Are You at Risk of Opioid Addiction?

For the majority of patients, opioid treatment provides short-term pain relief after surgery, when recovering from injury or when pain from illness becomes incapacitating. However, it is possible for a small number of people to become addicted to opioids even when they take them as prescribed, according to the National Institute on Drug Abuse (NIDA).

“By working together, patients and their physicians can prevent addiction and abuse,” says Richard Jermyn, DO, the director of the Neuromusculoskeletal Institute in Stratford, New Jersey.

Focusing on preventive care, Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to consider how environmental and lifestyle factors impact your health. Addiction is a preventable illness, and DOs understand that your family and personal history can indicate whether you could be susceptible.

Signs of Trouble

An estimated 2.1 million Americans suffer from substance abuse disorders related to prescription opioid pain relievers, according to NIDA, leaving patients and physicians to balance the need for relief against the risk of addiction.

It might be time to see your physician if you notice these patterns of behavior:

• Watching the clock closely in anticipation of the next pill.
• Combining pills with other drugs or alcohol.
• Increasing the dosage—either by reducing time between pills or taking extra medication.
• Crushing or altering pills to increase their effects.

“Patients who are unlikely to abuse medication are often those most afraid to take it, while at-risk patients often don’t recognize that they are vulnerable,” Dr. Jermyn says.

How Opioid Addiction Happens

Opioids include drugs such as OxyContin and Vicodin, which attach to receptors found on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs in the body. Opioid medications can produce a sense of well-being and pleasure because these drugs affect brain regions involved in reward.

When opioids are taken over time, the body stops making its own reward chemicals– like endorphins and encephalins—and the user becomes dependent on the medication to avoid withdrawal symptoms.

“No one sets out to become an addict, but abuse rates among pain patients mirror the general population, where we find about 7% are dependent on illicit drugs,” Dr. Jermyn explains.

As an osteopathic physician, I work with patients to help us both understand if they are susceptible to prescription drug abuse.

Osteopathic physicians take a whole-person approach to care, reviewing patient and family history to determine susceptibility to addiction. It’s increasingly common for all patients, regardless of their risk profile, to be regularly tested to confirm their dosages are appropriate and safe.

Who is at risk?

You could be susceptible to developing an opioid addiction if you are between ages 16-45 and have:

• A family or personal history of substance abuse, including alcohol, medication and illicit drugs.
• History of preadolescent sexual abuse.
• Personality factors, including ADD, OCD, bipolar disorder, schizophrenia and depression.

“It’s important to recognize that opioids are sometimes the most effective pain treatment for patients, regardless of their risk profile,” Dr. Jermyn says. “But it’s not the only line of defense. We work with patients to devise a multi-pronged approach, alternating or rebalancing medication to minimize risk and speed recovery.”