Prescription Drugs Articles

Opioid Tolerance Major Concern for Doctors Treating Patients with Chronic Pain

Patients under chronic pain management care with their doctor should pay close attention to the FDA warning on the labels of their medications. When you see what is known as the “Black Box” warning on a medication, this indicates the prescription drug may have serious adverse effects. Opioid-induced tolerance is becoming increasingly commonplace and doctors are very concerned about patients increasing the dosage of their medications over time. Hyperalgesia and opioid-induced tolerance are both conditions that seem to result from the long-term use of such opiate-based prescription drugs as OxyContin, Vicodin, hydrocodone and Methadone. The “Black Box” warning on opiate-based drugs means the drug has been thoroughly studied and its effects documented, and approximately 61 percent of all physicians have made note of a concern about adverse affects such as tolerance or dependency risks.

There are many risks associated with chronic pain management and the use of pain killers such as oxycodone over a long-term period. Long-term use may lead to physical changes in opioid receptors on the surfaces of cells. These receptors may experience “desensitization,” which causes the patient to feel more pain and produces the need for an increased dosage of the narcotic to get the same level of relief they once experienced. Increased tolerance to opiate-based medications is one of the first indications of a developing addiction, and anyone experiencing this should speak with their health care professional.

Recent research is beginning to show that over-stimulation of NMDA (N-methyl-D-aspartate) receptors through the chronic use of opiate drugs leads to the development of increased sensitivity to pain (hyperalgesia) and reduced pain-relief from opiates, even when the dosage is increased. In some cases of hyperalgesia, the pain can spread beyond the original pain site. NMDA-receptor activation is also associated with a variety of conditions such as dementia and Alzheimer’s disease as well.

Michael Lowenstein, who developed The Waismann Method of opiate detoxification , which uses heavy sedation to help detoxify patients rapidly from their drug dependency, encourages anyone being prescribed pain killers to become familiar with the many dangers of chronic use. Opiate tolerance can develop quickly and these powerful drugs taken to manage pain should be monitored carefully by a physician who understands the need to balance pain relief against the risks of developing addiction or hyperalgesia.

MEDNET Introduces Safe to Prevent Teenage Prescription Drug Abuse

With the increasing number of adolescents and teens abusing prescription drugs—many of whom obtain the drugs from parents or friends—it’s increasingly important to keep legitimate prescriptions safe and out of reach.

MEDNET, a national leader in premium-quality medical supplies, has formed an exclusive partnership with Axius Healthcare Group to distribute MedSafe, a safe that keeps prescription medications secured and out of the hands of children and teens.

“MedSafe is a real safe, setting it apart from medicine cabinets and other inferior lock-box products,” says Lorraine Yarde, principal of the Axius MedSafe division of Axius Healthcare Group.

“We’ve been developing this safe for five years in response to specific consumer demand. MedSafe is much more than a deterrent—it’s peace of mind for parents, grandparents, and caretakers, and provides real protection against prescription drug abuse.”

Made of high-grade steel, MedSafe ( features a biometric fingerprint reader, so its contents are accessible only to the parent or person who programs the safe. MedSafe technology has been used in the healthcare industry for years, securing medications in doctors’ offices nationwide.

“MedSafe is secure enough to store a loaded weapon, and that’s exactly what a prescription drug is when it winds up in the hands of teens and is abused,” says Rob Perissi, MEDNET’s president.

“The parallel is uncanny but pertinent, considering that one in five teens has abused a prescription pain medication, and one in 10 has abused cough medicine. Preventing access to such medications is our goal through this partnership with Axius. MedSafe is the best solution available with a proven record of over five years.”

MEDNET is the exclusive distributor of MedSafe, available in two sizes. MedSafe is ideal not only for homes but anywhere prescription and over-the-counter medications are stored in proximity of children and teens, including daycares, schools, camps and more.

Chronic Pain Can Lead to Painkiller Addiction

After suffering a foot injury, Lisa, a wife and mother in Kalamazoo, Michigan, became seriously addicted to the narcotic painkiller Vicodin, and was taking 30 pills a day at one point. Joan, a 55-year-old lifelong Kalamazoo resident, says she became addicted to opiates like Vicodin, Percocet, and codeine after necessary surgeries. She would go from doctor to doctor to obtain more drugs.

At one point, Joan was taking 20 Vicodin pills a day, along with Valium and a nightly bottle of wine. “I’m lucky I’m alive, to be honest with you,” she said.

Both Lisa and Joan, who asked that their real names not be used, are part of a nationwide problem. According to the 2007 National Survey on Drug Use and Health, an estimated 6.9 million people ages 12 or older used prescription medications for nonmedical use in the month before being surveyed. That total included 5.2 million using pain relievers, 1.8 million using tranquilizers, 1.1 million using stimulants, and 350,000 using sedatives.

Sally Reames, executive director of the local Community Healing Centers, a nonprofit substance abuse treatment agency, said as many as 30 percent of the patients in their inpatient and outpatient treatment are addicted to prescription drugs, and many have a “secondary” addiction to alcohol, which can be a fatal combination.

Jennifer Wezensky, special to the Kalamazoo Gazette, writes that Lisa was already a recovering alcoholic when she became addicted to prescription drugs. She said her pill addiction was fed by the euphoria and energy she felt when she was on opiates like Vicodin and OxyContin.

Her addiction caused a steep downward spiral that led to prescription fraud, drug court and court-ordered rehabilitation. She stole her husband’s fentanyl patches and other painkillers he needed for back pain, and replaced them with nonprescription drugs. She also had teeth pulled unnecessarily so she could get pain medications.

She also went to doctor’s offices near closing time to listen to nurses call in prescriptions; after picking up the medical jargon, she began calling in prescriptions for herself. After she was caught doing this, she went through the Kalamazoo Drug Court to avoid jail time and ended up in rehab. She relapsed several times, going through seven rehab stints between 1994 and 2003.

Lisa has now been clean for six years and is especially proud that she was able to remain clean after tragedy struck in her family (her husband recently died unexpectedly).

Joan sought help after she lost her job and her marriage ended. She went through detoxification at a hospital and is now in a 12-step recovery program with 16 years clean and sober.

“I had a hole, and I tried to fill that hole up with alcohol and with pain pills,” she said. “Most people that get addicted to pain pills don’t start out with the intention of getting addicted. Most start out with a legitimate medical reason. It works so well on the physical pain, you think, ‘Why not have it work on the mental pain?'”

Dr. Michael Liepman, a professor of psychiatry at Michigan State University Kalamazoo Center for Medical Studies and medical director of the Jim Gilmore Jr. Community Healing Center, says that people often mistakenly believe that prescription drugs are safe because a doctor is prescribing them.

Many patients who end up addicted to prescription drugs start with a legitimate pain condition. They develop a high tolerance for the drug, and it takes more and more of it to achieve the same effect.

“Sometimes people think, ‘If one pill makes me feel better, three will be better,'” said Dr. Richard Tooker, chief medical officer for Kalamazoo County. In the case of pain killers derived from opium, increasing the amount taken can be deadly because these drugs decrease brain activity, breathing rates and heart rates.

“Take three pills and maybe you wake up feeling better, or take three pills and maybe you end up dead,” Tooker said. “You’re really playing Russian roulette with your life.”

For some people, drugs as prescribed don’t give a strong- or fast-enough high. So they start taking handfuls all at once, mixing them with other drugs, chopping up the pills and snorting the powder or injecting a liquid solution made from the pills, Liepman said.

The prescription drugs that Reames has observed are most often abused are Vicodin, OxyContin, and the anti-anxiety medication Xanax. Liepman said he sees extensive addiction to opiate pain killers, anti-anxiety drugs such as Xanax, Klonopin, and Ativan as well as abuse of drugs prescribed for attention-deficit hyperactivity disorder.

Patients with physical addictions who decide to stop taking opiate drugs will go through withdrawal, which can be treated in an inpatient detox program. Opiate withdrawal can feel like a severe case of the flu, with hot and cold sweats, severe aches, anxiety, tremors, nausea and diarrhea, Liepman said.

Liepman said people trying to go off opiates sometimes need something else to help deal with the pain. Many addiction-savvy doctors will put patients on a drug called Suboxone, which is a less addictive opiate substitute that reduces cravings for opiates and provides pain relief, he said. It blocks the effects of other opiates so it prevents abuse. And if you take too much of it, it blocks itself.

It is easier for the recovering addict to manage this pain medicine than the other kinds they have abused, Liepman said.

Anti-Drug Efforts Shift from Marijuana to Prescription Drugs

Over the years, the US government has quietly shifted the focus of its anti-drug efforts from marijuana to prescription drugs. A CBS News survey of government and nonprofit anti-drug groups has found fewer anti-marijuana campaigns over the past several years as prescription and over-the-counter drug abuse has soared among adolescents.

According to a CBS article, the change comes as a result of the decline in marijuana use among teens and growing worry over the abuse of prescription drugs. In fact, the Partnership for a Drug-Free America hasn’t produced a single anti-marijuana ad since 2005.

Marijuana use has been declining for 10 years and past-month use is down 25 percent since 2001, according to the University of Michigan’s “Monitoring the Future” survey, the largest tracking study in the US.

However, prescription drug abuse has been steady over the past five years, with nearly one in five teens abusing prescription medication. The Partnership for a Drug-Free America even refers to young people today as “Generation RX,” pointing to prevalence of this dangerous habit.

The Office of National Drug Control Policy now dedicates all of its campaign resources directed at parents—about $14 million dollars since 2008—to prescription and over-the-counter drug abuse.

“The issue of prescription drug abuse, which the Office of National Drug Control Policy has been shouting about from the rooftops, it is a significant problem in this country,” National Drug Control Policy Director Gil Kerlikowske said on “The Early Show” last week.

A report issued by the Florida Department of Law Enforcement indicated that prescription drugs caused more deaths than illicit drugs, including alcohol-related car accidents. Prescription drugs were the cause of more than 25 percent of drug-related deaths in the state, and marijuana was not listed as a cause of death in Florida last year.

The National Survey on Drug Use and Health from the Department of Health and Human Services says that there are now more abusers of prescription drugs each year than there are abusers of marijuana. About 2.15 million people started using prescription pain relievers to get high in 2007, whereas 2.09 million people started using marijuana that year.