Recognizing Opioid Abuse

Learn the potential red flags, and how to help if a loved one is struggling

Legally prescribed pain relievers like hydrocodone (Vicodin) and oxycodone (Percocet) may seem nothing like heroin. But these drugs — as well as hydromorphone, codeine and morphine — are all opioids, and they're all part of a national crisis: the opioid epidemic.

"Everyone and anyone is at risk for opioid abuse," says Maki Sato, MD, a family medicine physician at Rush Oak Park Hospital. "So it's important to know how to recognize signs of a problem and ways to address it."

A disturbing trend

In 2016, 23 percent of deaths caused by opioid abuse were due to prescribed painkillers, according to the CDC, and the number of older adults hospitalized for opioid overuse has quadrupled over the past 20 years.

The problem begins simply enough. A doctor prescribes opioids to reduce short-term pain, such as that experienced after surgery. Or, doctors may prescribe opioids for chronic pain related to conditions like osteoarthritis.

While many take the drugs as directed and don't become dependent, others get used to how the drugs make them feel, experience mental dependence or have a hard time managing withdrawal symptoms. Eventually, these drugs can become habit forming.

Since the dangerous effects of opioid use have become better known in recent years, most health care providers avoid overprescribing opioids and offer pain-relief alternatives, such as other medications or non-drug therapies. But for many people, the problem of dependence persists.

How to spot an opioid problem

These are some common signs that a person may be addicted to opioids:

  1. Finishing prescriptions too early/calling the pharmacy for early refills
  2. Making recurring requests to a doctor refill an opioid prescription
  3. Seeking opioids from sources other than the prescribing doctor
  4. Unexpected periods of euphoria or sleeping more than usual
  5. Withdrawal symptoms, such as nausea, cramps or goosebumps
  6. The need to take the drug interferes with job or other daily activities
  7. Decreased activity, ability to function and/or relationships
  8. Constipation
  9. Increased confusion and falling

If someone pulls away when you offer help, becomes angry or denies a problem, they probably do have a problem.

What to do if you suspect opioid abuse

Suspect a problem in a loved one? As with any sensitive issue, approach them from a nonjudgmental and caring place. "Don't be accusatory," Sato says. "If you're confrontational, they may not listen."

If someone pulls away when you offer help, becomes angry or denies a problem, they probably do have a problem.

Encourage them to discuss the issue with their primary care doctor or a pain specialist who can objectively offer potential solutions. Or, request to join them at an appointment and ask the doctor general questions about opioids without pointing fingers. By learning more, you and your loved one can better address the problem.

"Becoming dependent is not their fault, and no one should feel ashamed," Sato says.

You can also look to comprehensive addiction programs, like the one at Rush, that specialize in helping people overcome their dependencies through a variety of approaches, including group therapy, inpatient and outpatient services, and medications.

"The important thing for your loved one to know," Sato says, "is that they're not alone. As doctors, we're always here to help." 

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