Health & Medicine - Posted by Lois Baker-Buffalo on Sunday, August 22, 2010 16:45 - 4 Comments 
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(2 votes, average: 3.50 out of 5) Loading ...Addicts get hooked at the pharmacy
"We are seeing an increase in the number of patients addicted to prescription drugs," says Richard Blondell, professor of family medicine and senior author on the study, "so we wanted to better understand how they first got hooked." (Credit: iStockphoto)
U. BUFFALO (US)—If you want to know how people become addicted and why they keep using drugs, ask the people who are addicted.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
Thirty-one of 75 patients hospitalized for opioid detoxification told University at Buffalo physicians they first got hooked on drugs legitimately prescribed for pain.
Another 24 began with a friend’s left-over prescription pills or pilfered from a parent’s medicine cabinet. The remaining 20 patients said they got hooked on street drugs.
However, 92 percent of the patients in the study said they eventually bought drugs off the street, primarily heroin, because it is less expensive and more effective than prescriptions.
They continued using drugs because they “helped to take away my emotional pain and stress,” “to feel normal,” “to feel like a better person.”
Results of the study appear in the current issue of Journal of Addiction Medicine.
“We are seeing an increase in the number of patients addicted to prescription drugs,” says Richard Blondell, professor of family medicine and senior author on the study, “so we wanted to better understand how they first got hooked.
“This information suggests that there is a progressive nature to opioid use, and that prescription opioids can be the gateway to illicit drug addiction. It also tells us that people who use prescriptions illegally may be at greater risk for subsequent heroin use than those who use prescriptions legally.”
The study group was recruited from patients who were addicted to opioids—defined as opiates that are made from the opium poppy (morphine, codeine and heroin) or medications that are developed artificially (methadone or fentanyl).
Researchers collected demographic and socioeconomic information from participants, plus the types of drugs they used, age of first use, preferred opioids, and how they administered the drugs. They also asked participants how they got started and how their drug use progressed.
Replies showed that the average age of users was 32; that 65 percent were men, 77 percent considered themselves white, and 74 percent had a high school diploma or equivalent.
Why did they begin using? Slightly more than half said they first used the drugs for pain—after surgery, for back pain, or after an injury—and 49 percent said because they were curious and/or someone they were with had the drugs.
Those who became addicted from using drugs legally prescribed for pain were more likely to be older, female, have a college degree and more likely to take their drugs orally, rather than nasally or via injection.
Users’ comments on how they got started using drugs other than for pain, and why they continued, were revealing. “Pill parties” were a common starting point. One person said the drug “was handed to me by my friend, this guy I know, someone who was at the party.” Another patient said kids are using it “like Viagra.”
Prescription drugs are available in high schools, “at the prom” and used by athletes “to make it through the game,” and later to get high on weekends and during the off-season, according to the users.
When asked if any doctor had ever asked about a substance use problem before writing a prescription, of the 53 participants who answered the question, 74 percent said no.
Blondell emphasized that the prescribing physician is in the best position to prevent or address addiction in their patients.
“I tell patients that addiction can be an unintended side-effect that occurs occasionally with the use of these medications,” says Blondell.
“Doctors need to be able to help them if this occurs, so doctors will need to monitor the use of these medications closely. I also tell patients to discard unused medication ASAP. to prevent addiction in themselves and those, such as teenage family members, who might get their hands on these leftover pills.
The research was supported by the University at Buffalo and the National Institute on Alcohol Abuse and Alcoholism.
More news from the University at Buffalo: www.buffalo.edu/news/
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4 Comments
Kathi
I agree with Kathi re:unanswered questions. However, my experience would call into question any figure as low as 0.01% for addiction following appropriate use of narcotics, though. How would you even determine that with any degree of statistical confidence?
Here in Oregon there is great pressure to prescribe controlled substances (coming from OSBME and legislators). Another question I would ask about this study is how “appropriate” the prescribing was to start off with. If you did this study here you’d get similar results, I am sure, but the quality of prescribing might be a major factor from the outset.
Cris
I would also offer, as a chronic pain traveler, that I believe the prescription of narco pain relievers has gone too far. I am a firm believer that in pain treatment, some pain must remain in the equation to encourage healing (post surgical, etc) – but the bottom line is those who are prone to addiction who trip over pharmaceutical narcotics are just as likely to be addicted to other elixirs that aren’t doctor prescribed.
My condition requires the use of pain medication to live anywhere close to normal. Should society and legislators overreact, based on a presentation of the “problem” of prescription drug gateway abuse, it is likely that others who are dependent (not addicted) on these meds would find it more difficult to resolve their pain issues.
Pain management treatments should, for acute issues, never seek to medicate to a zero pain threshold. Turning the volume down on root canal surgery, back injury or other events should be the goal. I would offer that patients prone to addictive tendencies would less frequently slip into addictive behavior if they did not experience the euphoric experience of near complete removal of pain (re: comfortably numb). It’s not politically correct, but it is my experience.
Emily
I agree withyou Rob, I believe that a doctors purpose in prescribing narcotic pain medications should be to reduce pain but not completely diminish it because then there just over-medicating & not encouraging the healing process. And i’ve read quite a few statistical reports that state most drug users start in a type of Domino-effect where they try one substance such as alcohol & that becomes a gateway drug leading to more serious habits over time. I myself think that addiction has to do with a persons personality & enviroment. If you have an addictive personality that leads to habit forming addictions & if your around people who abuse substances it just further encourages you to use because your personality causes you to be easily sucebtible to whats around you. So I do believe some of this study does occur but theres alot more to it. This subject is a very complex one with lots of debate from experts, FDA, users & pain management patients. I myself am a recovering user & my habit began from an ex-boyfriend
Were questions asked to ascertain if the people who developed addictions to pain killers had other or pre-existing addictions, such as alcohol or smoking? I’ve read figures that give the rate of addiction following prescribed use of pain meds for legitimate reasons as low as 0.01% so I am surprised at this study.