Due to the risk of addiction, physicians carefully monitor Vicodin use even when it is being used to treat long-term pain. Addiction occurs when the person develops a physiological and psychological dependence upon the drug. These dependencies are very real and therefore extremely difficult to overcome without outside help.

Vicodin and other opioids work to block pain by binding to specific pain receptors throughout the body. In this way, the message of pain is blocked from reaching the brain. Some experts argue that long-term use of opioids like Vicodin actually makes a person more sensitive to pain, thus driving their perceived need for the drug. Addiction also occurs in part because over time the body adjusts to the medication and eventually demands more in order to get the same level of relief. In either case, the person winds up craving more and more of the drug.

But not only does Vicodin blunt the feelings of pain, it moderates a person’s experience of pain by accentuating dopamine behavior in the brain. Dopamine is the brain chemical responsible for pleasant emotions. Not just the strong rush of euphoria that is associated with drug abuse, but all the desirable emotions which range from enjoying a sunset to the thrill of romantic feelings are connected to dopamine levels in the brain. A person becomes addicted to Vicodin because eventually all these pleasurable emotions start to feel elusive in the drug’s absence. The person now senses that they need the drug in order to feel any degree of normal happiness.

Alongside the very real physiological impact of the drug, is the risk of psychological addiction to Vicodin. This is especially true for those with a personal or family history of addiction or those who live in an environment which is sympathetic to drug abuse. Psychological dependence means that without physical reason, the person is convinced that they must use a substance in order to carry on with their everyday life. Psychological dependence is often part of the experience of addiction. Even though Vicodin addiction cannot be predicted with complete accuracy, when the drug is taken properly the risk of addiction is under ten percent. However, if these risk factors are present the potential for addiction rises sharply.

A person can become addicted to Vicodin. Misuse and abuse of Vicodin can become all-consuming which negatively impacts personal relationships, work or school performance and a person’s ability to enjoy interests and activities not connected to the drug. Drugs like Vicodin are controlled substances precisely because they can so quickly and easily wreak havoc in a person’s life.

Yet, the fact is that more Americans die each year from drug overdoses than from automobile crashes, and more of those overdoses are opioids than from heroin and cocaine together. People are misusing prescription drugs and it is a public danger.

A recent article on Science Daily referenced an opinion piece which appeared in the Journal of the American Medical Association (JAMA). That piece, written by a physician, decried the current over-prescribing of opioids that is taking place in doctor’s offices across the country.

The article suggested that the ever-growing number of prescriptions written for pain management may be partly to blame for the greater number of deaths through drug overdose and almost certainly fuels the black market for prescription opioids.

The article discussed efforts on the part of health insurers to stem the tide of opioid prescriptions sought out by patients through limiting opioid orders to a single prescriber. This measure is intended to halt doctor shopping, but as the writer pointed out, there still remains a flood of legally prescribed drugs out in the public sector.

The doctor chidingly pointed out that it is too easy to write a prescription without first exploring other possible treatments. That practice, he says, is not best for the patient and certainly does nothing to help efforts to stop illegal opioid abuse.

The glut of opioids out there in American homes, in the medicine cabinet and on store shelves is problematic. It isn’t only leading to drug overdoses; it is also leading to more addiction and more crime. There are stats to show the clear connection.

Throughout the last ten years, many issues have helped contribute to the abuse of opioid painkillers. One such factor is that doctors who are already overworked, may feel it’s easier to issue a painkiller prescription than take the necessary time to administer addiction therapy.

According to an article featured at Med Page Today, another problem is the declining reimbursements for such treatment.

Patients these days are also a lot less tolerant of pain than in the past, possibly because of the widespread availability of various pain medications. Those facing chronic pain are adding another layer of pressure to doctors. And, per Dr. Anna Lembke of Stanford University, this added pressure may lead doctors to prescribe medication to someone they know is probably abusing it.

In addition, doctors who don’t issue prescription pills for someone pleading in pain could be viewed as uncompassionate or uncaring. They are essentially at the mercy of the patient when it comes to ratings and customer satisfaction surveys.

Standing firm and telling a patient no when it is believed that pain killers are not necessary or are likely to be abused could result in negative backlash in the form of poor service scores. Lembke adds that in some hospitals and clinics, patient surveys are tied to doctors’ job security and compensation.

Compounding the problem is the fact that treatment of pain pays, while spending the necessary time to invest in a patient’s addiction therapy does not. Because of diminishing reimbursements, many psychiatrists are even shying away from taking insurance.

According to Lemke, the answer lies in education. She says many doctors don’t know that there are new billing codes available that permit reimbursements for addiction treatment. She recommends that physicians learn more about addiction through CME courses and says that clinicians should have the ability to review a patient’s drug history through a prescription drug monitoring program prior to issuing controlled substances.

Researchers, experts from the Prescription Drug Monitoring Program Center for Excellence at Brandeis University’s Heller School for Social Policy and Management, assessed existing prescription drug monitoring programs (PMDPs) across the U.S. and found a veritable “patchwork” of strategies and standards.

The epidemic of prescription drug abuse in America is not only devastating to families, but drains state and federal time, manpower and money.

“Being proactive is the key to success in the fight against prescription painkiller abuse,” said John L. Eadie, Director, PDMP Center of Excellence at the Heller School for Social Policy and Management, Brandeis University. The problem is, as Eadie outlines it, that where doctors might routinely collect and report data to a state program that signals where and when prescription painkillers, for example, are being abused, the state program may not share that information with others who may need it.

Principal investigator of Brandeis’ Center for Excellence, Peter Kreiner, said that state programs should analyze the data they collect and then “reach out to prescribers, pharmacists, insurers, law enforcement agents and others who can prevent powerful narcotics from falling into the wrong hands.”

And where such data analysis and outreach is already being done, Kreiner continued, “It has proven to be very effective.”

The report, “Prescription Drug Monitoring Programs: An Assessment for the Evidence of Best Practices,” is available on the Pew Health Group website (http://www.pewhealth.org/reports-analysis/reports/prescription-drug-monitoring-programs-an-assessment-of-the-evidence-for-best-practices-85899418404/3).

According to the report, by the end of 2001, 16 states had authorized the creation of prescription drug monitoring programs. Eleven years later, that number grew to 49 states and one territory that had passed legislation authorizing PMDPs. Today, 41 states have prescription drug monitoring programs in operation.

Established Value of PMDPs

The report notes at the outset that PMDP data are “unique and irreplaceable in identifying questionable activity with respect to prescription drugs, such as doctor and pharmacy shopping, fraud, and problematic prescribing. No other system exists that can compile all controlled substances prescriptions, regardless of who issued the prescription, which pharmacy dispensed it, or the source of payment.”

The paper addresses the question of which program characteristics and best practices are likely to enable PMDPs to more effectively collect, analyze, disseminate and utilize the data they do collect.

According to the report, by the end of 2001, 16 states had authorized the creation of prescription drug monitoring programs. Eleven years later, that number grew to 49 states and one territory that had passed legislation authorizing PMDPs. Today, 41 states have prescription drug monitoring programs in operation.

Best Practices Identified

The study identified a total of 35 best practices, 21 of which require research studies and documented expert opinion in order to proceed. The 21 represent a list of promising practices identified through anecdotal discussions with experts in the field, but there is no research evidence demonstrating their effectiveness or formal written documentation of expert opinions.

An additional six had documented case studies or expert opinions. These include:

• Adopting a uniform and latest ASAP reporting standard
• Collecting data on nonscheduled drugs implicated in abuse
• Reducing data collection interval time and moving toward real-time data collection
• Enabling access to data by appropriate users and encouraging innovative applications
• Enacting and implementing interstate data sharing among PMDPs
• Collaborating with other agencies and organizations

The researchers found research evidence (excluding case studies) for approximately one-quarter (eight out of 35) of the best practices identified in the paper. These best practices and the findings of the report include:

• Collecting data on all schedules of controlled substances – States that collected prescribing data for all controlled substances (e.g., anti-anxiety medication, and painkillers) reported lower rates of doctor-shopping (visiting multiple doctors to obtain prescriptions) than other states.
• Instituting serialized prescription forms – Three states, Texas, Nevada, and California, using serialized prescription forms had lower instances of opioid overdose death rates than states not using state-issued prescription forms.
• Conducting epidemiological analyses – Analyzing trend data helped law enforcement agencies of states neighboring Georgia identify possible “pill mills” in Georgia that were illicitly distributing prescription painkillers.
• Providing continuous online access to automated reports – After this change in Virginia, the number of data queries increased and the number of individuals meeting doctor-shopping criteria decreased. There was also increased use by Virginia medical examiners.
• Sending unsolicited reports and alerts – Proactively sending alerts about possible abuse to physicians and pharmacists was associated with decreased prescription sales; no effect of unsolicited reports on drug overdoses or opioid-related mortality but may reduce supply; in Wyoming, there was reduced doctor shopping after implementing sending unsolicited reports; in Nevada, there were a reduced number of prescribers, dispensers, and dosage units for individuals for whom unsolicited reports were sent.
• Conducting promotional campaigns – After promotional campaigns in early 2010, the number of registered users and data inquiries increased (Virginia).
• Improving data timeliness and access – Case studies suggest that enabling access to additional categories of end users increases PMDP utilization.
• Conducting user education – Provider detailing associated with reduced prescription opioid death rate and improved provider prescribing behaviors; PMDP prescriber educational intervention associated with reduced MEP use.

The research was funded by The Pew Health Group, a division of Pew Charitable Trusts.

What To Expect

While publicizing the results of the research is step one, what can the general public expect in the near term? Progress along these lines, like recovery from addiction itself, takes time, perseverance and attention to detail. As the subject matter experts and co-authors of the report indicated in press materials detailing their findings stated, more research studies and documented expert opinion are required.

The good news is that such activity is likely to be stepped up, given the seriousness of the prescription drug abuse epidemic in America. When best practices can be shown to be effective, i.e., reduced rates of doctor-shopping, lower instances of opioid overdose death rates, their spread will likely continue at a faster pace.

Bottom line: the fight against prescription drug abuse is a multi-layered and long-term effort that requires coordinated, measured, and consistent application of best practices that have been proven to work.

Not surprisingly, the New Orleans Saints found themselves the subject of a lawsuit after federal investigators put them under the microscope for misappropriation of supplied prescription painkillers. The lawsuit was filed in 2010, and according to inside sources, is still pending. Indeed, when representatives for the team were asked for their side of the story, spokespeople didn’t elaborate, only replying that the case was private, ongoing, and that there would be no further comment.

The Saints came under fire by the Drug Enforcement Agency for missing stores of Vicodin, which prompted a full investigation into the matter. The Saints previous director of security and former FBI agent Geoffry Santini accused the team of hiding the fact that prescription Vicodin went missing from the club’s drug chest. The charges will likely result in the Saints being slapped with stiff civil fees. These penalties can reach upwards of six-figures, and insiders are expecting stiff fines in light of the amount of damning evidence compiled by the DEA.

The DEA has not made individuals the subject of its investigation, but rather has focused on the team’s poor handling of the matter, characterized by the lack of accountability and concealing of evidence. Such actions are not taken lightly by legal officials and are considered a serious criminal offense.

Sources say that the Saints have been cooperating with the DEA to come to an agreement on civil penalties amassed. Currently the NFL has been silent on the matter.

Many doctors treating patients addicted to opioids (prescription painkillers) do not recommend an immediate break from the drugs. Even for those not addicted to them, many of these drugs recommend a slow weaning off period. For this reason, some physicians suggest that their patients switch from opioids to methadone as they carefully lessen their body’s dependence on chemicals. Methadone is a standard treatment for opioid addiction, but not one that enjoys universal understanding or approval from those outside the realm of addiction treatment.

The courts and criminal justice system many times view methadone as the exchange of one drug addiction for another. Because of this, when a pregnant mom follows her doctor’s guidance and enters a methadone program, she runs that risk that the courts will decide she is unfit and will take her newborn away. Hence the dilemma: if she stops taking opioids suddenly she runs the risk of premature labor or even miscarriage. If she takes methadone, she takes the chance that the justice system will make her give up her baby.

Opioid addicted moms then are caught between medical advice and a court system highly suspicious of methadone treatment. It’s true that we don’t know what may be the long-range effects of in utero exposure to methadone. But we do know that separating mothers and babies is traumatic for both of them and the repercussions extend through life.

The problem of celebrity addiction to prescription drugs is splashed across grocery store check-out magazine racks. But teens, who idolize those stars, are also abusing the drugs, as are sports figures, business executives and even moms and dads.

A few things are combining to create this perfect storm of drug addiction. To begin with, there are more prescriptions (particularly for painkillers) than ever before being written. Just between the years 2000 and 2009 there was a nearly 50 percent increase in the number of prescriptions issued by doctors for opioid painkillers like OxyContin, Vicodin and Percocet.

Another reason the problem has ballooned so greatly, is that these drugs are easy to get. There are pill mills which are phony pharmacies and bogus medical offices where the drugs are readily sold, and others who engage in doctor shopping, which means that they go to see several physicians with the same complaint and collect painkiller prescriptions to feed their habit.

But a person, especially a teenager, doesn’t have to do any of that. According to the CDC, 70 percent of people who abuse prescription drugs, get them from the bathroom cabinet or take a friend’s medication. A mere five percent buy their illicit prescription drugs through an online pharmacy or a drug dealer.

Sadly, many people, including teens and adults, are fooled into thinking that these drugs are safer to use than other kinds of drugs but this is simply not true. Prescription drugs are the new gateway drug. One-third of first time teen drug users in 2009, took prescription medications for non-medical reasons. Prescription painkillers are one of the top three substances most abused by teens and overdoses of prescription drugs now kill more people than die in automobile crashes.

Perhaps because of this false sense of safety concerning prescriptions, many Americans are mixing the drugs. Heath Ledger and Whitney Houston are just two examples of well-known stars that mixed pharmaceuticals and paid for it with their lives. Lindsay Lohan has a highly publicized habit of abusing alcohol and painkillers. Teens are following their example by combining painkillers, anti-anxiety meds or even over-the-counter sleep aids and antihistamines. All these drugs depress central nervous system functions like breathing and heartbeat. Mix those drugs with another depressant like alcohol and you are likely to pass out and never wake up. It’s time to talk with our kids about the real danger prescription drugs pose.

Researchers analyzed over 26,000 of the college student’s data from 40 different campuses in a 2008 survey from the American College Health Association National College Assessment. The survey asked questions about student use of nonmedical drugs like prescription painkillers, antidepressants, stimulants and others. It also asked questions about their state of mental health in the last year.

Almost 13 percent of students said they had used prescription drugs for nonmedical purposes. The ones that were much more likely to use them were those who had felt sad, hopeless, depressed or even had considered suicide.

The researchers discovered the association among the female students who used painkillers was especially strong.

Co-author Amanda Divin at Western Illinois University said since prescription drugs undergo testing by the FDA students see them as a safe drug, especially since they are also prescribed by doctors. They also see no harm by sharing them with other family or friends if there are some leftovers.

Divin explained that all drugs do have potentially harmful side effects and their study only showed that painkillers like OxyContin and Vicodin are related to suicidal thoughts as well as depression.

Such drugs should be overseen by your doctor and this is why there is a need for mental health resources especially at college campuses. The conclusion is that college aged students are using prescription painkiller drugs to relieve their mental stress.

Divin added that more investigation is certainly needed when you consider how widespread prescription painkiller sharing is on campuses coupled with the mental health problems associated with these college years as well.

Vicodin and Lortab, which contain Hydrocodone, are high on the list, as is Percocet, the brand name for Oxycodone. Methadone and Suboxone are used as substitutes for patients with opioid addictions but are also subject to misuse. Many individuals with painkiller addictions start out as normal, everyday people who develop dependency overtime.

And while the effects of addiction can be devastating, many find it difficult to remove themselves from the cycle of abuse. What starts out as relief can quickly turn into a crutch as the painkillers become a necessary part of getting through the day.

Many with pain pill addictions are considered to be high functioning individuals who hold down jobs and keep it together, at least on the outside. For that reason, the illness can be hard to diagnose. Recognizing painkiller addiction as a legitimate problem is important; however, it can cause all sorts of damage or even result in death.

Risks of painkiller misuse include organ damage, dangerous conduct, and overdose. What some don’t realize is that certain medications such as Vicodin and Percocet contain high levels of acetaminophen that when abused, can lead to permanent liver damage. Oftentimes, though, drive for the drug is stronger than the potentially negative consequences. 

This drive leads addicts to seek out their fix wherever and however they can get it. And when their supply dries up, they will go to dangerous parts of town or engage in risky behaviors just to get it. The potential for overdose in these situations is very real. 

Opioids cause a person’s breathing to slow down, reducing oxygen to the brain. Painkiller overdose leading to asphyxiation in one’s own vomit is also a real and deadly possibility.

There are many other dangers of abusing prescription drugs. While these drugs are wonderful for the short-term treatment of pain and discomfort, their use should be highly monitored so that the good doesn’t end up outweighing the bad.

Though the painkiller epidemic originated on the east coast in the Appalachia region, it is now stretching its grips across the entire United States. Data from the Centers for Disease Control and Prevention (CDC) in 2008 attributed almost 15,000 overdose deaths to oxycodone and hydrocodone, and this problem does not appear to be going away anytime soon. The DEA also showed a marked increase in sales of oxycodone during the last decade.

Gregory Bunt who serves as the medical director of Daytop Village Drug Treatment Centers in New York says the reason for the increase is two-fold. He attributes the increase to the ailing health of aging baby boomers and the fact that doctors these days are much more likely to treat pain with medication versus suggesting other alternatives.

While opiod painkillers do a great job of relieving pain, they also produce euphoria, which often leads to their abuse. Bunt adds that addiction is fueling sales of these painkillers as patients will simply hunt for another doctor if their primary decides to stop prescribing them. For some it’s as easy as crossing states borders to avoid sophisticated computer tracking systems and others resort to mail order pharmacies.

The widespread abuse of these legal painkillers is setting off alarm bells because many communities are unprepared when it comes to resources needed to deal with increased rates of dependency. Although beneficial for many, the dangers of addiction of these drugs are just as real as heroin or cocaine when used improperly.