One of my clients recently asked me in a guilt ridden voice how she could have missed her partner’s addiction to pain pills. After all, addiction can be easy to spot. If you’ve ever seen the HBO series, “Shameless”, you know without question that Frank Gallagher is an alcoholic. In the movie, “Trainspotting”, the downward spiral of the life of the straight-laced friend turned heroin addict unfolds right before your eyes. In the movie, “The Fighter”, Dicky’s crack addiction is blatant to those who choose to see.
However, as my client and I discussed, pain pill addiction is not always so obvious — neither to the person themselves nor to their surrounding loved ones.
According to the “Oxycotin Express” documentary pain pill use has taken first place over heroin, cocaine, and ecstasy combined. Perhaps the biggest danger about this statistic is that opioids are regularly used as medicine which means that addiction can be masqueraded as appropriate self-care. How can this happen? Rational reason for use, ease of access, and lack of normal addiction indicators can lead to oblivion of actual circumstances.
Before we explore pain pill use and addiction, it is important to note that there is not always a connection between the two. People often times use the medication appropriately and it serves the purpose for which it was prescribed. However, for a percentage of the population use can lead to abuse and eventual addiction. Pain management after an injury is one of the ways in which pain pill addiction can develop. The euphoric state delivered in a legal and often times prescribed pill can provide a relief that feels too good to be true. A central figure in the above-mentioned documentary demonstrates the slippery slope from medically appropriate pain pill use to addiction as a quick trip downward. He had been a high school football star with a future full of options until he suffered a life changing back injury. He said that he didn’t know he had an addiction issue until he punched a hole in the wall after his dad took away his prescribed opioid medication. In this man’s case, the medication that was (at least initially) appropriately prescribed ended up being a gateway drug. Pain pill addiction led to heroin addiction and participation in a film that documents the desperate state of affairs of medication that has become a primary product for many drug dealers.
The ease with which one can get pills removes obstacles in becoming, and remaining, addicted. Pain pills can be obtained in several different ways, none of which needs to include taking a road trip to the west side of Chicago. A real estate executive interviewed by CBS in February explained that all he has to do to maintain his addiction is make a quick phone call . Other reliable paths to synthetic euphoria include the emergency room, the doctor’s office, a family member or friend, and the Internet.
Normally when someone is addicted to a substance there are clear indicators. Apart from the obvious physical evidence, non-tangible clues include loss of self-control and disconnection with family, friends, and life in general. The substance becomes the most important thing – metaphorically the love of his or her life. With pain pills, however, the bottles can seem harmless, there are no needles to hide, no pipes to keep out of site, and depending on the gravity of the addiction, impairment is not always obvious. Until something extreme happens, it may seem as if the addicted person is quite content and happy. This lack of normal, obvious information creates a grey area when it comes to determining medically appropriate and inappropriate opioid use. One mom, whose son died of a pain pill overdose, recommends following your instincts and not relying on stereotypes to determine what an addict looks like .
As previously mentioned, people often use pain pills without becoming addicted. Pain medication can be safe and effective when used as directed by a medical professional. When taking opioids for medication, the following steps can prove helpful:
- Be honest with your doctor about substance abuse history
- Educate yourself on the medications you are prescribed
- Adhere to prescribed dosages
- Work closely with providers and loved ones to monitor your symptoms and recovery
Lastly, there are alternative treatment options for chronic pain. According to Barry Meier, New York Times reporter and author of the new e-book “A World of Hurt: Fixing Pain Medicine’s Biggest Mistake,” opioid treatment can be replaced by a more effective plan including intensive physical therapy, behavioral counseling, and intensive psychological counseling .
If you suspect that you or someone you care about may be suffering with an addiction, contact your EAP. If your EAP is Perspectives, please call 800-456-6327 and one of our counselors will talk with you and recommend appropriate next steps. When using Perspectives’ EAP, all conversations are confidential and our services are free for use.
Written by Colleen O’Brien, LPC, who is an Employee Assistance Program Counselor for Perspectives Ltd. She holds a MA in Counseling and Organizational Psychology from the Adler School of Professional Psychology and is a licensed professional counselor.