Tolerance to opioid medications means that over time, you require higher and higher doses of pain medications to achieve the same effect. As a result, patients sometimes end up on very high doses of opioid painkillers. Tolerance happens with every opioid.
As someone becomes more and more tolerant of opioids, they also become dependent on their opioids. Tolerance and dependence are two sides of the same coin -- not only do people taking opioids over long periods eventually require higher and higher dosages, they also come to need their opioids to feel normal. If they do not get their opioids, they will go into withdrawal, which can be an extremely uncomfortable set of symptoms ranging from nausea, vomiting and diarrhea to muscle aches, jitteriness, heart racing, yawning, chills and other symptoms.
Tolerance, dependency and withdrawal all go hand in hand, whether one is dependent on prescription medications or heroin. However, it must be emphasized that dependency is not the same thing as addiction. For instance, many diabetics require insulin to function normally and we refer to them as "Insulin-dependent" diabetics. However, they are certainly not addicted to insulin. Addiction comes into play when people dependent on opioids become willing to lie, cheat, steal and otherwise break the law in order to get their medications.
Many patients have become dependent on high dose painkillers that their doctors have provided for them, but they have never taken more than prescribed, and never broke the law. Nevertheless, their bodies will go through exactly the same withdrawal reactions if they do not get their pain pills as a heroin addict who can't get heroin. If they lose access to their prescriptions and get desperate enough, they may start to get medications from friends or relatives, or turn to non-legal sources, putting them in grave danger of crossing over to addiction.
Many people think that an addict uses drugs to get high whereas genuine pain patients are not trying to get high. This is a legitimate difference but not an absolute difference. Many heroin addicts will tell you that they have not gotten high in a long time, sometimes years, but need their drug in order to be able to function or to go to work. Similarly, some pain patients who have built up enough tolerance that the medications they get from their doctor no longer help enough, so they start taking more than they should and run out of medication too soon. They may resort to getting medications from friends, relatives, or off the street. They lose control and turn into addicts without ever trying to get high. Sometimes their doctor stops prescribing pain medications for a variety of reasons (retires, no longer wants the hassles of prescribing pain medications, loss of insurance coverage, inconsistent drug screens, etc.), putting the patient into severe withdrawal and they turn to illegal sources of pain medications.
All too often, the path to opioid addiction and heroin addiction starts with patients being prescribed painkillers for legitimate reasons such as back pain, motor vehicle accidents, kidney stones, etc. Part of our mission at Opioid Management Group is to carefully monitor patients on pain medications to make sure they are being properly supervised, to avoid sudden and catastrophic loss of access to medications patients have inadvertently become dependent on, and to catch patients early if they are losing control to keep them from becoming addicts.
As someone becomes more and more tolerant of opioids, they also become dependent on their opioids. Tolerance and dependence are two sides of the same coin -- not only do people taking opioids over long periods eventually require higher and higher dosages, they also come to need their opioids to feel normal. If they do not get their opioids, they will go into withdrawal, which can be an extremely uncomfortable set of symptoms ranging from nausea, vomiting and diarrhea to muscle aches, jitteriness, heart racing, yawning, chills and other symptoms.
Tolerance, dependency and withdrawal all go hand in hand, whether one is dependent on prescription medications or heroin. However, it must be emphasized that dependency is not the same thing as addiction. For instance, many diabetics require insulin to function normally and we refer to them as "Insulin-dependent" diabetics. However, they are certainly not addicted to insulin. Addiction comes into play when people dependent on opioids become willing to lie, cheat, steal and otherwise break the law in order to get their medications.
Many patients have become dependent on high dose painkillers that their doctors have provided for them, but they have never taken more than prescribed, and never broke the law. Nevertheless, their bodies will go through exactly the same withdrawal reactions if they do not get their pain pills as a heroin addict who can't get heroin. If they lose access to their prescriptions and get desperate enough, they may start to get medications from friends or relatives, or turn to non-legal sources, putting them in grave danger of crossing over to addiction.
Many people think that an addict uses drugs to get high whereas genuine pain patients are not trying to get high. This is a legitimate difference but not an absolute difference. Many heroin addicts will tell you that they have not gotten high in a long time, sometimes years, but need their drug in order to be able to function or to go to work. Similarly, some pain patients who have built up enough tolerance that the medications they get from their doctor no longer help enough, so they start taking more than they should and run out of medication too soon. They may resort to getting medications from friends, relatives, or off the street. They lose control and turn into addicts without ever trying to get high. Sometimes their doctor stops prescribing pain medications for a variety of reasons (retires, no longer wants the hassles of prescribing pain medications, loss of insurance coverage, inconsistent drug screens, etc.), putting the patient into severe withdrawal and they turn to illegal sources of pain medications.
All too often, the path to opioid addiction and heroin addiction starts with patients being prescribed painkillers for legitimate reasons such as back pain, motor vehicle accidents, kidney stones, etc. Part of our mission at Opioid Management Group is to carefully monitor patients on pain medications to make sure they are being properly supervised, to avoid sudden and catastrophic loss of access to medications patients have inadvertently become dependent on, and to catch patients early if they are losing control to keep them from becoming addicts.
A New Danger
Patients who resort to pain medications from non-official sources now face a new danger. They may think that pain pills are less dangerous than illicit drugs such as heroin. Sadly, that may no longer be true.
Recently, there have been new developments that markedly increased the risks with prescription painkillers -- this is the introduction of counterfeit pills that first showed up in the summer of 2016. These are pills that look like authentic pain pills available through pharmacies, but are "fake pills" manufactured by illegal entities, and laced with much more powerful and dangerous opioids, such as fentanyl. They can look so much like the real pills that even a pharmacist would not be able to tell that the pills are counterfeits. When patients turn to non-medical sources for their pain medications, they might end up with a pill that is much more potent than they had bargained for.
This may be the reason that the pop music icon, Prince, died. Autopsy showed that Prince died of a fentanyl overdose but a search of his residence showed pain pills that look like Hydrocodone pills, even marked "Watson 385", which is the marking on hydrocodone/acetaminophen 7.5mg pills. Yet, lab analysis showed these pills contained fentanyl, a drug 80-100 times more potent than hydrocodone.
When patients decide to take pills from non-medical sources, they may now be flirting unknowingly with potentially deadly consequences.
Patients who resort to pain medications from non-official sources now face a new danger. They may think that pain pills are less dangerous than illicit drugs such as heroin. Sadly, that may no longer be true.
Recently, there have been new developments that markedly increased the risks with prescription painkillers -- this is the introduction of counterfeit pills that first showed up in the summer of 2016. These are pills that look like authentic pain pills available through pharmacies, but are "fake pills" manufactured by illegal entities, and laced with much more powerful and dangerous opioids, such as fentanyl. They can look so much like the real pills that even a pharmacist would not be able to tell that the pills are counterfeits. When patients turn to non-medical sources for their pain medications, they might end up with a pill that is much more potent than they had bargained for.
This may be the reason that the pop music icon, Prince, died. Autopsy showed that Prince died of a fentanyl overdose but a search of his residence showed pain pills that look like Hydrocodone pills, even marked "Watson 385", which is the marking on hydrocodone/acetaminophen 7.5mg pills. Yet, lab analysis showed these pills contained fentanyl, a drug 80-100 times more potent than hydrocodone.
When patients decide to take pills from non-medical sources, they may now be flirting unknowingly with potentially deadly consequences.