is a good way of to show your commitment to helping your friend get clean and sober, and making it easier for him or her to say “yes” to treatment. If you or your loved one hasn’t done so already, a good place to start is to contact an appropriate medical professional, such as a physician, local hospital or health clinic, to discuss your loved one’s circumstances and solicit advice on what to do next.

Friends and family members can also help by compiling a list of potential treatment centers in the general area that provide detoxification and rehab services for the particular drug at issue. There are literally thousands of physicians, health care professionals, and facilities throughout the U.S. that specialize in substance abuse treatment services. Two excellent resources for locating treatment programs are SAMSHA’s Behavioral Health Treatment Services Locator and the American Academy of Addiction Psychiatry’s Practitioner Database. Once a list of potential facilities is compiled, contact each program directly for more information.

Finally, consider contacting a local 12-step program – such as Narcotics Anonymous or other support group – for help. Most provide free-of-charge information and moral support to anyone with a drug problem.

What to Expect from a Prescription Drug Addiction Program

As mentioned earlier, substance use disorders – including those involving prescription medications – can be treated effectively. There are a number of program options, but the best one for treating prescription addiction is an inpatient residential program. Inpatient programs vary in length from 30 to 90 days, or longer. A minimum of 30 days is needed to allow for the patient to address the underlying issues of his or her addiction, and establish the foundations and structures needed to live a drug-free life.

A typical 30-day rehab program is highly-structured, with patients required to adhere to a specific daily routine and a number of strict rules of behavior. Elements of treatment include individual and group therapy sessions, as well as exercise and other physical and mental wellbeing activities. Patients are also normally given homework assignments to be completed during non-scheduled hours. Patients live at the facility and are required to remain on-premises throughout their stay, although off-premises activities may be included, especially in the later stages of the treatment program. In some cases, patients may remain in inpatient treatment for a period beyond the initial 30 days.

  • Detox: Withdrawing from Prescription Medication
  • Visiting Someone in Rehab
  • Addiction Therapy: Participating in Treatment
  • Drug addiction withdrawal refers to the physical, mental, and emotional effects experienced by the addict when he or she stops using the addictive substance. The sudden withdrawal from an addictive prescription drug, particularly a depressant, can be extremely dangerous and should not be undertaken without the supervision of an experienced medical professional. Symptoms of withdrawal from a prescription drug vary depending on the drug, as well as the depth and length of the addiction. Common symptoms include depression, anxiety, extreme fatigue, fever, muscle ache, and joint, stomach and muscle pain.

    Detoxification is the controlled and supervised process of withdrawal designed to help manage the dangerous and unpleasant symptoms of the withdrawal. Detox is the first step in the recovery process. It may be incorporated into the inpatient treatment program or take place immediately prior to starting a rehab program. Detox may last for a few days to several weeks, depending on the drug involved. Medications may be employed during the detox process, particularly for opioid and benzodiazepine withdrawal.

  • Two of the questions most frequently asked by friends and family members about drug rehab are, “Can I visit my loved one while he or she is in rehab?” and “Should I visit my loved one in rehab?” The answer to both questions is a resounding: maybe. Regarding the first question, most treatment centers allow, and even encourage, visits from loved ones. Visitation rules vary by facility, however. Pre-approval is normally required, and visits may be forbidden or limited during the early stages of recovery.

    As to whether someone should visit, there are a few items to consider. If the visitor is currently abusing drugs or alcohol, visiting someone in rehab is strongly discouraged, and will be disallowed by facility personnel if they suspect recent drug use by the visitor. Visitation may also be disallowed if staff members believe the visitor intends to try to lure the patient into leaving the facility, or otherwise bring with them the toxic environment that the patient left behind when he or she entered treatment.

    If a loved one invites you to visit, you are encouraged to do so. It’s important, though, to keep a few things in mind. First, follow all visitation rules to the letter. You will likely be searched at the facility upon your arrival, so do not try to sneak anything in, even if you think what you’re bringing is harmless. Keep the conversation light and full of positivity, praise and encouragement. Most importantly – leave the family drama at home.

  • The importance of the family in the rehabilitation process can hardly be overstated. Recovery from prescription drug addiction is not accomplished alone, it requires the active participation of those closest to the recovering addict. And who is closer to the addict than his or her family?

    Understanding the family dynamic, and resolving any and all underlying family-related issues is crucial to long-term sobriety, which is why most treatment programs include couple’s and/or family therapy components. Family therapy educates participants about drug addiction and teaches them how to support the patient’s continued sobriety. It also provides a forum for healing between the addict and family members, as well as among the other family members themselves.

Life After Prescription Drug Rehab Programs

The successful completion of a prescription drug rehab program is a tremendous accomplishment, but it only marks the beginning of a life-long active commitment to sobriety, which will require the continuing love and support of the addict’s family and friends. Loved ones can help by providing a substance-free environment, encouraging healthy exercise and eating habits, supporting the addict’s continued active participation in 12-step meetings and activities, and providing patience and non-judgmental acceptance.

It’s very important to understand that relapse is a common occurrence in the recovery process. It does not mean that all of the hard work of the addict and his or her loved ones was in vain. The best way to help an addict who has relapsed is to encourage him or her to stop using immediately and, if necessary, return to treatment as soon as possible.

Find Personal Support

The recovering addict is not the only one who needs support. It’s essential that family members and friends of the addict take care of their own physical and emotional health. Fortunately, there are a number of support groups specifically for the families and friends of those in recovery, including, among others, Nar-Anon, Families Anonymous, Learn to Cope, SMART Recovery Family & Friends, and Co-Dependents Anonymous (CoDA). Many drug treatment centers offer continuing support to the friends and families of their patients following program completion, so be sure to contact your loved one’s treatment facility for support availability.

Q&A With a Prescription Medication Addiction Expert

David Brooks, MA, LCADC
David Brooks, MA, LCADC

David Brooks is the Owner and Clinical Director of Brooks Behavioral Health Services, LLC, a Level I outpatient facility located in Frederick, Maryland that offers individual, group and family counseling sessions, as well as a wide array of assessments for substance abuse disorders. Mr. Brooks holds a Masters of Arts in Educational/Clinical Counseling from Prairie View A&M University, and several professional licensures and certifications, including a Maryland Licensure in Clinical Alcohol and Drug Counseling.

  • Can you tell us a little about Brooks Behavioral Health Services?

    What I do is work with people who have substance abuse issues that most people don’t try to tackle. I deal with people who sell drugs, people that get caught with possession charges, possession with intent – just breaking the law. People who have been in prison for a while and can’t adapt to society again – that’s kind of what I do. Everything at my facility is 100 percent evidence-based.

  • Are you seeing a lot of people come in with prescription opioid abuse issues?

    I would say about 80 percent of the people that I deal with, that’s their issue. They either started out with prescription pills and then moved to heroin, or they’re just constantly on oxycodone or Percocet.

  • How are people getting hooked on opiates through prescription opioids?

    What I’m starting to see is a trend with young people, younger than the age of 25 or so. They start out with their parent’s prescriptions – getting them out of the cupboard or their mother’s purse. They start out like that and it moves into heavier use. And the ones who didn’t start that way usually start out with a back injury, knee injury in sports – just pain – and were given large amounts of prescription medication. Then the doctor says you’re not getting anymore, and it just progresses from there – buying it on the black market, doctor shopping, that kind of thing.

  • How about non-opioid prescription medications, like stimulants or sedatives?

    Benzos is a really big one. I have people who have been prescribed large amounts of Klonopin and Xanax. And the problem is they come in with a heroin and a pills [problem]. They have pills, like opioids, and then they have a prescription of benzos. And they’re getting them from two different doctors. Another thing about the prescription medication [bought on the street] is that there are people starting to sell fake pills that have other stuff in them. People are pressing everything, and it looks exactly the same, but it’s just not.

  • What do you do if someone comes into your facility for help to detox?

    As soon as [someone] walks in, I do an assessment. I see if they’re in withdrawal, if they’re not in withdrawal. I’ll be honest with you. It’s way difficult. The beds for detox – a lot of times I try to get them straight to detox, but there are no beds available. The next avenue is trying to get them to a doctor that prescribes either buprenorphine, or I try to send them to somewhere they can get a Vivitrol shot. Every person is different. Some of them already have it made up in their minds, “Just send me to a detox. I don’t want to get on another medication. I’m trying to get away from all medications.” Then you have some people who think that if they take methadone or if they take buprenorphine that they’re really not clean.

  • What about patients who are put on medication?

    If they get on a prescription for Buprenorphine, for example, as soon as they get prescribed, then I start doing the groups with them. I give them groups every day so that they keep coming into my office and I can see them, talk to them, talk about their withdrawals and how they’re feeling, making sure the medication is working. I try to meet with everyone at least once a week. Or if somebody is in active use and they haven’t quite gotten that appointment yet, then I keep them in my office as much as I possibly can.

  • So you’re trying to help people even when they’re still using.

    Yeah. One thing that I’ve learned is that I try my best not to judge people. And the good thing about my groups, all of the people who have already been through the detox, they feel for the person because they know what they’re going through. But I just tell them to keep coming. Don’t worry about what it looks like, don’t worry about any of that. Just keep coming to group. I really don’t care how you come in. Just keep coming in.

  • How important is family involvement in helping the addict overcome addiction?

    If the family is not involved, it’s very difficult. What I normally do is try to get the family here so that I can teach them how to react to the person if the relapse or if they’re struggling – how to manage that. It has more to do about education. I try to educate them on the process that it’s going to take for the person to get better.

  • What would like to see done to improve the fight against prescription medication addiction and increase the chances for successful recovery?

    If I had a wish list, the top thing would be to help take away the stigma. I think the stigma in society is what puts people in a greater bind. What is usual is that people come into treatment when everybody’s shunning them. And once you put the guilt and the shame on them, a lot of people isolate themselves. Yeah, I think that’s the one thing that I would change.