Many people go to their doctors for treatment of an injury and are given a narcotic medication like vicodin or Percocet. These medications work initially, but over time two things happen; they tend to lose their effectiveness, and when a person stops taking them the person feels very sick. Both of these are signs of physical dependence, and are referred to as tolerance and withdrawal.
In addiction the medications have effects on how the person feels that go beyond pain; people feel a sense of warmth and pleasure from the medication and often use the medication to temporarily relieve anxiety, tenseness, insomnia, or even fatigue. When the medications are stopped on the other hand the person has ‘rebound’ of these symptoms, and feels much worse than before starting the medication. Because of tolerance, patients often take more pills than prescribed, causing them to run out early; when they call the doctor they are suddenly treated as if they have done something wrong. Sometimes they are scolded; perhaps it is even worse when nobody says anything out loud, but instead the patients detects ‘little looks’ from the doctor’s staff or rude treatment that suggests that people in the office are thinking of them in a negative way. Patients wonder if they are imagining things, or if people are really talking about them.
Effects at Home
At home the patient on pain pills becomes more and more irritable. He is worried about running out early and having the return of pain, or even withdrawal symptoms. He feels sick more often. He has become more depressed. He starts to feel as if nobody understands him, and he takes more and more of the pain pills to try to keep his mood and energy level up so that he can go to work. The fights at home become more and more frequent, and he feels more and more alone inside.
Use ‘on the Street’
In other cases this same sequence will occur, but instead of starting win injury it starts with experimentation. A person is given the pills by a friend, or finds them in a parent’s medicine cabinet. Or maybe the person has been feeling down, and notices that the codeine that they took for their wisdom tooth surgery made them feel better, and so makes up an injury so that the doctor will prescribe more.
In all of these cases the people involved become more and more depressed and more and more sick and tired, eventually reaching a level of desperation. This is the good outcome; other people find medications that are more and more potent, and accidentally take too much— causing a fatal respiratory arrest.
Treatment is Available
Until recently there was one primary treatment for this type of addiction— residential treatment for one to three months in a treatment center. Yes, another option is to attend AA or NA (Narcotics Anonymous) meetings, but meetings alone rarely make headway against opiate dependence. Another option that has been available is ‘maintenance treatment’ in a methadone program. This type of treatment carries a number of inconveniences, including the need to report to the treatment center each morning to receive the medication.
We now have a third treatment option— buprenorphine or Suboxone— that has saved countless lives. This treatment option is almost universally effective given one requirement: the person must be truly sick and tired of taking the pills and must be motivated to get better.
If you or a loved one suffers from addiction to these medications I strongly encourage you to seek out more information and to learn about your options. Life is too short to remain miserable .
Jeffrey T Junig MD PhD
Suboxone Talk Zone