Managing Pain and Addiction

You are in an accident or perhaps have a sports injury. Maybe you are hurt by equipment at work or have a bad fall. Regardless of the circumstances, you go to the doctor in horrible pain, and the doctor prescribes you an opioid, whether that be codeine or hydrocodone or any other of its many names. You are at risk. It is believed that approximately 2 million people are addicted to opioids.  

Another highly addictive and readily available substance is alcohol. Some people use it to “have a good time,” to unwind after a stressful day, or to relieve anxiety, but by doing so, they are also taking a risk, and they sometimes compound that risk by combining opioids or Zanax with the alcohol. It’s a deadly combination.

We will delve into the science behind pain management and addiction, why it is so easy to become addicted, the dangers of mixing drugs with alcohol, and the road to recovery.

Opioids and Opioid Addiction

Opioids are “a class of drugs naturally found in the opium poppy plant.” They calm the body and, due to that effect, are often administered to patients experiencing moderate to severe pain. Because of the calming, euphoric effects opioids have, they are sometimes used for recreational purposes. Opioids work by activating receptors throughout the body that are related to the sensations of pain and pleasure. When they bind to these receptors, they cause dopamine to be released, and the dopamine causes us to feel pleasure. 

This feeling of pleasure can cause us to abuse opioids because we want to feel that pleasure and relief again. Long-term use and abuse, however, can lead to addiction. Tolerance can occur as well. Tolerance happens when a user must increase the amount of the drug they take to cause the same effect. Increasing the dosage of opioids can be deadly.  Almost 47,000 people died of opioid overdose in 2018 alone. The problem with opioids has become so severe that it is considered by many to be an epidemic.

Due to the opioid crisis as well as dangerous drug interactions that can occur when a patient is taking numerous medications, the World Health Organization recommends ethical prescribing, a multi-step process when prescribing medications that helps providers zone in on the intent of the treatment. In ethical prescribing, a clinician examines each patient’s needs and situation through a multi-step process to make sure that the treatment recommended for a particular problem best fits the individual. 

Effects of Alcohol on the Body and Mind 

Another substance often abused is alcohol, and it can be found just about everywhere. Many use alcohol to lessen anxiety, and it works — briefly. Increased levels of anxiety are caused by a deficiency of a protein in the brain called CREB, and it has been proven that alcohol increases CREB levels, thus reducing anxiety.

The long-term effects of frequent, heavy drinking, however, are many:

• Causes your body to produce more stomach acid which can lead to acid reflux

• Contributes to heart-related conditions including high blood pressure and stroke

• Compromises the immune system which can lead to becoming ill more frequently

• Leads to possible infertility 

• Reduces the filtering ability of the kidneys

Routine, heavy drinking can lead to Alcohol Use Disorder (AUD). AUD is “a chronic relapsing brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” Approximately 15 million individuals in the U.S. are considered to have AUD.

Dangers of Mixing Prescription Drugs With Alcohol

The medication Xanax is prescribed for treating anxiety, and, like opioids, some people take it to get high. Combining Xanax with alcohol use, however, is very dangerous.

Alcohol is a depressant, and they slow your bodily functions down. This means, when drinking alcohol, you are likely to have a decreased heart rate and blood pressure, and your mental functions also slow down. The problem is Xanax is also a depressant. Taking both at the same time can lead to respiratory depression, which is when your breathing becomes so shallow that it could stop altogether. Long-term consequences of combining Xanax and alcohol include the following:

• Liver damage and failure

• Heart disease and stroke

• Difficulty with memory

• Cancer

The opioids discussed earlier are also depressants and can have many of the same effects when combined with alcohol. 

Addiction Recovery

Historically, drug and alcohol abuse has been greatly stigmatized. Science has proven, however, that roughly 15% of people in the U.S. are predisposed to acquire an addiction. Kenneth Leonard, the director of Clinical and Research Institute on Addictions at the University at Buffalo explains that the brain’s chemistry actually changes, and when the addictive substance is no longer present in your system, the brain says, “Hey what happened? You’ve changed conditions dramatically on me.”

The first step to addiction recovery is detoxification, ridding the body of the chemicals it is addicted to. This can take anywhere from a week with alcohol to over six months with opioids. During this period, medication may be required to control the worst of the withdrawal symptoms.

The next step is education, to teach and alter a person’s perception of the drug and his addiction. Many times, people walk into rehab denying they have a problem or are ambivalent about quitting for good. Education attempts to change that.

The person also receives therapy concerning his addiction. The goal is to teach him coping skills so he will not revert to his old habit. In this aspect, technology has begun to play a role. Robotics have assisted in surgeries and have been used in other healthcare applications. Now, in Guangdong Province in China, they have begun to use a robotic “counselor” at a substance abuse center. People suffering from substance abuse are often embarrassed when talking to others about their addiction. The robot solves that.

People use opioids in addition to other drugs and alcohol to mitigate pain, but the long-term effects can be devastating. There is light at the end of the tunnel, however, in the guise of a successful recovery program. Addiction does not have to be a life sentence.