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Subscribe to RSSSarah Mayer, 27, and her father Randy, 54, of Hilliard Ohio, share her story of addiction and recovery with NBC News.
The use of prescription painkillers recreationally is at epidemic levels, according to the Centers for Disease Control and Prevention. What is it about the pills that makes them so dangerously addictive and a potential gateway for heroin?
The surprising answer, at least to many non-medical professionals, is that the common painkillers that doctors and dentists prescribe to patients after injuries and surgeries have the same active ingredient as the drug that alleyway users inject into their arms. And both act in similar ways on the human brain to produce a sense of pleasure that can overwhelm its reasoning functions.
While many who abuse prescription painkillers think of heroin as a low-class drug that will never make its way into their lives, they don’t realize, they’re already addicted to a form of it.
Prescription painkillers of the sort that 12 million Americans used nonmedically in 2010, according to the CDC, are narcotic opioid drugs, more commonly referred to as opiates. They include hydrocodone and oxycodone, also known by the brand names Vicodin and Oxycontin, respectively.
Reward system
According to the National Institute on Drug Abuse, when opiates are consumed, they enter the bloodstream and activate neurotransmitter receptors in the brain’s reward system. Scientists call the link between the drug and the receptor a lock and key relationship, because one specific neurotransmitter activates specific receptor molecules, the same way only one key fits a particular lock.
When the opiates reach the opiate receptors, the latter release the hormone dopamine. The dopamine – which acts as an “excitatory neurotransmitter” – produces feelings of pleasure and satisfaction. It’s this action at the most basic cellular level that provides the foundation for drug addiction.
Young recovering heroin addicts Tej Yaich, 20, Holly Yates, 20 and Tara McCormac, 22, and Dr. Joseph Gay share their stories and discuss the growing heroin crisis in Ohio.
Although the initial effect of the drug is rewarding and results in a “high,” or feeling of euphoria, the effect is time stamped. When it wears off, the user feels much worse than before having taken the drug.
Addiction psychiatrist Dr. Stuart Gitlow, president of the American Society of Addiction Medicine, compares this phenomenon to alcohol use, saying that people drink for the immediate effect, regardless of the inevitable hangover that will follow.
"The only connection a patient makes is that use of the drug leads to immediate relief -- not the longer-lasting discomfort that follows. Unfortunately, the drug causes both the immediate relief and the following discomfort. As time passes, the discomfort becomes more apparent than the relief and the drug is used merely in an effort to avoid the discomfort that the drug has caused in the first place."
Gitlow explains that humans are not biologically programmed to think about cause and effect in this way. “The only thing a patient connects in their head is with the immediate relief -- not the effect felt days later,” he said.
Also, as with alcohol, the pleasurable effect diminishes over time, he said.
At the cellular level, chronic activation of the opiate receptors eventually saturates them -- requiring higher and higher dosages of the drugs to achieve the same pleasant feeling. It is for this reason that an addict will seek more potent forms of the opioids.
“There are certain medications that invite an escalation to more serious drugs and narcotics and opiates are two of those” said Dr. Nancy Snyderman, NBC News chief medical editor.
The speed with which the different forms of opiates enter the bloodstream and flood receptors depends on the form in which it’s consumed, explains Snyderman. Consuming a pill by mouth can take up to a few hours to have an effect because it has to be digested by the stomach and intestines before it makes its way into the bloodstream. Injection is the second-fastest way to achieve the desired effect, as the drug enters the bloodstream instantly but has to make its way to the brain. Snorting a crushed pill or a powder crosses the blood-brain barrier in a matter of seconds; that’s what makes snorting so addicting and the drug delivery system of choice.
It also means there’s less margin for error if a person has a drug reaction or overdoses, Snyderman said.
In an opiate overdose a person may experience confusion and physical discomfort. In severe cases, a person’s breathing can slow down so much that breathing stops, resulting in a fatal overdose. The CDC estimates that more than 100 people die every day from unintentional drug overdoses -- many of them involving prescription pain killers.
In addition to the immediate effects produced by the drugs, numerous short- and long-term side effects can be associated with opiate use and abuse.
Among the most common side effects reported are constipation, nausea and what’s known as pin-point pupils. As an addict increases consumption, the side effects become more severe and can include extreme sleepiness and slowed respiration and pulse rates.
The most widely known side effect is the physical dependence that occurs with long-term use.
Dr. Joe Gay, director of Health Recovery Services in Ohio, points out that “As tolerance goes up, susceptibility to withdrawal becomes a real factor.” Withdrawal symptoms can be excruciating and including muscle aches, anxiety, sweating and insomnia, to name a few.
Like any addiction, opiate abuse is considered a relapsing brain disease. While you can’t predict whether a given person will become addicted to drugs or not, certain factors can increase a person’s risk, including genetic makeup, environment, socioeconomic status, and others, researchers say.
One example comes out of a new study from the Seattle Children’s Research Institute, in the June issue of the Journal of Adolescent Health. It found that adolescents and young adults with mental health disorders were about 2 ½ times more likely to become long-term opioid (synthetic opiate) users that their peers without such disorders.
Msnbc.com contributor Rita Rubin also contributed to this report.
Read more of NBC's special report:
Crackdown on painkiller abuse fuels new wave of heroin addiction
For parents: Opiate use warning signs and getting help
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Cant help but sound heartless.... if that's the life they want to live ... let them.
But when the show up for "entitled" assistance .... slam the door in their face.
That's what I thought until it happened to my own family. I pray that it never happens to yours!
You can't fix people who want to destroy themselves.
Often, attempts to "help" end up enabling.
The best thing is to take care of yourself (which is not selfish, the world doesn't need TWO dependents!) and let the other person figure it out their own life.
If a friend or family member is driving their car off a cliff, the best thing you can so is MAKE SURE YOU ARE NOT IN THE BACK SEAT!
I say this from experience.
Robert platt bell - NA AA CA all free support from ex addicts to current addicts (that no addict need to die) - its in the phone book, an addict can get help IF they WANT it and there are agencies with counsellors to help motivate addicts to want to kick their addiction - however an addict will ALWAYS have an excuse to not get help or stop their using - you are right to take care of yourself so that you can be healthy and happy when they get well, the addict needs to come to their own conclusion by themself.
OMG, people....smoke one and chill out already.
I have never abused drugs. I don't like the taste or after affects of alcohol. I would like to be able to get some sort of pain medication relaiablly for my back. Went back to the pain specialist yesterday and he did a spinal block that increased my pain and left me nauseated. The greatly regulated pain medication market is due to irresponsible people that do not take care of the medications by selling them, leaviing them within reach of their children, etc. I do not want to be "hooked on drugs". I would like to have an hour or two out of pain once or twice a week so I can do small things around the house or shop for groceries. I will settle for the pain and the end of my life rather than becoming an addict. Using medication properly as pain relief and control should be allowed especially if someone is older and injured as I have became due to work injuries.
However, with things the way they are, it does not appear that there will be even a respite from my pain. I will live with it until I can no longer tolerate it. Then, I won't have to tolerate it any more.....
Thank you to all that have made it impossible to get real pain meds available for those that need it. Have to love all of the regulations in place now. Please go to hell. Thank you.
This hits too close to home. My son has been struggling opiate and heroin addiction for a couple of years now. He gets clean and then uses again. He was ready to get clean and had saved money to pay for rehab and the insurance company denied inpatient rehab - they would only pay for out patient. We appealed they denied. No detox and out patient for a heroin addict - it's laughable!
L. Kai, I'm so sorry for what you're going through. I've never taken drugs in my life so can only speak from experience as a parent. Inpatient is the way to go. Your son needs to be in an inpatient program and end every single relationship he has with his current friends. Every single one, no exceptions. It would even be good if you moved so he has no associations. It sounds like he wants the help so that's a good thing. Once he has completed rehab he will still need support programs and may need antidepressants, something to do with how the opiates effect dopamine levels in the brain if taken when they're very young. Good luck.
I do wish you the best with your son. We do have a broken system when it comes to treatment for those addicted. My prayers are with you.
JUNKIES destroy everything and everyone in their lives; this is the price we pay for saving the ones nature tried to drop at nirth.
I was trying to figure out what you mean by the term nirth?
I have found that regardless of why I go, my dr constantly asks me if I want anything for pain relief. Since I know I am prone to addiction, I refuse to take any pain killers.
I do not understand the vendetta. Possibly some small mind of someone who has never suffered.
I have chronic back pain and MUST use opiates as the ONLY control for the pain. My condition is inoperable and I have had 15 back injections.
I am so sick of the trauma caused me of having to explain to friends and family why I have to take them. You see, they don't understand either because they are not suffering.
Please, MSNBC, when you sensationalize the relatively small number of abusers you feed the small minds(which include doctors) around the country and results in pre-establishing an opinion and bias of anyone legitmately requiring this drug.
I am sick of practically having to beg for this relief and feeling as an outcast because I need it.
Please, Please stop this sensationalism and whatever vendetta someone on your staff seems to have. You contribute to my pain and grief and the stigmatism and bias attached to this drug for those who need it.
Ask yourself, what is this article going to do? Make the problem go away?
No.
It just makes it worse because of the false awareness you are spreading that there is a drug out there that "everyone" is doing.
It causes some to think, "wow, this stuff must be good. I gotta try it."
Again, you just feed the problem.
I'm sorry you are "so sick of the trauma" but you are so wrong when you say "relatively small number of abusers." We need people to know what is going on so hopefully parents and others can educate their kids. I had no idea about painkiller abuse until years after the fact. No, you can't stop people from doing certain things, but having some education about it and being able to pass the information on is critical. I really am sorry to all those who legitimately need painkillers and now have trouble getting them, but as parent of kids who got addicted to opiates through painkillers, we need to know. It should have been that difficult to get them in the first place. This problem is huge and the kids I have talked to, had no idea how addicting the pills are. I didn't until this came to light. I've never had them in my house and have never even considered taking something like that. I hope you get relief but you can't ignore what is going on or pretend it's not a problem. It's everywhere and it's epidemic whether you want to admit it or not.
I was a 20+ year chronic pain suffer who wanted nothing to do with pain killers in 2003 I was put out of work due to herniated disc X 8. carpal tunnel arthritis . I tried to get in every trial there was for my first 2 years of being disabled and was turned down every time. My doctors said the only thing they could do for me was pain killer pain management. I had no interest in that so I started to research other avenues over he course of 5 years I put together a amino acid vitamin mix that not only rid me of my pain but as other people asked to try it because of my results I discovered it could help people quit smoking with no withdraw. So then I helped some one close to me who had a 8 year oxy cotin addiction and they tried the other avenues to quit methadone, counseling,sub oxin and cold turkey to no results that ended their addiction.I made a amino acid vitamin mix for them geared at their addiction and I got them thru it with only a case of the chills they were amazed at how well it worked considering the hell the went thru trying to get off of pills.
To me pain management means to learn how to control your pain without medication. I could be wrong here but isn't having a bunch of pills prescribed to you called "pain relief" not "pain management?" after doctor recommendations I authorized to use and cultivate medical marijuana here in Arizona which provides more relief than the oxy's and gabapentin ever did, I wonder if they added to the problem? Today using medical cannabis yeah I'm still in pain from this disease but I have my life back and the pain is a never ending problem but I really don't care its there, in which the disease I have is RSD or Reflex Sympathetic Dystrophy or the new name CRPS Complex Regional Pain Syndrome. The one thing with medical marijuana that helped more was learning to use it as medication in almost the same way as a prescribed drug and that worked.
@ frankiejrjr
Please share the amino acid vitamin mix that you came up with. I would like to try that. I would prefer to be healed than managed. Thank you.
If you've not already heard about this the following link give the story of two Florida brothers who set up a chain of "pill mills" set up in strip malls. It's a long article but well worth taking the time. Unbelievable things were going on. One of my favorities was that they had a shuttle bus service to/from different parking areas because the "patients" were taking up all the parking spots in the mall. Another was the explanation of how, while the "pain clinics" were being raided (armed SWAT etc) the patients were still at the front desk demanding that their prescriptions be filled.
This is a huge problem in PA too. I live in a mostly middle-class rural area and have beautiful twin daughters in their 20s finally getting to the other side of this addiction. The only thing that has worked for them is methadone. I think it saved their lives. Living in a rural area has its own set of obstacles to treatment and with the heroin problem as bad as it is in this area, I would really love to see more options available to us. The nearest methadone clinic is 35 miles away. I feel lucky because my kids know others who travel a lot further than that to get to the clinic every day. Paying for the methadone and the gas to get to the clinic is a challenge even when you have a job. Probably more so when you work because you don't qualify for any benefits. My girls work and are finally at the point where they are getting take-homes so that has helped. There aren't even any close AA or NA meetings so all their counseling is done at the clinic.
The parents need support too. I feel traumatized by the events of the past four years or so. I have seen and dealt with things I've never even imagined. I think the parents are suffering in silence just trying to get through each day but too ashamed to reach out and share what's going on. It's pretty awful to say that your kid who seemed to have so much potential is addicted to heroin especially in a place where everyone knows everyone. It's one of those things that seems to undo or taint all the good someone has done and the road back is incredibly long and difficult. I've tried to accept the truths of the addiction so that I can help my daughters recover. I just wish I had enough energy to try and help others or find a way to get some services in the rural areas. The only good that has come out of this nightmare is my grandson and I can only thank God that he was born as healthy as he is based on what my daugher was putting into herself when she got pregnant.
I think it is time to let Darwinian Science run its course. Let people drug themselves until they die. Abolish all health care for illegal drug users. California could reduce its population by 20%! Obama wouldn't have any friends to give jobs to. Obama wouldn't be.
The result of doctors giving out pain medication like candy instead of trying to treat cause of pain.Long term use of these heavy duty pain medications end up causing pain if you try to back off of.
The current mechanism for 'substance control' has gotten way out of hand and completely out of touch with reality. We've fallen back a century to a time when the substances were put to blame rather than those who abused them.
The result now is that people in genuine need of things like pain medications, are held in suspicion, if not even contempt, by certain segments of society and government. Bureaucratic entities like the DEA have been given the power to ruin the same lives they were originally created to protect.
It's time for a complete re-gearing of drug laws and even an emptying of our overcrowded prisons of non-violent substance offenders.
to have so many drug addicts, alcohol addicts, high crime rate and very high poverty rates, Americans must be really unhappy people... I thought that was the most wonderful country in the world... Oh really ??
Fools ! I live in one of the best country in the world, a country that has the best social system in the world that is the envy of the rest of the world. You, people don't know what you're missing ! In the mean time, crimes, poverty and addiction goes on..
My stepson overdosed on Heroine 2 1/2 years ago. He went into what the medical community calls code blue. He stopped breathing and had a massive heart attack and a bunch of mini strokes. After they unplugged his life support and he woke up happy as could be. He smiled at everyone. He was only 23 years old. We realized that he had lost many IQ points, but retains his ability to think (it is a little murky at times). He cannot speak. He now lives with a Tracheotomy and cannot eat solid food. He cannot walk and his friends and girl friend have long since abandoned him. Only his parents go to visit him now and he sometimes cry's when we leave. He lives in a Nursing home with a lot of old people. I tell you his story not to make you sad, but to make you think. He always rationalized his choices and never dreamed this could happen to him. Please don't use Heroine and if you are using it, please listen to his story and get help! PLEASE!
Pain is your body telling you to stop doing things that cause additional injury. Masking pain can cause additional damage, hence you need to mask more next time. I've been in pain, I dealt with it. If I were an 8 out of ten pain level I would take aspirin or tylenol to get to a 5 (manageable for me) not go to a zero and be a drooling monkey and unable to perform the simplest task.
Know your body, listen to it and control your urge to get high. I hate doctors who push pills for everything, it's your medical choice to take or not take what is offered, pain pills are bad enough, but when you have psychotropic meds for mood disorders and the doctors go from one pill to the next you are in danger.
Eat healthy, be as physically active as you can and try to enjoy life without the haze of drugs. Life isn't one giant party, it's reality, ups, down and middles, just deal with it.
Good Point. Doctors don't know everything and they certainly don't know you. You are your own best advocate for your health and well being. Doctors tell you you have a condition, educate yourself on it and make a decision based on the knowledge you have gained and come up with a treatment that both you and your doctor agree upon
How does someone go from prescription pain killers to heroin so easily? While being similar in highs, it's a completely different drug market. So, someone is hooked on Vicodin then runs out, I'm pretty certain most people aren't going to make the connection to heroin unless it was readily available to them and they thought it would work as a replacement for their prescription addiction. Unless you know a bunch of druggies, or live close to a place that you can buy smack. Then you'd have to learn how to take it cause it's consumption is different than other drugs.
Why are we supposed to feel sorry for people who CHOOSE to take drugs?
The headline should have read, "Idiots who used to take pills are now Idiots on Heroin."
Put 'em all on a plane and ship them to Afghanistan. Lots of opium there.
Obviously you've never heard of addiction, or had to take major pain medication for a long period of time, then suffer withdrawals? You're a very obtuse person.
We have alot of lazy doctors and mental doctors that only push pills instead of investigating a problem with someone. It starts with the mental doctors with a hyper kid. Issuing out drug pills to that child. It's a pill factory in Las Vegas. Destroying the young adults. I'm sure it's happening throughout America. At a young age they learn the exact words on obtaining these pills from certain doctors. They buy them on the streets as a first priority without bringing food to the family or paying regular bills. They lie that someone stole their money, when actually they bought pills with it. Strict rules needs to be applied today, but I see nothing out of Congress or the States laws. In the politician world, everything is fine. In the real world of the streets, it couldn't be worst.
Gateway drug def: Phrase initiated by government to instill fear in the populace when rationality fails. ie Tobacco is a gateway drug. Cannabis is a gateway drug.
Coming soon: Sugar is a gateway drug. Animal fat is a gateway drug. Rap music is a gateway drug. Gambling is a gateway drug. Sex w/o marriage is a gateway drug. College education is a gateway drug. Video games are gateway drugs.
Not coming ever: Alcohol is a gateway drug. Prescription drugs are gateway drugs.
Profits and revenues from vices may not be gateway drugs but they sure are addicting to pharma, brewers, distillers, politicians, and the penal system.
Life is a gateway to almost everything.
It seems like there's an "Epidemic" for just about everything.. too much sugar, too many obese people, too much texting, too many illegal immigrants, too many pain killers, too many children being abused, too many porn viewers, too many road rage incidents, too many people not getting enough exercise, too many people on welfare, too many kids droping out of school, too many people gambling, too many kids smoking pot, too many kids taking ADD meds, too many people taking prozac, too many people consuming alcohol, too many cars consuming gas...One "epidemic" after another. Gimmie a break, Media News Corporations !!!! stop selling this doom and gloom propaganda. Why it's another "Epidemic" ! Oh dear...
The game is to keep you in fear, its a form of control that lies beneath a hidden agenda.
Feeling like crap from drinking or drugs is such a not fun experience that the fun part of it wasn't enticing to me at all. Like all young people I did whole drinking phase of life thing but once i got deathly sick from too much cheap keg beer, I became a two drink max person. I wish I understood addiction more. i don't understand the pleasure pain principle. I just can't understand why anyone would want to go through life with such highs and lows. And i do fear for people who need a mind blowing high and do the direct snort thing. I'm definitely not against a smoke off the bowl once in a while or a nice cold beer after work, but why can't humans just be content with a happy safe non addictive socially good time instead of so many people seeking out that totally wild over the top high?
Drank and toked in college just like most other students. Quit before I graduated. Still have an occasional drink but haven't touched any weed in years. It is possible to stop given the right motivation.
After having two caesarian sections, I was given morphine for the first three days after surgery. While I would not particularly care to attempt to function on a daily basis under the influence of morphine, I am certainly glad it was available to deal with unbearable pain after being sliced from side to side and "glued" back together with several dozen surgical staples!
Obozo doesn't get my vote again. He's just another arrogant politician who promised us many things (Gitmo on of many) and delivered on little.
What does your comment have to do with this article?
It proves what an intensely stupid person he is.