Abuse of Prescription Pain Relievers: Oxycodone (OxyContin), Hydrocodone (Vicodin), Hydromorphone (Dilaudid)
Whether swallowed, snorted, smoked, or injected, these drugs are highly addictive, pose serious overdose dangers, and their unlawful use results in serious criminal penalties.
These painkillers are often termed opiates because they are similar in effects to drugs from the opium or poppy plant. The drugs are also called narcotics. Heroin is an opiate that has no legal use in the U.S.
The drugs covered here include: Opium/morphine/codeine; Oxycodone (trade names include Percodan, Percocet and OxyContin); Hydromorphone (Pallodone, Dilaudid); Hydrocodone (Vicodin, Lortab); Meperidine (Demerol); Fentanyl; Methadone; and Buprenorphine
All of these opiate-like drugs are useful, safe, and appropriate drugs when prescribed by a physician for legitimate medical purposes. They are manufactured, distributed, and sold under strict regulation by federal and state governments.
Use or possession of these drugs by anyone not the holder of a lawful prescription is a crime subjecting the offender to serious criminal penalties including imprisonment. Unlawful (no valid prescription) possession and use of these drugs by a Loyola student will constitute grounds for suspension or expulsion from the University.
Abuse of these opiate drugs has increased in recent years on college campuses, especially by snorting or smoking of the drugs rather than by intravenous use. Users believe that avoidance of dangers associated with I.V. use, such as HIV and hepatitis disease, by snorting or smoking the drugs, reduces the dangers of physical dependence, addiction, and overdose. That belief is dangerously incorrect.
Dangers Associated with Non-Prescribed Use of Opiates
Let’s use oxycodone as an example. Like other narcotic medications, oxycodone can impair mental and physical abilities, and is a central nervous system depressant. Side effects include breathing irregularity or respiratory depression, headaches, nausea, dizziness, seizures, low blood pressure, and heart failure. Overdose death is possible due to cardiac arrest or slowed breathing, especially when ingesting or snorting crushed OxyContin. Users crush the drug to break the slow release mechanisms in the drug and get the full effects right away.
Overdoses can cause death, coma, and brain damage, often brought on by respiratory failure. The symptoms can begin soon after the drug is taken. Symptoms of overdose include:
- Slowed breathing
- Contracted pupils
- Clammy or cold skin
Addiction and Physical Dependence
Addiction basically means a pattern of use of a drug despite adverse consequences. What is important is not necessarily how often the addict uses, but what happens when he/she does use. The addict may not be physically dependent on the opiate in order to have an addiction.
Here is the formal definition of addiction: a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. This is the crucial part: addiction is characterized by behaviors that include one or more of the following: impaired control over drug use (loss of control), compulsive use, continued use despite harm, and craving.
Physical dependence: a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist ( a drug that causes withdrawal).
Any individual that takes an opiate, regardless of the reason, will, after use every four hours or so, over a week to 10 days (or less), become physically dependent on the drug and go into withdrawal upon abruptly stopping use.
Tolerance: a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time. In other words, over time, the user needs more of the drug to get the desired effects.
It is possible to be physically dependent on a drug (with tolerance and withdrawal syndrome) without having addiction (as defined above), and conversely, it is possible to have an addiction without being physically dependent (developing tolerance and withdrawal syndrome).
There are many examples of physical dependence on drugs without development of addiction. One would be the patient with cancer who becomes tolerant to, and physically dependent on, opiates prescribed by a physician to control pain. Such a patient may experience withdrawal symptoms with discontinuation of the usual dose, but will not experience social, psychological, or physical harm from using the drug and would not seek out the drug if it were no longer needed for pain relief.
An example of addiction to opiates that can occur without physical dependence (tolerance/withdrawal) is a patient with an oxycodone addiction who has been recently detoxified from the drug. In this situation, the patient may no longer be suffering from withdrawal symptoms or tolerance but may continue to crave an opiate high and will invariably relapse to active opiate abuse without further treatment.
Withdrawal and Recovery
Withdrawal from physical dependence on opiates, absent presence of a serious complicating medical condition, is not a life threatening situation, and is often described as feeling like a bad case of the flu (one feels as if he/she will die, and maybe wishes to do so, but doesn’t). Narcotics addicts have a genuine terror of getting sick and suffering withdrawal. This fear can be a serious obstacle to treatment with abstinence as the goal.
The short term withdrawal, as unpleasant as it may be, is the easy part of recovery. Recovery from opiate addiction is possible, but is difficult. The opiate addict needs comprehensive treatment and support in order to put together a long term recovery. Treatment often includes completion of a residential treatment program or of an intensive outpatient treatment program, and regular, preferably daily, attendance of Twelve Step meetings such as Narcotics Anonymous.
Any Loyola student with concerns about drug addiction may call Jan Williams, director of Loyola’s Alcohol and Drug Education and Support Services, to schedule a confidential appointment: 410-617-2928.