Prescription Drug Dangers: How to Spot an Addict in Your Clinic

According to the CDC, two people die every single hour from overdosing on prescription opioids. In fact, death from prescription drug use is the 4^th leading cause of death in the United States.

Most people assume that any treatment prescribed by their physician will promote their health and well-being. And for the most part, this is true. But unfortunately, when it comes to prescription drugs, they can be dangerous and deadly.

The National Institute on Drug Abuse reports: “Increases in prescription drug misuse over the last 15 years are reflected in increased emergency room visits, overdose deaths associated with prescription drugs, and treatment admissions for prescription drug use disorders, the most severe form of which is addiction. Among those who reported past-year nonmedical use of a prescription drug, nearly 12 percent met criteria for prescription drug use disorder.” Here’s a common scenario: David, a college athlete, hurt his ACL playing football. He underwent ACL repair and was prescribed post-operative pain medication. Two weeks later, David’s pain begins to dissipate, but he requests additional pain medicine to help cope with his physical therapy treatments. His doctor obliges and submits a refill. David believes that taking the medication is aiding his recovery as he is able to tolerate PT and increase his range of motion. Over the next six weeks, David continues to show improvement in therapy but unfortunately, his dependence on narcotics has now become an addiction. According to The Substance Abuse and Mental Health Services Administration: “This problem is snowballing due to increased availability of these drugs, less oversight on inappropriate prescriptions, and drug users’ perception that the drugs are not as dangerous as they actually are. Because these drugs are prescribed by doctors, who are highly respected professionals in our society, people tend to perceive them as less harmful than they potentially can be. There are a number of judgment biases in the field of psychology that explain how perceptions of prescription pills become warped in the minds of their users. Prescription drug users may suffer from the risk compensation effect, believing their drug to be safe because they have a prescription from a doctor. They believe they can appreciate the drug for its sensational effects instead of its assistance in daily functionality and adjust their dosage as they please.” Prescription Drug Dangers: The Most Common Medications Causing Addiction Patients can become addicted to a variety of medications: stimulants, anti-depressants, sleep aids, etc. But, the most common drugs that lead to addiction are in the opioid class:

• Methadone (such as Dolophine®)
• Oxycodone (such as OxyContin®)
• Hydrocodone (such as Vicodin®)
• Morphine
• Fentanyl
• Codeine

Opioid medications are surprisingly easy to obtain. In 2010 alone, an estimated 210 million prescriptions for opiates were dispensed. As healthcare professionals, it’s important to monitor our patients for addiction, and get them the help they need before it’s too late. But, how can you spot an addicted patient in your clinic versus a patient who truly requires pain medication? How to Spot an Addict in Your Clinic The top signs of prescription drug addiction in patients include:

• Complains of vague symptoms to get more medication.
• Uses more than the recommended dosage of medication or develops a high tolerance.
• Lack of interest in treatment options outside of medications.
• Reports of “losing” medication bottles.
• Seeking medication for new sources of pain.
• Expressing overwhelming concerns about the continued availability of pain medication in the future.
• Asking about seeing another physician who can prescribe medication or asking the rehab professional to prescribe medication.
• Reports of alienation, withdrawal, or new conflicts with friends or family.
• Reports not being able to return to work or missing work.
• Taking prescription medications prescribed to other individuals.
• Experiencing mood changes, such as becoming defensive, hostile, agitated or anxious.
• Complains of flu-like symptoms such as joint pain, body aches, sweating, or insomnia.
• Acts secretive or deceitful.
• Continues using the medication “to relax” or “to fall asleep” after pain has ceased.

Aside from the patient’s complaints, family members may report changing physical or behavioral symptoms. Pay attention and make note if any caregivers, family or friends mention one or more symptoms of the patient:

• Confusion or forgetfulness
• Mood swings, anxiety, anger or hostility
• Dehydration or dry mouth
• Dizziness, weakness, or lack of coordination
• Low blood pressure
• Changes in sleep habits – either sleepiness or insomnia
• Slurred speech
• Flu-like symptoms
• Droopy eyes
• Changes in appetite
• Skin irritations or rashes
• Acts “distant” or has a loss of interest in activities or work/school
• Acts secretive or deceitful
• Sudden financial problems or asking to borrow money

If you are concerned about a patient’s medication dependence or addiction, talk with him/her. Also, be sure to communicate your concerns with the treating physician. Last, you can find and share details about a treatment program nearby with this Substance Abuse Treatment Facility Locator: www.findtreatment.samhsa.gov References: <1> https://www.cdc.gov/drugoverdose/data/overdose.html <2> https://drugabuse.com/library/opiate-abuse/ <3> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC315480/