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Prescription Pain Medicines—An Addictive Path?

Many Americans may have been startled last summer when an Associated Press (AP) analysis of U.S. Drug Enforcement Administration statistics showed that retail sales of five major painkillers rose 90 percent from 1997 to 2005.

The report revealed that ever-increasing amounts of prescription painkillers called opioid analgesics are being used on a daily basis. These drugs, which can become habit-forming over time if not strictly monitored by a health professional, are readily available with a prescription.

Now, researchers funded by the National Institute on Drug Abuse (NIDA) have launched the first large-scale national study evaluating a treatment for addiction to these drugs, which include codeine, morphine, oxycodone (OxyContin), hydrocodone (Vicodin), and meperidine (Demerol). The study is a direct response to the growing national problem of prescription drug abuse in this country.

According to the 2005 National Survey on Drug Use and Health, the incidence of new nonmedical users of pain relievers is now at 2.2 million Americans aged 12 and older. This is greater than the number of new marijuana abusers (2.1 million). In 2005, more than six million Americans reported current (in the past month) nonmedical use of prescription drugs. That is more than the number of people abusing cocaine, heroin, hallucinogens, and inhalants, combined.

"The abuse of prescription opiates continues to be unacceptably high, producing steep increases in emergency room admissions,'' says NIH Director Dr. Elias A. Zerhouni. "This trial is part of our ongoing commitment to develop better treatment approaches for drug abuse and addiction, so devastating to millions of Americans and their families. "

The study will test the effectiveness of buprenorphine/naloxone tablets, marketed as Suboxone, along with different models of drug counseling in patients addicted to prescription painkillers. Buprenorphine works by acting on the receptors in the brain affected by heroin, morphine, and prescription painkillers. The tablets relieve drug cravings without prompting the same intense high or dangerous side effects. When combined with naloxone, buprenorphine's abuse potential is further limited, since those who try to inject it to get high experience severe withdrawal symptoms, while no adverse effects occur when it is taken orally, as prescribed. This medication has been approved for prescribing by specially trained physicians, greatly expanding the treatment options available for opiate addiction.

"This study is important because most of the research to date has been done on treatment for those addicted to heroin, not prescription pain medications," says Roger Weiss, M.D., clinical director of McLean's Alcohol and Drug Abuse Treatment Center and lead investigator for the study. "It also isn't clear whether people who started taking these medications for legitimate reasons will respond to the same treatment in the same way as those who use pain medications solely on an illicit basis."

For more information about the study, go to:

Read More "Chronic Pain" Articles
Easing Chronic Pain: Better Treatments and Medications / Fighting Chronic Pain / Prescription Pain Medicines—An Addictive Path? / Block That Pain! / The Team Approach to Pain Relief

Fall 2007 Issue: Volume 2 Number 4 Page 22