Prescription Pain Medication

Prescription Painkillers: The Opioid Epidemic

In 2016 there were approximately 50,000 fatal deaths in the United states caused by overdoses. This is greater than the number or deaths due to handguns or automobile accidents. But this is just the tip of the iceberg:
For Every 1 Death From Prescription Painkillers:
  • 10 People enter treatment for abuse
  • 32 People visit emergency departments for overdose, misuse or abuse
  • 130 People abuse or misuse prescription painkillers
  • 825 People are non-medical users or individuals without a pain killer prescription

If you have a problem with opioid pain pills such as OxyContin or Percocet, you are not alone. The Opioid Epidemic directly affects over 14 Million Americans.

Massachusetts Opioid Epidemic: Confronting the Crisis

In 2016, 1,933 people in Massachusetts died of opioid overdose. This was the highest ever reported.  And, 56% of the 2016 deaths occurred among people age 25 to 44 or in the prime of their life.

Fentanyl, many times more potent than heroin, is often mixed with heroin or in cocaine or sold as heroin to people who don’t realize how dangerous it is. Fentanyl is deadly; it was present in 69 percent of opioid-related deaths in 2016.  With less prescription opioids on the street, people are turning to heroin and fentanyl as their drugs of choice.

Are You Addicted? Ask Yourself These Questions:

  1. Has your use of prescription opioids increased over time?
  2. Do you experience withdrawal symptoms when you stop using them for pain?
  3. Do you use more than you would like, or more than is prescribed?
  4. Have you experienced negative consequences to your using?
  5. Have you put off doing things because of your drug use?
  6. Do you find yourself thinking obsessively about getting or using your drug?
  7. Have you made unsuccessful attempts at cutting down your drug use?
  8. If you answered yes to any of these questions, you maybe addicted to opioids.

What are Opioids?

Opioids are a group of drugs used in treating pain that include:

  1. Vicodin® Hydrocodone
  2. Oxycontin®,
  3. Percocet® Oxycodone
  4. MS Contin® Morphine
  5. Ultram ®Tramadol
  6. Duragesic® FentanylPrescription Opioid Addiction
  • Taking Prescription Opioids on a regular or daily basis for a prolonged period of time leads to the development of the symptoms of addiction:
  • Warning! Percocet and Vicodin contain Acetaminophen such as found in Tylenol and can lead to serious liver problems and liver failure! This makes the misuse of these opioids especially dangerous.
  • Psychological dependence including craving drugs and addiction behaviors;
  • Tolerance of the drug or needing more just to feel normal;

Physical dependence resulting in withdrawal symptoms if opioids are abruptly stopped. Opioids act by attaching to specific proteins called “opioid receptors”, which are found in the brain and spinal cord.  When these drugs attach to their receptors, they reduce the perception of pain.

The Dangers of Opioid Use

A high dose of opioids can cause death from cardiac or respiratory arrest. Tolerance to the euphoric effect of opiates develops faster than tolerance to the dangerous effects. Therefore people often overdose by mistake trying to get a higher-high.

Opiate Withdrawal

  • Opioids are particularly dangerous to adolescent brain development and can cause irreversible delays in brain maturation or impaired cognitive, intellectual performance and social behaviors.
  • People experience a euphoric response to opioid medications, since these drugs also affect the brain regions involved in reward and pleasure. Taking the drug in large amounts, snorting or injecting them, increases the “high” but also the risk of overdose.

How Do Opioids Affect The Brain?

  • When opioids are abruptly discontinued, symptoms of withdrawal appear. These include restlessness, irritability, muscle and bone pain, insomnia, cramps, diarrhea, vomiting and cold flashes with goose bumps.
  • Opioid withdrawal can be very uncomfortable, but unlike withdrawal from alcohol and sedatives such as benzodiazepines, it is not life threatening.
  • The physical withdrawal symptoms can last anywhere from one week to one month, and the emotional symptoms such as low energy, anxiety and insomnia can last for several months.

Medications Used to Help Treat Opioid Addiction: Buprenorphine  (Suboxone®, Subutex®,  Zubsolv®)

DEA certified Physicians can provide office-based treatment for detoxification and/or maintenance treatment.  FDA approved this medication can prevent opioid withdrawal symptoms and craving and can be used:

  • To slowly detoxify from opioids over weeks to months helping to minimize the pain, discomfort and anxiety associated with withdrawal.
  • As a maintenance treatment for several months to years.
  • As a tool to manage physical and psychological opioid dependency while a patient in working toward sustained abstinence.

If safely prescribed, one month at a time, one can have normal daily activities.

Some people argue Buprenorphine Treatment is just substituting one addictive drug for another.  The National Institutes of Drug Addiction (NIDA) disagrees:

  • Buprenorphine is a highly effective and safe treatment for preventing Opioid misuse. The stabilizing effects of buprenorphine therapy, helps people enjoy a healthy life style and meet family and career commitments.
  • The cycle of rush, “crash”, withdrawal, and craving which leads to increasing chemical and psychological dependency is avoided.
  • It keeps people away from the street culture of crime and violence associated with drug use. It reduces risky and destructive addict behaviors such as IV-needle use and discourages poly drug misuse.Vivitrol ® (Naltrexone)

Vivitrol® (Naltrexone)

  • A once-a-month Intramuscular Injection administered in the privacy of a doctor’s office.  Because it is not a pill, it cannot be skipped which helps prevent relapse or overdose.
  • It can be used as a tool to manage physical and psychological opioid dependency while a patient in working toward sustained abstinence.
  • It is an FDA approved medication that prevents opioid users from getting “high” even if they use drugs by blocking the euphoric effects of these drugs.
  • It is a non-habit forming medication that can be used to treat co-occurring alcohol or heroin addictions.

Your ARCH Individual Evaluation & Treatment Plan for Opioid Care is designed by our MD’S and will include a combination of selection below:

  • Addiction, Medical and Psychiatric Evaluation by our Addiction Psychiatrist
  • Evaluation and Treatment of Co-occurring Medical Disorders and Poly-Addictions
  • Psychological, Social and Family Interventions
  • Cognitive Behavioral Restructuring of Stresses and Cues
  • Medically Supervised Detoxification using Buprenorphine as Suboxone® or Subutex®
  • Buprenorphine as Suboxone® or Subutex® Maintenance Treatment
  • Medically Supervised Detoxification or Maintenance using Naltrexone as Vivitrol®

Please call us in Danvers:

(978) 820-5500

Dr. Michael J. Kittay, M.D.
160 Sylvan Street, Danvers, MA 01923
Phone. (978) 820-5500
Fax. 978-820-5502

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