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Beating Addiction Requires Everyone's Help
As previously discussed, health care professionals, law enforcement, and foremost the involvement of friends and family is vital to intercept possible narcotic addiction. However, it is ultimately the patient's responsibility to use narcotics responsibly.
A few years ago, narcotics were only prescribed after surgery, severe trauma, or for terminal cancer because of a concern over the possibility of addiction. Recently, they have been cautiously prescribed to treat moderate to severe non-malignant chronic pain in conjunction with other modalities such as physical therapy, cortisone and trigger point injections, muscle stretching, meditation, or aqua therapy. Unfortunately, the upsurge of narcotics as medical treatment also increased associated cases of abuse and addiction.
Derived from either opium (made from poppy plants) or similar synthetic compounds, narcotics not only block pain signals and reduce pain, but they affect other neurotransmitters, which can cause addiction.When taken for short periods, only minor side effects such as nausea, constipation, sedation and unclear thinking are noted.
However, when narcotics are taken for several weeks to months, these side effects can become more challenging: loss of effectiveness due to built-up tolerance, possible addiction, or overuse for a temporary "high," not for pain.
Because of the potential for addiction, whether physical (anxiety, irritability, nausea, vomiting, abdominal cramps and insomnia) or psychological (compulsive use, craving the drug and needing it to "feel good," narcotics are considered controlled substances, which means that the FDA and DEA govern their distribution, prescription, and use and classify them into different schedules as per the Controlled Substances Act of 1970.
While weak narcotics such as Tramadol (Ultram) and Schedule IV opiod analgesics such as Darvon or Darvocet N 100 have a low risk for physical dependency and addiction with mild side effects such as dizziness, sedation, headache, nausea and constipation, Schedule III opiod analgesics such as Lortab, Tylenol #3, Vicodin and Vicoprofen have a low to moderate potential of physical or psychological dependence. Demerol, Dilaudid, Duragesic, Oxycontin and Percocet, which cannot be automatically refilled, fall under Schedule II because of their high abuse potential, and possible severe physical or psychological dependency.
In view of the fact that narcotics can be addictive, they should only be prescribed when no other alternative is available and should only be taken as directed by your doctor. Most often, patients are required to consent to adhere to certain rules regarding the use of their prescription listed in a "Narcotic Agreement" between the patient and physician. Often, violation of this contract, especially selling, sharing, or trading the medication, attempting to obtain duplicate pain medication prescriptions from different physicians, and attempting to have the medication refilled early, at night, or on the weekend, to mention a few, would result in the patient's discharge from the practice.
By Dr. Yong H. Tsai
Published in The Daytona Beach News-Journal
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