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Avatar universal

Has the 'addiction' problem reached staggering proportions in the US?

I've read recent studies show that people do not become addicted to their pain medications.  Do you think genetics, social environment, or personality is a major factor?
  Are we just playing w/ dynamite, and  once addicted, will you battle this for the rest of your life?  Is brain chemistry changed?  Do some people just become preocupied w/ obtaing drugs because its not readily available?  We do live in a "Mcdonalds drive-up" society.  I want it fast and I want it now.  I think I've answered my own question.  It all depends on the individual, and addiction has many faces.
  Do you think the US will one-day change laws so opiate pain medications will not be used for chronic pain patients?  Do you foresee this being implemented in the future?  This of course, may also affect people suffering from addiction who may need Methadone.
44 Responses
Avatar universal
Annie,  WOW,  I was reading some of the posts that I have missed over the past several days.  We, everyone in my house has been down with one kind of virus or another, couldn't keep the kids' temp below 104 and 105.  Anyway, I have missed alot.  I have been an addict since I was about 12, seeking one kind of relief from some kind of pain or another. Grandpa dies, I was around 15, 1975, maddog 20/20 killed the tears, another grandpa dies a month later, a six pack and grain killed the pain,Nursing school, 5 pounds to get rid of and massive tests I had to pass, amphetamines killed 2 birds with one stone and so it goes.  Whe I went into treatment for opiate addiction, 1989 or so I was told that addiction is a disease, genetic,  It has to do with chemicals in the brain, called THIQ, and If I am not mistaken serotonin, I could be wrong.  My grandfather (maternal) was an alcoholic and for as long as I can remember up until her death my mom always believed that a pill could coure anything,  She never abused her medication but if she was "nervous" a vailum or something would help, back pain, headache etc. a pain pill was the cure.  I always followed suit.  I have the typical "addictive" personality and will abuse anything.  I was told in treatment that I have no abilty to judge amounts.  They observed me without my knowledge and later told me no matter what I did one was never enough.  Not one cookie, but 2 etc.  Now i do take notice and this is quite true.  I cannot even do the speed limit...I have to be 2 MPH over the limit.  Now my sister on the other hand, was raised in the same house as me and is totally opposite, if you give her a vicodin she will cut it in half, and if she does not like something she won't take it,  I will take it and make myself like it as long as it gives me a high.  If she has a headache she will lie down with a cool cloth on her head, I'll go straight for the demerol.  Now my husband I am also questioning.  he has been in recovery for cocain and alcohol addiction which started when he was young..l  he entered tratment on his own.  he will take one vicodin (he is chronic pain patient)and he hates them,  they make him hyper..he hates that feeling, he has been drinking one beer every few months, usually pouring out half of it.  saying he just had a taste for it.  Is he really an addict?  or was it something he got into as a teenager?  never a desire for cocaine, opiates are really not for him so who am I to day he is an addict or jsut a rebellious kid who did some experimenting.  Does what I am saying make any sense?  That is a really hard question you proposed.  Makes me think   As far as taking the meds away from the chronic pain patient,  I don't think that will happen.  Medication is a very valued tool in treatment of chronic conditions.  it is proven that patients recover from surgeries etc shen the pain is greatly diminished. I just spoe with a friend of mine last night who still works on an orthopedic floor at the hospital and sshe talked alot to me about the pain control regulations that are being implemented as we speak and they are very lax.  Nurses will be allowed to treat pain in a way never seen before, at least in this area of Ohio.  I would guess each hospital would be responsible for their own policies as long as they adhere to the new pain laws.  As far as out patient treatment goes, I wold bet that tighter control of the narcs especially oxy will be seen in the near future and then there are always those ingredients such as Naloxone that blocks the euphoric effects of the opiate. ex.  Talwin NX.  I can't say fro sure but I'll bet the DEA etc. will be leaning alot harder on prescribing docs.  We jsut had a case here in Ohio and drug addicts sleeping with a well known Dr. for Narcs.  The the Doc alledgedly raped the girl and here comes the DEA.  My sponsor has heard complaints from clients of hers about this particular doc.  Oxy's were of course one of the drugs.  then the news continued to say that the drug company will hlpd a press conference re: the abuse of this particular drug.  Wow, didn't realize i typed so much  sorry....take care   cindi
Avatar universal
......Thank you.  Not long enough in my book.  After reading the doc's reply, I remained somewhat confused....till I got to yours.
You cleared up a lot of questions.  He stated that drugs, even prescribed correctly, do more harm than good.  Then he ends w/ the statement "prohibition would not be in our best interest"...who's interest, addicts or pain patients; which often are two in the same.  I guess he meant both, but if he thinks it does more harm than good, then only certain pain sufferers should get it or terminally ill patients???  Not sure.  
Thanks for your reply and WOW to you.  Great information.  I feel like I could write a book...lol  Actually I believe "tom" would be best for that task.
I was wondering what had happend to you?  Can't believe everyone's been sooo sick.  Take some vitamin "c"...its non-addictive...lol  I had a post somewhere below the thread for you, inquiring on your whereabouts.  Glad yall survived..lol
Thanks for taking your valuable and limited time to answer my many, many, questions. (:  PS...My tendencies fall somewhere in between you and your sisters.  She sounds a little like me...breaking the tablets in half...lol
Avatar universal
I think the doc got his words down bassakwards. I think he meant to say that, properly administered, they did more good than bad. I think you read a typo.

Stats indeed do support the fact that most patients do not get addicted to their pain killers, at least not in time-limited situations.

When an opiate is introduced into the human body on a daily basis over time, a natural process occurs that results in dependence. No moral failure. No charater flaw. No work of satan. Just plain human physiology.

I think we need to get our terms straight, so we know when we're talking about a chronic pain patient naturally habituted to his medicine, and a good old fashioned drug fiend, like myself, who, takes opiates because he goddamn loves the way they make him feel, then blows some disks out and now really NEEDS the damn drugs to function and earn a living to keep his family off the street.

The emergence of super narcs like buprenorphine and some they still don't have names for promise to provide morphine level pain relief without the euphoria. Bup is already characterized this way. I am reading about new drugs that can distinguish between the opiate receptors that provide pain relief and the ones that get one high. Things are changing. Hope is in the air. This all might become academic. If we could achieve the same thing with unwanted preganancy, all babies would be welcome and no one would need to get an abortion. We can only hope to live long enough to see both situations solved.
Avatar universal
.........Bravo!  Bravo!.......My thoughts exactly.  Well, said.
knowledge, hope, and perserverence will ultimately pay off in the end.  Let us move forward in knowledge, gaining promise and be driven to succeed! Willingly or not, we are all part of these legislative battles.
Avatar universal
I want to make it clear that the "Euphoria" experienced from Opioids is not related to Opioid receptor sites, but is caused by increased firing of VTA Dopaminergic cells by hyperpolarizing local GABA containing interneurons with secondary disinhibition.
Opioid receptors are more involved with aspects like the emotional interpretation of pain as modified by opioid "M" type receptors in the limbic system.Just because a drug is an Opioid does not mean it only effects opioid receptors,It is the same VTA cells that produce cocaine and amphetamine euphoria.
Avatar universal
Thank you for your explanations of other questions you have answered for me in other threads. I can't go to each one but I will thank you here.

Anyway... this is interesting.. the VTA cells.... tell me if there is anything that is good for pain that will not re-awaken addiction. Seems from your post that if the action of the VTA's could be blocked then this would be assistive in combating addiction and subsequent relapse.

Also, if this were the case couldn't there be a very safe med that would guarantee satisfaction of the craving but not produce any euphoria... and not necessarily be a pain killer either. From what I read here it seems that if addicts, not those in pain, could take a pill every day or so often that would touch the opiate receptor and not activate the VTA's then nobody would relapse except those who simply wanted to get high. Does this make sense ??? Is there anything out there on the horizon ??
Love, Brighty
Avatar universal
Welcome to
The Addiction Medicine Forum
(Smoking, Drinking & Getting High)

What more can I say?.
Avatar universal
You are correct and we are working on it.Actually Scientists all around the world have been trying for a hundred years,First attempt:HEROIN,last attempt ULTRAM,both failed,you will have to sit back and wait for the unsubstantiated claims of these people to be proved incorrect,they actually tried to avoid the Opioid receptor with the latest,all I can say is VTA,VTA,what is going on out their is money that important,they would wreck peoples lives in an attempt to get it or maybe they did not study for hours and hours everyday for over 20 years like I did nothing but Psychotropic Drugs and Psychiatry?.They even censored my comments about ULTRAM,questions are; what are they afraid of and how did they find the site.After I joined this Forum I recieved a nice friendly email from the couple who set it up and they clearly showed intention of helping people,so what gives.
Its the last great challenge to deliver a drug specifically to the receptors that need it and avoid others,maybe developments in Genetics may enable more specificity in future,but it costs a lot of money.
Sometimes I wish people would just stop complaining about their addiction other times I know I feel their anguish.
Avatar universal
It may not be a Typographic error,as I believe a doctor needs an ADVANCED knowledge of Addiction to prescribe Opioids to be able to prescibe them without causing unbelievable GRIEF to the patient.as opioids affect emotional appreciation of pain and life itself is painfull.
Avatar universal
....Are doctors going to take the time and spend the money to learn how to treat chronic pain and addiction????  I don't think so.  Then there is still the issues w/ DEA breathing down everyones back.  I think congress plays both ends against the middle where this topic is concerned. Untill chronic pain patients fight and stand up for their rights.....things will not change.  It's hard for us to do this.  We're dealing w/ pain, addiction issues, and illnesses to begin with.  We are the one's who have the voice, but lack the vim there of.  If there is one thing I've learned....Addiction and pain go hand and hand.  Who should decide what path should be taken...public officials, doctors, patients....I think we should decide!  After all we are the ones who are suffering.

Annie
Avatar universal
I agree with you and by advanced I mean,well read this Doctors attitude to prescibing,I consider that ADVANCED knowledge.Addiction is just a mild side effect really,the GRIEF,is because they are so bloody paranoid about it,find a Doctor like the one below and stop suffering.
ABSTRACT
Doyle Bunderman, M.D., Ph.D., P.C. said:
> Within my pain management practice, I encounter much apprehension as regards
> very heavy, possibly "excessive" hydrocodone use. These concerns are
> largely misplaced. While hydrocodone bitartrate (Vicodin, Lortab, Lorcet) posesses
> a relatively mild abuse potential, it remains one of our most efficacious narcotic
> analgesics. Hydrocodone produces a profound euphoric effect which is essential
> in providing moderate to severe pain relief. For patients with stubborn discomfort,
> I will routinely prescribe 2-to-4 Lorcet 10/650 tabs every three to four hours.
> (Each tab containing 10mg. hydrocodone bitartrate.) Much paranoia seems to exist
> with regard to liver and/or kidney damage, possibly resulting from acetaminophen
> intake. This risk is minimal in the extreme and should not be a concern. Addiction
> to hydrocodone is virtually unheard of, at least as compared to codeine, morphine
> or even propoxyphene (Darvon or Darvocet), the latter being no more effective
> than Aspirin and far more toxic. Patients who require hydrocodone prescriptions
> should confront their physicians STRONGLY, and in essence, refuse to accept
> reluctance to prescribe it in reasonably large to very large quantities. I usually
> provide my patients with 100 or 200 tablets (of the 10mg. strength of hydrocodone)
> in order to cover a one-month period. Physicians should not be unwilling to
> write for 500 or 1000 Lorcet 10/650 or Lortab 10/500 tabs for treatment of more
> severe pain. Furthermore, adding Valium (diazepam) 10mg. to each dose of hydrocodone
> dramatically increases analgesia provided by hydrocodone (or certainly Valium)
> alone. The whole issue of "addiction," applied to hydrocodone, is
> a virtual non-issue. There may be slight discomfort, primarily psychological,
> following abrupt discontinuation of very high dosages taken over long periods
> of time. Hence, GRADUATED reduction of dosage in degrees that maintain patient
> comfort offers an exceedingly easy and tolerable way to withdraw hydrocodone
> therapy when such becomes feasable. Many American physicians thrust themselves
> into a negative and almost psychotic, panic-ridden state whenever the need to
> prescribe respectable quantities of hydrocodone arises. This represents a warped
> and unreasonable reaction to the anti-drug hysteria which runs rampant in America
> today. I assure you: when THEIR OWN pain is being treated, these puritannical,
> self righteous doctors make a beeline for Demerol, Dilaudid, morphine, oxycodone...
> anything STRONG, STRONGER and STRONGEST. I feel it is a crime against humanity,
> not to mention a selfish disregard for the physician's own oath, when they expect
> Naprosyn (for example) to relieve the patient's pain, while, given the same
> condition, the doctor will settle for nothing less than a schedule II or III
> narcotic. BE FIRM WITH YOUR DOCTOR! One sure way to get what you need is to
> withold payment (or your business altogether) when encountering resistance to
> the prescribing of a wonderful drug like hydrocodone. Finally, when hydrocodone
> fails to provide the required potency for a given condition, look to "Oxycontin,"
> a relatively new preparation containing oxycodone. But accept nothing less than
> the 40mg.-to-80mg. strength. Good luck controlling your pain and in fact, achieving
> profound comfort while doing so.


Avatar universal
This is sooo unbelievable.  I am grossly undermedicated, even more than I suspected.  He states 10 mg. of hydrocodone(for chronic severe pain).....I have been on only 5mgs,and  For such a painful surgury as this!!!!  I can not even bring myself up to a theraputic level, because of the pain.......and my muscle is virtually down to nothing.  Not to even mention the gagging and dizziness due to the pain I had experienced last weekend!
Where is this doctor???  I totally agree w/ him.......I have never had a problem coming off of Hydrocodone.  I can not even tell you what a severe withdrawal is.  When this accident first occurred, I was on the strongest percoset in a 2 month hospital stay, and can't say I had severe withdrawals coming off.  
This is amazing information.....If my lifestyle would permit, I would create a portfolio, including this info.  I still might do this.  Something has to be done in this country.  I may survive this, but some may not.  I just heard of another suicide here in my state...local to me.  This guy was being under-treated for cancer no less.  Can you believe this????  Thank you for the info.  This is becoming a serious purpose in life for me!!!

Thank You!!!!
Annie

ps.....How are the drug enforcement laws where you live???? Does it spill into the medical field, as it does here in the U.S.
Avatar universal
I was also amazed at the article RE: hydrocodone,  My sis had been on it for 3 years, quit cold turley and had the runs for a few days.  This country, from what I understand is one of the most under-medicated in the world.  I may have told you in another post, when I worked at the hospital, i had a male patient with a kidney stone (pain supposedly is comparable to labor pain)  He was ordered 100 mgs of demerol and 25 of Vistaril...that did not help his pain,  His doc upped the dose to 150 mgs of demerol and not one nurse on my unit was willing to give that much except for me....(go figure)  I later read that 150 mgs is not abnormal in other countries....not much later another patient with renal calculi(stone) was ordered, get this....1 darvocet every 6 hours for pain....this man checked himself out AMA and what happened after that only one can guess.  How sad this is, my mom had to beg for pain med etc. and she was dying.....what do we do?  who do we fight?  I am at a loss and totally disgusted with this ****.  Hope you are feeling better   talk to you soon    Love to all    cindi
Avatar universal
.....and you know first hand what goes on.  You understand exactly where I am coming from.  I don't know where to begin.  Maybe right in the doctor's ofc.  It's rough.  I wish I had the time to get more involved .....to make a change.  I just sent an email to a "compassionate" pain doctor here in the U.S.  He is w/ the underground railroad.  Maybe he can advise me.
What is AMA??  I know duh...lol

Love ya,

Annie
Avatar universal
AMA means "against medical advice".  It's the doctor's way of saying that you did something stupid, thereby resolving him of all irresponsibility in your treatment(mistreatment?).
I posted a few months ago about not getting adequate pain meds for kidney stones and leaving the hospital AMA.  I felt that I had to in order to get some relief.  And I got it thanks to my wife's doctor and my PC doctor.  There's more than one way to "skin a cat", but when you are sick and hurting it takes on a new dimension. Yes, I feel that we are undermedicated for pain in this country as a whole.  Why the people who are sick and in so much pain being attacked like this is mindboggeling!  J.B.
Avatar universal
I don't like to repeat myself, I think I may have posted somewhere else before that right before I got in trouble at work I had a patient that had a stroke and a history of cancer, she was unable to speak but I could tell she was in pain.  She also had a feeding tube, she was unable to swallow, anyway i requested something for pain for her and the doc ordered 1 ultram for cancer pain.  I threw a fit and asked for something to be given IV and I was accused of wanting the drugs for myself, at that point I was truly wanting pain meds for the patient.  I was swiping percocet that time, not demerol or Morphine.  They felt because she could not speak that she was not in pain.  I really did and still am sick and tired of the whole deal......and Annie, I know where you are at with this and I truly do feel for you, I only wish there was some way I could help....Love ya  cindi
Avatar universal
I can't believe the nurses were talking to you about addiction,  I would have never ever made any remark like that, I have had patiens ask me if their pain meds were addicting,  This is when I would do the patient education.  I really did care about these people, I always considered myself to be a patient advocate.  Sometimes it really did get me into trouble.  Your right Only in the USA.  LAter tater   Love ya  cindi
Avatar universal
JB.....It's sad isn't it??  I can speak from experience, when my pain is under control, I walk faster, heal faster, and do not slip into a depression.  Is this really so bad.  What's wrong w/ these people....did I say people???

Cindi, It's clear to me...Your very compassionate, and seeing what you did, caused you to much pain...And you know what??? I woulda probably swiped those percs myself.  You cared deeply for your patients, and the others were just cold hearted.  I know this all to well.....My first stay in the hospital was 2 months long, and I could point out the paycheck nurses and the caring nurses who entered the field to help sick and injured.  Can you believe some nurses were already coaching me about addiction.  Here I was.....at their mercy for 2 months, w/ 28 broken bones, and all I heard was, "don't be an addict now!"...It's really silly isn't it.

The good old USA!
Annie
Avatar universal
This is Fiction for Entertainment and educational purposes only!!!!!!

=============what ==========a====sick=================Society====

1.Our Health DEPT decided to cut off an unemployed,lonely starving,patients supply of "Maintenance Methadone because he could not afford the $2US($4-AUS) for his daily dose,he walked under a train and killed himself that day,before he was EVEN in Withdrawal.....?.
2.They did the same thing to an old man using Methadone for Chronic Pain relief,(he also had Parkinsons disease)he committed suicide last year.(even though police inspections of his house showed weeks and weeks supply of stashed Methadone Tablets everywhere!...?.
3.three yes ******* 3-of my closest friends are DEAD from Heroin overdose,because Prohibition has meant a flourishing black market,were doses are not easily determined.
Every single problem that is associated with DRUGS is due to Prohibition,now that (PRAY)has established and traced the international money trails,we know the system behind prohibition,we are disgusted,what if we told civilians?do you want another civil war,except this time the people versus the Government?.If you read this and you know you are a part of that system it is already to late,I am marked for extermination.I refused 1 million dollars US to destroy our evidence and declined,it is only a matter of time now,many more will take my place. YOU WILL LOSE.

============================and================more=====fiction==

If the GOVERMENTS of this World want a war on Drugs,WE will take up arms(chemical,biological,Psychological,Computer and of course,"the BOMB" NUCLEAR weapons;'^554*>india/afganistanPU238weapons grade/russia,Japan sa**in gas you guessed it, brief case nukes,sorry ICBM sats not hacked YET?still trying) to defend our Moral, ethical and Civil Rights to determine what drugs/chemicals anybody wants to take,you want a WAR well WE(PRAY) just declared it.YOU WILL LOSE. Oh and I love the smell of Napalm and burnt flesh in the Morning..........God I LOVE you America.hello Carnivore.
Avatar universal
Greetings to all.  I have been following this board for several months now as I recover from painkiller addiction.  My drug of choice was hydrocodone.  I find it incredibly hard to believe that any doctor, regardless of how ignorant of addiction, would espouse a viewpoint such as Dr. Bunderman's.  By the way, if anyone knows, what kind of doctor is he?  After searching the American Medical Association's database for a "Doyle Bunderman" and coming up empty, this is an interesting question.  Thanks to all the "regulars" here for their intersting and insightful commentary -- although I don't revel in anyone's personal misery, stories like these help remind me why I stay clean.
Avatar universal
I respect your choice to stay clean, but may I ask, what was the reason you had to take pain meds in the first place.  Do you still have pain???  I was denied medication for 8 years.  I had over 25 broken bones and left w/ several problems, and now i'm dealing w/ degenerative arthritis etc. etc.....So I have to respect a doctor like Bunderman too.

As a recovering addict, you should be happy w/ the choice you've made for yourself, and understand that some people need these meds to live a quality life.  The negative stigma, causes many to suffer needlessly.  Just my 5 cents.

Best Wishes!

Annie
Avatar universal
I personally would expect(well know for a fact)that large and long term doses of Hydrocodone will cause Severe addiction and Withdrawal symptoms,but never-the-less I posted The abstract because it seemed legitimate.Although ludicrous and fantastic.
=================================================================
Annie is definately being undermedicated,which is worse than ludicrous and fantastic,it is evil and immoral,and highlights the REAL dillemma and that is DOCTORS ARE NOT SUITABLY QUALIFIED tO PRESCRIBE OPIOIDS.
Avatar universal
Thanks for adding this, Spook.  As I stated in my post to Annie, physician education is the only way this problem will be addressed.  I wonder how many people will have to be destroyed before this happens.

Sorry for the negativity of that last, but I've seen too much with my own eyes to feel otherwise,

Peace,
Pelle
Avatar universal
Annie,

Your situation certainly sounds like it requires strong pain relief. . .however, for every one of you there at least one or more people who are addicts who are trying (and succeeding) to use physicians as drug suppliers.  This of course makes it more difficult for legitimate patients such as yourself to get what you need.  This is unfortunate, but only better education on the part of physicians will provide a solution.  Today's med school program requires only one week of addiction training in the entire seven-year program.  I suppose in light of this, Dr. Bunderman's statement "Addiction to hydrocodone is virtually unheard of," even in relation to other drugs, is not so unbelievable.  However, the facts speak for themselves.  If reading this and other forums is not enough evidence, then certainly the many people I and others like me have met personally certainly is proof enough that hydrocodone is one of the most dangerous drugs on the market.  No matter how well-intended or sincere this physician's statement is, in reality it is patently ludicrous, as well as dangerously false.

The problem of HMOs and assembly-line patient care definitely doesn't help either.  Physicians in many cases do not take the time to explore their patients' needs and histories to the extent needed to even remotely guess their addictive potential relative to the necessity of the drug in question.  Of course, if the patient lies, the time is not a factor. . .but here, as stated before, thorough (or at least adequate) training in addictionology by medical schools would enable doctors to see the signs of deception that are so apparent to addicts (recovering or otherwise) themselves.  I take no pride in the fact that as an addict myself, I need only listen to (or read) someone's comments about pain medicine and addiction before it becomes apparent to me which side of the fence they are on.

Yes, my medications were all indicated, at least initially, for the relief of physical pain.  But when the pain subsided and my use did not, and indeed increased; when I began to doctor-shop on the Internet and elsewhere; when I began to lie and steal in order to get my fix; when I contemplated forging prescriptions. . .I found that the addiction was for me a symptom of long-term underlying issues with which I had never dealt which were making me ill spiritually as well as physically.

I am happy with my choice to be clean, Annie, and I do realize that many do indeed require the help of narcotics to live a quality life.  I wish you well.  Once again, and in conclusion, the stigma out there is not of your making, but the solution, if there is to be one at all, will come from true chronic pain sufferers such as yourself.  If the med schools will not educate the physicians about this, then you and those like you must do so if you would have this stigma erased.  I, on the other hand, can only provide a perspective from another hell, that where prescription drugs have destroyed lives and killed people I know.  Peace to you on your journey.

Pelle
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