Drug addiction statistics and the laughable percentages!

Addiction...it's a scary thing, true! However, the statistics of someone possibly becoming addicted to any drug is 1 out of every 100,000 people. So, let's do some math: if there are roughly 50 million Americans that are treated with Oxycodone (in some form) and only 1 of every 100,000 of those people can POSSIBLY become addicted then that means 10 people/million are potential addicts. Multiply ten by fifty and that equals 500. Out of 50 million Americans taking Oxycodone only 500 people are POSSIBLE addicts. Let's look at this in terms of percentages: 0.00001% of all people taking Oxycodone could POSSIBLY become addicted to the drug. Wow! I'm not sure about you, but if my chances of becoming addicted to medication i'm taking is 0.00001%, or one billionth of a percent chance, then i really wouldn't worry about becoming addicted. In fact, to think about it is almost laughable!

In fact, one may only become addicted if they are able to achieve a "high" or "euphoria" from the drug. Oxycodone only merely changes the way a person PERCEIVES pain. Also, people with TN have SO much pain they can't ever get rid of ALL of their pain, even when taking high dosages of Oxycodone, extremely frequently. Because of this fact, one would never be able to achieve this supposed "high" from the medication. Therefore, making it physically impossible for ANYONE with TN to become addicted.

I hope this tid-bit of information helps! Maybe it will relieve some people from being scared to seek help. Don't become another statistic and commit suicide when it can be prevented, entirely! But, if after you do decide to take any pain medication and it does NOT help then there is no worry about addiction since you won't be taking it! Bottom line: don't worry about addiction: 0.00001% chance is laughable!!! LOL!

http://www.nationalpainfoundation.org/articles/134/addiction-and-chronic-pain

Addiction and Chronic Pain

By: Jennifer P. Schneider, PhD

Chronic pain, especially chronic pain unrelated to cancer, is notoriously under-treated. In 1999, the American Pain Society surveyed 805 people who had chronic pain about the adequacy of treatment they received from their physicians.1 More than 50% of the survey respondents had been in pain for more than five years, and more than 40% of respondents with moderate-to-severe pain could not find adequate relief. For most sufferers, the cause was arthritis or back disorders. Almost half of the 805 patients had changed doctors at least once. The most common reasons for changing doctors were

  • too much pain (42%),
  • didn't know a lot about pain management (31%),
  • the belief that the doctor didn't take their pain seriously enough (29%), and
  • the doctor's unwillingness to treat their pain aggressively (27%).
Only 26% of those respondents who had "very severe" pain reported taking opioids (i.e., narcotics— the strongest pain relievers available) at the time of the survey.

Opioids are medications derived from morphine or chemically similar drugs created in the laboratory. They are the most effective pain relievers we have. Opioids have been used to treat pain for thousands of years. The most commonly used opioids are morphine, oxycodone, hydrocodone, fentanyl, hydromorphone, and methadone. All except methadone are short-acting medications. If your pain is present around the clock, you are likely to do better with formulations that are released slowly in the body, lasting longer before you need another dose. Morphine, oxycodone and hydromorphone are available in pills that need to be taken only once or twice a day, and in rare cases, three times. Fentanyl is available in a patch that lasts two to three days after it is applied to the skin. Hydrocodone is available only in a short-acting form in combination with aspirin or acetaminophen.

The Myths Surrounding Opioids


Why are some physicians reluctant to treat chronic pain with opioids – the most effective available class of medications for treating pain? It's for the same reasons that many patients fear strong pain medications – the many myths surrounding the use of opioids. These myths include:

  • using opioids means you are a bad or weak person,
  • opioids damage the body,
  • people who use opioids are likely to become addicted, and
  • the body gets used to the opioid dose, which then needs to be increased again and again in order to continue getting pain relief.
Every one of these beliefs is incorrect. Below we'll go over the facts one by one and see what the reality is.

Myth Using opioids means you are a bad or weak person
Fact
Opioids are just another drug treatment for pain
Over and over again, when I've suggested an opioid to suffering patients, they say, "Morphine! That's a dangerous drug. My family would think I'm an addict," or "Methadone? That's what heroin addicts use. Not me!" Because opioids can be abused, their legitimate use for pain has become stigmatized. As a result, too many people suffer with pain.

Myth Opioids damage the body
Fact
Opioids are very safe drugs when used as directed
You may be surprised to learn that the American Geriatric Society has determined that opioids are safer for older people than anti-inflammatories (NSAIDS) such as ibuprofen or naproxen. NSAIDs can increase the blood pressure, cause gastrointestinal bleeding, and damage the kidney. Opioids do not — opioids do not damage any organs. They do have some side effects, such as nausea and sedation, but these effects rapidly diminish as you continue using the drugs. Other side effects, such as constipation, don't lessen with time, but can be prevented or minimized by taking stool softeners and bowel stimulants on a regular basis. Some men on high doses of opioids experience decreased testosterone levels, but this hormone can be replaced by using a testosterone gel or patch.

Myth People who use opioids are likely to become addicted
Fact
Most people who are treated with opioids do not become addicted
Addiction is a psychological and behavioral disorder. Addiction is characterized by the presence of all three of the following traits:

  • loss of control (ie, compulsive use),
  • continuation despite adverse consequences, and
  • obsession or preoccupation with obtaining and using the substance.
As an addiction advances, the person's life becomes progressively more constricted. The addiction becomes the addict's number one priority, and relationships with family and friends suffer. The addict's inner life becomes filled with preoccupation about the drug. Other activities are given up. Life revolves around obtaining and using the drug. This constriction is an important characteristic that distinguishes use of a drug by an addict from its appropriate use by a patient with chronic pain. Patients who take opioids for chronic pain hopefully expand their life, the opposite of what happens with addicts. Pain patients feel better and are able to increase their activities. They may begin gardening, going to movies, playing with children and grandchildren, and many are able to return to work.

A patient who is addicted to drugs may keep increasing the dose without discussing it with the doctor, might repeatedly use up the medications early, go to several physicians for opioids and lie about seeing other doctors, might inject their oral or topical drugs, or sell drugs to get money with which to buy other drugs. These behaviors are not typical of most pain patients.

Most pain patients taking opioids are not addicted to drugs. What is true of them is that they usually becomephysically dependent on the drug. Physical dependence has nothing to do with addiction. It simply means that a habituated user will experience certain symptoms if the drug is stopped abruptly. For opioids these withdrawal symptoms can include: anxiety, irritability, goose bumps, drooling, watery eyes, runny nose, sweating, nausea and vomiting, abdominal cramps, and insomnia. Withdrawal from morphine starts six to 12 hours after stopping the medication and peaks at one to three days. Longer-acting opioids, such as methadone, have a slower onset of these symptoms, and they are less severe than with shorter-acting drugs such as morphine and hydromorphone. Withdrawal symptoms can be avoided simply by tapering the drug dose over several days.

MythOpioid dosages will have to be increased because the body gets used to the drug
Fact
Significant tolerance to the pain-relieving effects of opioids is unlikely to occur
Tolerance means that a person needs more medication to continue getting the same effect. This is also true of addiction. With time, the addict needs more of the drug to obtain the same mood-altering effect. This is why cigarette smokers tend to increase the number of cigarettes they smoke. When opioids are taken for chronic pain, tolerance develops to some of the opioids' effects (e.g., nausea and sedation will lessen) but not to others (e.g., constipation and pain relief will continue as long as a patient takes the opioid). Unless the source of your pain progresses, as is true of many cancer patients, you are likely to remain on the same dose that gave you adequate pain relief when you first took the drug.

Tips for Getting the Treatment You Need


The treatment you need depends, first of all, on the diagnosis, so ask your doctor whether he or she is satisfied (s)he has finished working up your problem. For example, the solution to severe ongoing knee pain might be surgery to replace a knee joint damaged by osteoarthritis. You will need to be evaluated by an orthopedic surgeon. If medications are the key to treatment and non-opioids have not given you enough pain relief, ask your doctor what (s)he thinks about a trial of an opioid. Some doctors will be uncomfortable with this approach. You can also ask your doctor for referral to a pain clinic, where various options are available, including injections and medications. If you have been addicted to alcohol and/or drugs in the past, your doctor will be understandably reluctant to prescribe opioids. In that case, it would be worthwhile to get a consultation with a pain specialist who also understands addiction. A pain specialist with training in addiction can figure out a treatment plan that will provide you with pain relief but also addresses safety so as to minimize your chances of relapsing. This plan may or may not include opioids, depending on what substance you were addicted to, how long you've been clean and sober, and what you are doing to maintain recovery. If you have an active addiction as well as severe chronic pain, you will need addiction treatment before a physician will even consider treating your pain with opioids.

You can learn more about the various treatments for chronic pain, including medications, physical modalities, surgery, psychological approaches, and alternative treatments, by reading my book, Living with Chronic Pain (2004). The book also addresses the issues relating to pain and addiction.

Jennifer Schneider, MD, PhD, practices pain medicine and addiction medicine in Tucson, Arizona. She is the author of Living with Chronic Pain (2004), available from www.amazon.com.

References
  1. MDs struggle to treat chronic pain. The Quality Indicator Compendium on Pain, Nov. 2002, pp. 9-10.

I enjoyed that you used the tag "laughable" and "scary" with this post, as the situation facing chronic pain patients is laughable, but it is also scary considering the fact that the medical profession itself nicknamed TN, "The Suicide Disease".

So, why would they not treat it's symptoms, if it is "possibly the worst pain known to man".

I cannot find any stats out there on how many of us victims commit suicide, but obviously, many do. If opiates work in treating the symptoms of such a horrific disease, then being afraid of them, if they work, because of the rare chance that someone may become "addicted", seems more like medical negligence than ignorance, to me.

I'm tired of seeing all of the needless suffering.

If you can remember the source of your percentages, I would love to have access to it. I think many would like to print it and take it with them to appointments with their healthcare providers.

Thanks so much for this blog.

Stef

In fact, source it, and obviously, this piece needs to be "Featured", if you don't mind.

If you cannot remember the source, that's ok, but if you can, please let me know and I will append it.

Best wishes,

Stef

There have been a few stories on lately about addicts robbing drugstores and other such things, and it makes me crazy angry, makes me want to go slap them around, because of the INCREASINGLY difficult time it makes for we who are in serious pain!

Stef, can you also copy this discussion to the "Opiate Therapy" group? It is really a great discussion! Thanks Chris for doing it!

Best wishes, Sheila

Sure, Sheila! Great idea.

Consider it done.

On the topic of knocking off pharmacies: who really knows if the person was an addict? I hate to admit it but the street value of oxycontin in its various formulas probably has the highest amount of any pharmaceutical. I think that reason alone would be enough for someone (that may not necessarilly be a junky) to steal such pills for resale. Many people are forced to steal to eat, making something like robbing a pharmacy (known for having very little or no security guards present) very appealing.

Even if the person really WAS and addict i think the fact they felt they had to steal speaks volumes as to the ideas we have about what addiction is and how to treat it. Could they not have gone to a methadone clinic? Maybe methadone was simply not their drug of choice? Who is to say?

Please see:

http://facial-neuralgia.org/treatments/drugs/opioids.html

"In late summer 1996, a consensus statement was issued by the American Academy of Pain Medicine and the American Pain. This consensus proposes a necessary balance between the relief of pain and possible addictive process. It likewise addresses legitimate concerns that powerful opiates should not be diverted into the drug black market.

By patient and physician report, many face pain patients do get some relief from their pain with prescription opiates. It is documented that pain precludes healing, if there is a disease or injury process causing the pain. If there is no disease process evident, the benefits of relatively controlled pain may outweigh the negative impacts on the patient. In patients with the kind of overwhelming pain produced by TN and ATFP, addiction is seldom a problem. Frequently, the increase in functionality afforded by appropriate pain control will far outweigh the negative impacts of opiate use.

Face pain patients report success (success being defined not as an absence of pain, but of an increased level of control of the pain) using continuous doses of morphine and its derivatives. Please consult your physician, if you feel that you may be a candidate for opiate therapy. If he or she is adamant about the inappropriateness of this type of treatment, you might wish to seek referrals to a physician more sympathetic to the needs of patients in chronic pain.

The resources offered below may help you to understand the effects of medications which are prescribed for you. Some of the resources also include on-line assistance by physicians or pharmacists."


__________________________________________________________________

Please see the link below. I have probably 15 more which would concur, if further documentation is needed.
I am a real life success story, right now, because of pain management using opiates! Please take the time to hear me out, please, because I am not an addict. I am a dependent. The only thing I am addicted to is being able to live without the hellish torture which can be Atypical Trigeminal Neuralgia!
If it were not for the help of opiates and opoids, my life would be nothing but a series of falling asleep and waking up (but not really wanting to) wrecked by chronic intense facial pain which would be characterized by the root of every tooth throbbing, a vice grip feeling on both sides of my face, the feeling that someone has a branding iron on the insides of both of my cheeks, and an intense burning in my upper palate and gums. This is no way for ANYONE to have to live!

My case has been progressing for 8 yrs.
I waited 6 before going on pain medication. Before, I was in so much pain most days. One day, I wanted to die, it was so bad and I found myself begging my fiance, who I love more than you'll know, to leave me alone, as I was "no good for anyone in this condition", and trying to think of anyone who could raise my children, children I would die for, so that they would not have to see me enduring this HELL@! I wanted them to be able to be raised by SOMEONE ELSE BECAUSE IN THOSE PAIN LEVELS I WAS NOT FIT!!
Yes, in my opinion, and because of what I have experienced, LONG-TERM OPOID, or OPIATE USAGE IS SOMETIMES INDICATED TO TREAT THE SYMPTOMS OF ATYPICAL TRIGEMINAL NEURALGIA. I am only using caps, not to yell, but to get the point across about how strongly I feel on the subject.
I am currently having some days with hardly any symptoms now. I am not dingy. I don't use them dangerously, and I am not an addict. I am a dependent. I am dependent upon pain relief.
I've tried all of the usual drugs that sometimes work for TN, and rarely, for ATN. NONE OF THEM WORK FOR ME! I WISH THEY DID!
I would be a miserable wreck of a person right now, without the ones I love and without any hope if a compassionate Pain Management Physician had not mercifully prescribed me Morphine, and Roxicodone for breakthrough pain. I am just praying that these people do not retire, leave, or something like that before I can get my girls through high school, because, right now, people with this disease suffer NEEDLESSLY, and some are at the end of their ropes, because some overly cautious doctor will not prescribe opiates or opoids to them for the CHRONIC INTRACTABLE PAIN. These medications are not for everyone, but personally, I would think something with pain so horrific that they the medical profession nicknamed it, "The Suicide Disease", may warrant them TREATING THE PAIN!
Yes, it is hard for a chronic pain patient to become an addict!
I am not angry with you for your postings, but they perpetuate a misperception which could be dangerous!
Best regards,
Stef

Since we're quoting Wikipedia:

"Opiates such as morphine and oxycodone can be prescribed, and there is evidence of their effectiveness on neuropathic pain, especially if combined withgabapentin.[19][20]"

taken from Wikepedia on the topic of Trigeminal Neuralgia. Please look under the treatments section:

http://en.wikipedia.org/wiki/Trigeminal_neuralgia