Prescription drug addiction is a growing problem worldwide and the fastest-growing drug problem in the USA.
In South Africa, almost 1 in 5 adults suffer from chronic pain, and 7% of rehab admissions are due to prescription drug addiction.
Painkillers, sleeping tablets and tranquillisers are prescribed by doctors and dispensed by pharmacists every day, but many suffering from pain, insomnia, or anxiety are at risk of becoming addicted to what is being described as a “hidden pandemic” to prescription and over-the-counter (OTC) drugs.
Dr Shaquir Salduker, a pain management expert and member of the South African Society of Psychiatrists (SASOP), stresses that addiction and substance abuse problems can arise not only from illicit drugs such as heroin and cocaine but also from prescription and over-the-counter medicines that are widely assumed to be harmless.
Three million US citizens and 16 million individuals worldwide have had or currently suffer from opioid use disorder (OUD). More than 500 000 in the United States are dependent on heroin.
Prescription drug addiction can lead to dangerous drug-seeking behaviour – lying, stealing, seeking out illegal supplies – as well as the risk of developing further addictions to other drugs or alcohol and negative behaviours such as compulsive gambling.
Salduker strongly believes that people need to be more aware of the risks of addiction from commonly used prescription and OTC medications, as well as that doctors and pharmacists need more education on pain management and opioid painkiller alternatives.
“Opiates are the most addictive substance known to humankind.”
Opioid and benzodiazepine are the “highs”, which give the user feelings of euphoria, relaxation and pleasure can be highly addictive and just as addictive as “street drugs”.
“Just because these drugs are prescribed by physicians or stocked in pharmacies does not make the risk of addiction any less, nor are they any less likely than illicit drugs to cause long-term permanent damage to the individual’s brain function, overall mental and physical health, and ability to be a productive member of society,” says, Salduker.
Overuse of prescription drugs can have similar long-term effects to “hard” drugs on brain function, moods, concentration and thinking abilities, as well as impacting on mental and physical health, with potential long-term organ damage and the risk of premature death by overdose.
He says the entire pain management field is poorly understood and even more poorly managed, and this becomes a fertile breeding ground for opiate abuse and dependency and the initiation of a vicious cycle of pain and increased medication prescription for chronic pain conditions without any long-term plan or sustainable option to manage these conditions can lead to addiction.
Raising the prescribing level of opiates and launching a national awareness campaign about their risks are very crucial, says Salduker, in addition, SASOP is lobbying the SA Health Products Regulatory Authority (SAHPRA) to have codeine-containing medications moved to a higher schedule with greater control over dispensing.
Those who suspect they may be addicted to prescription medications should seek help and support.
Medically assisted detox and withdrawal may be required, along with counselling and psychotherapy, to help manage withdrawal symptoms, understand the roots of a person's vulnerability to addiction, and assist them in getting their lives back on track with improved pain and stress management skills.