Addiction to opiate-based painkillers: the facts

[KomodoMK]

Medicines containing opiates can include cough/cold treatments, painkillers, analgesic tablets and capsules, and some diarrhoea medication, according to the Over-Count Drugs Information and Advice Agency.

A type of opiate, codeine has the same roots as heroin and cocaine; in fact, in 1898 a German company patented heroin and began to sell it as a cure for the common cough.

Codeine acts as a depressant on the central nervous system, and effects can include euphoria and relaxation but also mental detachment.

During a recent interview with the BBC, a neurologist was quoted as saying that it "took as few as six or eight [painkiller] tablets a week", consumed over an extended period, to develop dependency.

Some of the risk in over-the-counter (OTC) preparations is also linked to paracetamol content. While the drug is convenient due to its rapid absorption properties, even in limited doses it can damage the liver. Overdoses can be fatal. Paracetamol was introduced in the UK in 1956 as a prescription-only drug; it was then added to opioid analgesics such as codeine and dihydrocodeine after 1963.

White-collar employees working long hours and prone to tension headaches are those most likely to become addicted to painkillers, according to Dr Alan Wear, medical director of the rehab centre Priory Hospital Marchwood in Southampton. What starts as "a couple of paracetamol before work" can soon escalate into "frightening quantities" of tablets on a daily basis, he says.

Others vulnerable to addiction include those taking treatments for pre-menstrual pain, back pain, or insomnia.

Dr Robert Lefever, director of Promis rehabilitation clinics, notes that painkillers can become "just as addictive" as illegal drugs. The difficulty, however, lies in recognising an addiction to a drug that does not initially appear 'serious'.

[sbt8080]

Thanks for the post, but with all do respect, you didn't really post any "facts."

a neurologist was quoted as saying that it "took as few as six or eight [painkiller] tablets a week", consumed over an extended period, to develop dependency.

6-8 tablets of which drug? And what dosages? And who's the neurologist?

Some of the risk in over-the-counter (OTC) preparations is also linked to paracetamol content. While the drug is convenient due to its rapid absorption properties, even in limited doses it can damage the liver.

What "limited doses" can damage the liver? Etc.

I understand that you may not have written this yourself, but please provide a source if you copied it from somewhere. Simply giving a subject line of "...the facts" indicates that you have some specific knowledge and/or detailed information to share.

Thanks.

[0utrider]

besides cocaine and codeine being of same roots?

outriderx added 1 Minutes and 22 Seconds later...

but this thread kinda inspired me: how about a thread with actual FACTS about dependence and neurology/brain chemistry ?!

[fiveleggedrat]

Everyone loves statistics

[0utrider]

not only statistics but more factual things like: does opioid addiction actually change brain chemistry

[fiveleggedrat]

Well, Swim does not have any of those, but he found this.

Heroin Statistics

• According to Drug Abuse Warning Network, or DAWN, heroin and morphine accounted for 51% of drug deaths ruled accidental or unexpected in 1999.
• Heroin is a highly addictive drug, and its use is a serious problem in America. Current estimates suggest that nearly 600,000 people need treatment for heroin addiction. Recent studies suggest a shift from injecting heroin to snorting or smoking because of increased purity and the misconception that these forms of use will not lead to addiction.
• In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs.
• The number of ED visits involving heroin/morphine increased 15 percent, from 84,409 to 97,287
• The route of administration among heroin users entering treatment has been changing. In 1993, 74% of admissions for heroin abuse were injectors. By 1999, this had declined to 66%. There was an increase in admission for heroin inhalation for 23% in 1993 to 28% in 1999.
• In 2000, as part of DAWN's year-end emergency data report, heroin related emergency room visits increased 15% from the last year.
• According to the University of Michigan.s Monitoring the Future Study in 2002, 1.6% of 8th graders, 1.8% of 10th graders, and 1.7% of 12th graders surveyed reported using heroin at least once during their lifetime. That study also showed that 0.9% of 8th graders, 1.1% of 10th graders, and 1% of 12th graders reported using heroin in the past year
• In another study, of those high school students surveyed in 2001 as part of the Youth Risk Behavior Surveillance System, 3.1% reported using heroin at least once during their lifetime. Male students (3.8%) were more likely than female students (2.5%) to report lifetime heroin use.
• During 2001, wholesale prices for South American heroin ranged from $50,000 to $250,000 per kilogram. Southeast and Southwest Asian heroin wholesale prices ranged from $35,000 to $120,000 per kilogram, and Mexican heroin ranged from $15,000 to $65,000 per kilogram. Street-level heroin usually sells for $10 per dose, although prices vary throughout the country.
• The heroin addict spends between $150 to $200 per day to maintain a heroin addiction.

Not much, I know. Let's see what else I can find.

• Approximately 3.5 million Americans aged 12 or older reported trying heroin at least once during their lifetimes. (ONDCP)
• According to Drug Abuse Warning Network, or DAWN, heroin and morphine accounted for 51% of drug deaths ruled accidental or unexpected in 1999.
• Of an estimated 108 million emergency department (ED) visits in the U.S. during 2005, the Drug Abuse Warning Network (DAWN) estimates that 1,449,154 were drug-related. DAWN data indicate that heroin was involved in 164,572 ED visits.

Can't find anything about changes in the brain, but that is something Swim wonders, especially ever since the opioid tramadol stopped having effects on him, but no other opioids seem to be affected. Not tolerance/addiction related.