Painkillers that Hurt

Opiates are the continuing focus of this week’s Recovery Place blog series on addiction education.

With roots in medicine, opiates were created to help people suffering from pain and other physical conditions.  Unfortunately, the potential for physical and psychological dependence and addiction were unexpected.

All opiates are derived either directly or indirectly from the opium poppy and its various parts.

Opiates affect the central nervous system of the body.  In addition to relieving pain and reducing severe coughs, they cause the user to feel a sense of euphoria (a high or rush) and reduce alertness.  These side-effects of euphoria and the dulling of sensations are why some people begin misusing drugs such as codeine, morphine, Percocet, hydromorphone (Dilaudid) and other opiate drugs.

Codeine, morphine, Percocet and Dilaudid are common opiate medications that all have a high potential for dependence and addiction.

This potential for addiction also means that the body and brain become used to having the drug, regardless of whether a person is using the opiate to achieve the euphoric effects or for legitimate pain control.  And this means the body will experience withdrawal symptoms when the drug is abruptly stopped after an extended period of legitimate use or misuse.

Many people who are addicted to opiates crush the tablets and smoke, snort or inject them, in order to hasten or intensify the effects of the drug.  They may need more of the opiate to get the same effect.

Morphine is one of many kinds of drugs (including medications for not only pain, but also high blood pressure, chronic heartburn, seasonal allergies and many other medical conditions) that are now available in a timed-release form.

This was great news in the pharmaceutical world, because it meant that the drug could be effectively released over time, and keeps the level of the drug in the blood consistent.  Timed-release versions of painkillers meant that cancer patients, and other patients with chronic pain, no longer had peaks and valleys in their pain control.

Oxycontin is a time release version of oxycodone, and MSContin is a time release version of morphine.  Both have huge value as a street drug and are highly addictive.  A time release version of codeine is available in Canada, and it, too, has moved from being a medical wonder to a street drug.

Why are time released drugs so valued by addicts?

By crushing an MSContin or Oxycontin tablet an addict can obtain a higher amount of drug than can be found in a single non-time release pill.  This crushed time release tablet can be taken by mouth, snorted, or injected into a vein when mixed with a solution. Using time released drugs in this way also means that a person can overdose and die.

Many opiates are combined with acetaminophen (Tylenol) in order to potentiate their effects.  This means make them work better for pain control.  Percocet, Tylenol #3 (codeine plus Tylenol), and Vicodin are examples of this acetaminophen/opiate combination drugs.  Taking large amounts of acetaminophen, whether alone or in combination with another drug, can actually damage or destroy a liver.