Proceed with caution
A TV commercial for a network of treatment centers encourages drug addicts to contact them for rehab. Another has New Jersey Gov. Chris Christie warning there is an epidemic of opioid addiction, but addicts have a way out.
“Help is within reach,” he says.
You might have seen these commercials, but perhaps you have not been – as I have – swallowing an oxycodone tablet while watching them.
This pain medication was prescribed for me by my orthopedic surgeon following a recent knee replacement surgery. Heaven knows, recovery from knee replacement surgery is well known to be very painful. But when I looked into that first prescription bottle of 30 tablets, I would never have believed that I would not only empty it, but I would then call for a prescription refill. With so many warnings out there about how addictions begin with medically necessary prescriptions, I was worried.
In the Lehigh Valley, town hall meetings and public forums have been hosted by state legislators, police departments and others who are educating the public about the serious nature of the addiction epidemic which has hit this region very hard.
So much information is out there about what to do if you or someone in your family becomes addicted to opioids, but why is there not more emphasis about how to avoid it? Every time I saw one of those commercials, I wondered what action I should take so I would not find myself, this time next year, buying heroin from a drug dealer to feed an addiction.
According to Dr. Karsten Kueppenbender of Harvard Medical School, 97 percent of patients do not have a problem with opioids. But, while I find it entertaining to take chances at the Sands Casino, the possibility of becoming one of the 3 percent of patients at risk for addiction was not a gamble I wanted to take.
How long is it safe to continue taking an opioid medication such as OxyContin, Vicodin, Dilaudid or Demerol? What are the signs that I might be developing a dependency on it? What can a patient do to minimize the risk of dependence or addiction?
The Centers for Disease Control and Prevention reports 91 Americans die from an opioid overdose every day.
Dr. Kenneth Katz, a toxicologist and emergency room physician at Lehigh Valley Hospital, is very familiar with the problem.
“I see patients with opioid overdoses and addiction almost daily,” he said in a telephone interview recently. “In 1980, the addiction potential (of opioids) was believed to be low,” he said. “Clearly that has not been the case. What we’re seeing now is a tsunami of opioid-related deaths.”
A number of factors should be considered before prescribing opioids, Katz said, including the patient’s previous addictions to alcohol or tobacco, which increase the risk of opioid use leading to addiction.
Other pain relief should be considered instead of automatically prescribing an opioid.
“Try everything that is non-opioid first,” he said. “Be your own advocate.”
A few weeks after my surgery, I called my doctor’s office and had a long conversation with a nurse there about a precise program that would help me successfully step down my use of the oxycodone. It put my mind at rest to know the exact action I should take to manage the discomfort while reducing the use of this potentially addictive medication.
Ideally, Katz said, any doctor prescribing an opioid should inform the patient of how long it is safe to take it and what steps to take when it’s time to use other pain relief. If the doctor does not offer that information, the patient should ask for it.
“The ultimate thing is, there has to be a game plan,” he said. “The patient should know why it is needed and how long it is needed.”
When I called my doctor’s office that day to speak to a nurse about a new pain relief plan for me, I first had to listen to the familiar menu of connection choices. Among them was the recorded voice offering me the easy – but risky – way out: “For prescription refills, press 5.”
I am glad I did not.