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Painkiller addiction: What are the treatment options?

Painkiller addiction: What are the treatment options?



Throughout history, those with addiction were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to alcoholism and drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic actions. Scientific advances and discoveries about the functioning of the brain altered views toward addiction and enabled us to respond effectively to the problem. This guide will help you understand more about addiction and the treatment options available for it. 

Addiction is a complex problem, perhaps a disorder or even a disease that affects the structure and function of the brain and an individual’s behaviour. It is characterized by intense and, at times, uncontrollable craving for the drug or activity, along with compulsive behaviour of seeking and use that persist despite devastating consequences for health, functioning, work and social life including relationships.

Scientific research has argued that addiction is a brain disease.  While the path to addiction begins with the act of taking drugs or indulging in the activity, over time a person’s ability to choose not to do so is compromised, and seeking and consuming the drug/activity becomes compulsive.  This behaviour results largely from the effects of prolonged exposure (to drug or activity) on brain functioning. 

Whilst pleasure and enjoyment may have been originally sought with the drug or activity, but with habitual use/involvement, it will be needed to feel normal.  Many individuals may indulge to reduce unpleasant feelings or emotions. Addiction affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behaviour. 

Simple biological or genetic basis cannot explain the heritability of addiction or addictive behaviour, and it is established that vulnerability is multifactorial with the interplay of genetic makeup, age of exposure to drugs (and activity), environmental influences (including stress from work, relationship and social milieu), and psychological status.  Associated medical and psychiatric illnesses are common and there has been an argument whether they are the cause or effect of specific addiction.

Recognizing addiction is the first step to seek/give assistance, and this involves considering his/her lifestyle, daily functioning, and regular habits, including if he/she is consuming any substance. The addiction leads to mental disorders that affect all spheres of the individual’s life. It can severely affect the social, psychological, and physical functioning, and the treatment calls for unconditional family support to help the person recover for good.

Psychological or Psycho-Social Interventions

There is a range of individual, family, group, and community-based psychological interventions that are highly effective in treating substance abuse or addiction disorders.

Individual-based interventions

Motivation enhancement therapy is specifically designed to induce motivation to assist in recovery from substance abuse. These factors include the internal aspects like sleep disorders, chronic body aches, and extreme tiredness that are the internal locus of control. The procedure includes conducting motivational interviews with the individual to encourage him/her to stop dependence on substance or drugs following a structured plan to address, reduce, and eventually put an end to substance dependence. The various stages of motivation enhancement therapy include:

  • Precontemplation
  • Contemplation
  • Determination
  • Action
  • Maintenance
  • Relapse

It’s important to follow certain principles and procedures to ensure motivation enhancement therapy is effective in eliminating drug addiction. These include:

  • Showing empathy throughout the process
  • Avoiding arguments that only lead to negative attitude
  • Don’t deny to offer unconditional support throughout the therapy
  • Brainstorm to help the individual share his/her feelings and experiences
  • Relapse prevention
  • Manage cravings
  • Induce substance refusal skills and coping skills

Family-based interventions

Family aspects and other related factors play a vital role in addressing addiction disorders. It’s a thoughtful process where the individual is encouraged to express his/her suppressed feelings and emotions. The therapy is based on extensive training and supportive psycho-education that can change the attitude of the family and transform the outlook they have on the individual and the habit.

Positive factors of family dynamics are introduced into the therapy to create a holistic environment for the individual and for the family to connect on a deeper level. Healthy family interactions and constant support are followed up with enhanced family support to enable the individual spring back to life with enthusiasm.

Community-based interventions

Community-based interventions prove highly effective in ensuring permanent abstinence from substance abuse. This includes training healthcare providers, including NGO staff, renowned counsellors, academic teachers, general doctors, and other medical professionals with insights into addiction and treatments that help in addressing the root cause of these addictions. They’re introduced to groups like Alcoholics Anonymous and Narcotics Anonymous that operate within a holistic network.

Painkiller Addiction

Painkillers are prescribed drugs used by millions around the world to relieve themselves of acute pain in various parts of their body. Painkillers are supposed to be used only for the prescribed duration and only the prescribed dose should be consumed. However, most people develop painkiller addiction by consuming the drug to relieve themselves of even normal and manageable pain. The overuse of the drug eventually leads to several health ailments, including damaged organs and life-threatening diseases.

How People Develop Painkiller Addiction?

Normally, a person uses painkillers when they have acute pain in their body. When used for a long time, it creates a feeling of euphoria. This intense pleasure develops an increased level of physical and psychological dependency with a higher level of tolerance and withdrawal symptoms. Ultimately, the person finds it difficult to stop consuming the painkiller.

Signs of Painkiller Addiction

Watch these initial signs that indicate the possibility of painkiller addiction:

  • Taking heavier doses other than what’s prescribed
  • Consuming the drug frequently
  • Making stories to continue taking painkillers
  • Forgoing responsibilities
  • Having preoccupied thoughts about the drug
  • Asking for further prescriptions by lying about the pain
  • Making every effort to get money to buy the drug

 Psychological Side Effects of Painkiller Addiction

  • Mood swings
  • Poor judgement
  • Loss of appetite
  • Behavioural change
  • Sleep issues

 Physical Symptoms of Painkiller Addictions

  • Nausea
  • Seizures
  • Poor breath rate
  • Drowsiness
  • Constipation
  • Pinpoint pupils

 Mental Illnesses Associated with Painkiller Addiction

  • Depression
  • Stress
  • Anxiety disorder
  • Psychosis
  • Bipolar disorder

Treatment Options for Addiction

Addiction is a complex but treatable disorder. Addiction has many dimensions and disrupts so many aspects of an individual’s life, so treatment is not simple. Effective treatment programs Alcohol treatment programs must incorporate many components, each directed to a particular aspect of the illness and its consequences.  Careful consideration should be given to approaches most fitting, likely to elicit the desired effect, and compatible with a particular culture. 

Addiction treatment programmes must help the individual stop drug or activity, maintain a drug/guilt-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is a disease, people cannot simply stop using drugs for a few days and be cured.  In modern times it may be unrealistic, for example, to expect Internet addicts to abstain from computers altogether, and emphasis of treatment would be on identifying and addressing underlying core issues feeding a behaviour, reducing computer usage.

Most individuals with addiction will require ongoing advice, support and structured care and support/ therapy to achieve the desired goal, of sustained abstinence, harm minimization, change in patterns of behaviour and balanced lifestyle.

It is my opinion that any treatment programme must incorporate 3 steps: Intervention, treatment and rehabilitation. These three steps will include an effective combination of early identification, medicinal and psychological intervention (counselling or psychotherapy/ talking therapy, behaviour modification, support groups, etc) and ongoing support.

The following is an overview of some of the commonly used approaches to the treatment of addiction, in particular alcohol dependency.

Early detection and Brief Intervention: Effective early detection can be done with a detailed account of alcohol, drugs and behaviour in question from the individual. Speaking with a spouse and family member is important as addicts may underestimate their problem due to subjective shame and guilt. The brief intervention involves 5-10 minutes of information and advice, with 2-3 short sessions of motivation intervention to encourage a change of behaviour. It can be conducted in general health settings, designed for health professionals who do not specialize in addiction treatment.  It aims at reducing drinking, and behaviour rather than abstinence. However, it has been used for independent individuals to motivate them to enter specialized treatment programmes. Freemantle and his colleagues (1993) demonstrated the effectiveness of brief intervention with 24% reduction in alcohol intake by the end of the year.

Motivational Interviewing (MI): Initially described by William Miller (1983), this technique focuses on exploring and resolving ambivalence and centers on motivational processes within the individual that facilitate change. It centers on the idea that individuals with problem drinking or behaviour may recognize it but will require assistance in addressing their ambivalence for change. It uses a specialized psychotherapeutic technique to encourage the individual to set realistic goals, using positive feedback to encourage and sustain progress and change. Psychotherapeutic approaches like Brief Intervention and Motivational Enhancement Therapy (MET) are underpinned by Motivational Interviewing.

Cognitive Behavioral Therapy (CBT): A form of psychotherapy or talking therapy initially developed for the treatment of anxiety and depression. It is based on the idea that feelings and behaviours are caused by a person’s thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave.  In the treatment of various addictions, the goal of cognitive behavioural therapy is to teach the person to recognize situations in which they are most likely to indulge in drink, drug or behaviour, avoid these circumstances if possible, and cope with other problems and behaviours which may lead to their said habit.

General Counselling and Supportive Therapy: It centres on addressing emotional issues and problems that may be contributing to addictive behaviour. It can be used as an effective method to enable individuals to develop insight and understanding of problems and associated issues, and help consider specialized intervention.

Medicinal Therapy: Commonly used to assist individuals with drug dependence especially alcohol and opioid dependence. It centers on the idea that by easing the symptoms of withdrawal and craving one may assist individuals in achieving drug-free status and encouraging further engagement in motivational processes for sustaining change. This intervention must always be done along with the psychological intervention described above.

Various forms of medical treatment are used in hospital and out-patient settings for alcohol and drug detoxification.  Choice of setting is guided by the severity of dependence, successes of any previous treatment approach available support from family and friends, associated psychiatric and medical illness, besides individual personal resources to engage in therapeutic processes. For alcohol dependency, a reducing dose of minor tranquillizing medication like Diazepam and Chlordiazepoxide is commonly used for detoxification.

Other drugs like Disulfiram (Antabuse), naltrexone, and acamprosate are among the most common drugs used for the treatment of alcohol dependency, as they enable aversion, reducing the euphoric effect of alcohol and craving respectively.

Rehabilitation: In some individuals who have experienced recurrent relapses to addiction and those with severe underlying mental illness, prolonged residential rehabilitation may be required for effective delivery of many of the above-mentioned interventions,  and enable the development of lasting personality change and alternative coping strategies.

For all behavioural addiction, the above psychological strategies apply, with the importance of practical advice, support and strategies. It is important to recognize medical and psychiatric co-morbidities, which will require specific treatment. Unattended underlying illness and psychological problems are important factors in relapse.

Addiction is a treatable disease. A highly structured and empathic approach is required when dealing with individuals presenting with drug or behavioural dependency, as it is likely that they will be plagued with guilt and shame, and be suffering from ambivalence or scepticism about change. 

There is no substitute for being thorough in evaluating the said behaviour and habit, and all treatment should be patient-centred. It is important to recognize that motivation fluctuates, and to err is human! Therefore relapse should not be seen as a failure of the individual or treatment modality, but rather as an opportunity to further individual understanding of the addiction and associated issues.

Why Cadabam’s?

Cadabam’s is a state-of-the-art rehab and restoration centre that addresses numerous mental health disorders with a personal touch emphasized by customized treatment packages. The modern infrastructure and all-inclusive amenities provide a tranquil environment for speedy recovery.

Disclaimer – We strive to treat our patients with dignity and the utmost sensitivity. We understand that mental health illness or addiction is a disease and not a sign of weakness. The term addiction is used not in a derogatory fashion but to remain relevant to user search trends and common usage. In case you or a loved are struggling with any type of addiction or you are caring for one, do share your unique viewpoint on how we can improve this content for our readers, please reach out to us at info@cadabams.org