Prescription Painkiller Addiction Linked to Substance Abuse History

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People With History of Substance Abuse More Likely to Misuse Prescription Painkillers

April 28, 2015 Drug Addiction

New evidence from a group of American researchers points to drastically increased risks for prescription opioid addiction in people who already have a history of abuse/addiction related to the consumption of non-opioid substances.

Prescription opioid addiction is a pressing and fairly widespread problem in American society. In a study published in February 2015 in The Journal of Pain, researchers from three U.S. institutions gauged the impact that a history of non-opioid-related substance use disorder (substance abuse and/or substance addiction) has on the odds that a person receiving therapeutic doses of an opioid medication will develop an opioid addiction. These researchers concluded that a substance use disorder history steeply boosts a legitimate prescription opioid user’s addiction risks.

Substance Use Disorder

The American Psychiatric Association (APA) uses the term substance use disorder as a convenient catchall for all instances of separate or combined symptoms of diagnosable substance abuse or substance addiction. When doctors diagnose these symptoms in their patients, they actually use the name of the specific substance producing problems in the individual. For example, people with diagnosable abuse/addiction issues related to the consumption of cocaine or methamphetamine have a condition called stimulant use disorder, while people with diagnosable abuse/addiction issues related to the consumption of marijuana or other forms of cannabis have a condition called cannabis use disorder. All told, the APA maintains nine subcategories of substance use disorder associated with the use of specific substances, as well as a number of miscellaneous subcategories.

Prescription Opioids and Addiction

Throughout the 21st century, opioid medications have consistently been the most heavily misused prescription substances in the U.S. When taken properly under the guidance of a doctor, these medications play a prominent role in easing the damaging effects of moderate or severe pain. However, when consumed in excessive amounts and/or used without the benefit of medical guidance, opioid medications come with a clear risk for the onset of opioid addiction (one of the chief components of the substance use disorder subcategory called opioid use disorder). This is true because all opioid substances can produce lasting and dysfunctional changes in brain function when consumed repeatedly over time. People in the U.S. develop opioid medication addictions far more often than they develop addictions to the opioid street drug heroin. They also overdose on opioid medications far more often than they overdose on heroin.

Impact of Pre-Existing Substance Problems

In the study published in The Journal of Pain, researchers from Case Western Reserve University and two branches of the Cleveland Clinic used a project involving 199 adults to assess the impact of pre-existing, non-opioid-related substance problems on the odds that a person receiving an opioid medication for pain will develop an opioid addiction. All of these adults were receiving prescription opioids as part of a long-term attempt to cope with medically serious pain.

After analyzing the substance use histories of the study participants, the researchers concluded that, overall, a pre-existing history of non-opioid-related substance abuse/addiction increases the odds that a person receiving opioids for pain will develop an opioid addiction by 2,700 percent. They also concluded that the risks for opioid addiction in people with such a history go up by roughly 100 percent with every 50 milligram increase in the amount of opioid medication consumed on the average day. The risks for addiction increase by approximately 200 percent with every 100 mg increase in daily dosage.

The study’s authors note that an unexpectedly low dose of an opioid medication can boost the odds of opioid addiction in a person who has already experienced diagnosable problems with other types of substances. They believe that doctors can use daily opioid dosage as a relatively accurate gauge of the addiction risks in populations known to have pre-existing substance issues.

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