COMMUNITY PROBLEM REPORT

The Misuse and Abuse of Prescribed Pain Medication for Chronic Pain

The University of Texas at El Paso

COMMUNITY PROBLEM REPORT

The Misuse and Abuse of Prescribed Pain Medication for Chronic Pain
There are so many different types of medications prescribed to patients to treat many
different things. Many types of these prescribed medications are abused such as: stimulants,
depressants, and opioids. Stimulants are used to treat ADD (attention deficit disorder) and
narcolepsy (a sleep disorder). Depressants are used to treat things such as anxiety and also sleep
disorders. Opioids, which are used to treat chronic pain, are getting abused more and more over
the decades because of how often they are prescribed and how easily it is for people to get their
hands on them. Although this goes for any drug, the main focus is on opioids that are getting
abused and misused.
What are some prescription pain medications for chronic pain that are commonly
abused/misused?
Opioids are the type of drugs that are used to treat chronic pain. They act on the nervous
system sending signals to the brain, particularly to the part of your brain that deals with emotion,
which then weakens the pain stimulant. An effect of taking this drug is tolerance, which means
that your body will get used to taking the drug and you may have to take more of the drug in
order to feel the same effect on your body. Morphine, hydrocodone, hydromorphone,
meperidine, oxycodone, and propoxyphene are some highly addictive opioids. Prescription drug
overdoses now claim more lives than heroin and
cocaine combined, fueling a doubling of drug-related
deaths in the United States over the last decade
Figure 1: Some numbers related to this epidemic.

(Scott Glover, Lisa Girion 2012). Although chronic

pain is a serious health condition, people often tend to overlook the fact that prescribed
medications, coming from their doctor, can be just as harmful and addictive as heroin or cocaine.

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Granting that these prescriptions are easily taken advantage of, if taken properly and as
directed just like any medication, the drugs can be safe and not harmful. Regardless of the fact
that these drugs can be safe if used as directed, dependency build up is always possible when
taking drugs for a long period of time. This epidemic is a prevalent problem that merits attention
from the community. According to the Centers for Disease Control, In 2010, about 12 million
Americans (age 12+) reported nonmedical use of prescription painkillers in the past year.
There are actions that can be taken if one does get dependent on the drug such as: clearing the
system of the drug and also to take different medications to reduce the symptoms. Dependency,
though, is not the only possible outcome from taking prescribed medications for a long amount
of time.
What are the long term side effects of taking prescribed pain medications?
Just like any other drug, taking prescribed or over-the-counter pain medications has its
pros and cons. Obviously taking away the suffering from chronic pain would be a pro. As for
cons, taking opioids for a long period of time can lead to physical dependence, but that is not the
same thing as addiction. As the National Institute of Drug Abuse (NIH) said, Dependence is
often accompanied by tolerance, or the need to take higher doses of a medication to get the same
effect (NIH, November 2014). Dependence to a drug is when your body physically needs a drug
and will get sick without it. Although dependence and addiction can both lead to withdrawal
symptoms, addiction would be when someone goes out of their way, possibly even breaking the
law, to get the drug they are addicted to. Addiction, which can include physical dependence, is
distinguished by compulsive drug seeking and use despite sometimes devastating consequences
(NIH, November2014). Therefore, it is always a good idea to slowly wean yourself off of a
medication by decreasing your dosage weekly, rather than just to stop taking it completely

COMMUNITY PROBLEM REPORT

because doing so can also cause harm to your body causing withdrawal symptoms such as:
restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose
bumps ("cold turkey"), and involuntary leg movements (NIH, November 2014). When opioids
are abused, it can lead to Hypoxia, which is when your brain does not receive the amount of
oxygen needed, also called hypoxia, and abusing these drugs can also lead to death. Hypoxia can
also lead to having permanent brain damage, or even lead to being in a coma.
Another possible side effect would be causing the body more pain than it is already
receiving. According to health pro Lasich, Specifically, the nervous system can become more
sensitive to painful stimulation. This phenomenon is called opioid- induced hyperalgesia. The
nervous system becomes hypersensitive because of physical changes to the way pain signals are
transmitted (Lasich, March 23, 2011). Other things in your body can be effected as well, such as
a hormonal imbalance. In men, levels of production of testosterone can decrease or even stop
completely. More hormones that can be essentially effected would include thyroid hormones,
cortisol, and basically the entire hormone system in the body. A hormonal imbalance can start a
domino effect by then causing emotional imbalances, sleep disruption, metabolic changes, and
cardiovascular stress (Lasich, March 23, 2011). Not many people would think that these
prescribed medications could cause such harm to your body.
What is associated with the illicit use of prescription pain medication among college
students?
Obviously many people take opioids for chronic pain, but that is not the only reason that
people take opioids, especially among college students. Many college students will take these
drugs to experiment, get high, or even to relieve pain such as anyone else. According to Doctors
Boyd, Cranford, McCabe, and Teter:

COMMUNITY PROBLEM REPORT

The leading sources of prescription opioids were friends and parents although there were
gender differences in reports of primary sources. More than 1 in every 10 nonmedical
users reported intranasal administration. Multivariate analyses indicated nonmedical
users of prescription opioids who used for motives other than to relieve pain, obtained
these drugs from non-parental sources, or used these drugs via non-oral routes of
administration were significantly more likely to experience substance use related
problems.
These drugs that college students get their hands on can come from a number of sources
including, the black market, their family members drug cabinets, friends, etc. Easy access to
these drugs includes more times to experiment.
As you can see, it is not too difficult to obtain these drugs. According to one study, The
majority of students obtained prescription pain medication for illicit use from peers and the
second leading source was family members. There were several gender differences in the risk
factors and sources of illicit use of prescription pain medication. (Boyd, McCabe, & Teter). This
study also showed that it is more likely for women to get these types of drugs from family
sources, while men are more likely to get these drugs from peer sources. Although, the majority
of men and women get them from peer sources. Still, there are other factors as well that depend
on how these college students get their hands on these types of drugs. As you can see, gender is
one of the main factors, but we must also take into consideration when looking at where these
college students get these types of drugs would be their gender/ethnicity, their living
arrangements, and even their family income. Most of the time when people have money, they can
afford to go to the doctor more often and are more likely to have these types of drugs already in

COMMUNITY PROBLEM REPORT

their houses due to access via prescriptions. Doctors also are contributing to this epidemic, even
though they may not know it.
How are doctors contributing to or preventing the abuse?
A few ways that doctors are contributing to this epidemic would be overprescribing these
types of medications. Most of the time doctors give their patients what they ask for to keep them
happy and to keep their cliental. One of the most important things that plays a role is of course,
business. In 2007, Purdue Pharma and three of its top executives pleaded guilty to criminal
charges that they had misled the F.D.A., clinicians, and patients about the risks of OxyContin
addiction and abuse by aggressively marketing the drug to providers and patients as a safe
alternative to short-acting narcotics (Gounder, November 8, 2013). As doctors, we need to look
at the long term effects of what we do, not just the short ones.
Although doctors are contributing to the abuse, some are trying their best to control their
patients consumption of medications. According to Patrice A. Harris, there are a few things to do
to prevent this which include: Use state-based prescription drug monitoring programs (PDMP),
discuss with patients available treatment options, and take advantage of educational
opportunities. People need to have more knowledge about the subject in order to help control it.
Conclusion
If health care providers, physicians, and patients would approach these things to prevent
the abuse and misuse of prescribed pain killers, together, we can slow down this epidemic from
spreading any larger. The faster we can make people aware of this problem, the faster we can
come up with a solution.

COMMUNITY PROBLEM REPORT

7
References

Celine Grounder (2013, November 8). Who is responsible for the pain-pill epidemic? Retrieved
from http://www.newyorker.com/business/currency/who-is-responsible-for-the-pain-pillepidemic
Center for Disease Control (2011, November). Prescription painkiller overdoses in the US
Retrieved from http://permanent.access.gpo.gov/gpo49429/2011-11-vitalsigns.pdf
Christina Lasich (2011, May 23). The consequences of long-term opioid use for chronic pain.
Chronic Pain. Retrieved from http://www.healthcentral.com/chronicpain/c/27148/138734/consequences/
Kathryn L. Hahn (2011, March-April). Strategies to prevent opioid misuse, abuse, and
diversion that may also reduce the cssociated costs. American Health and Drug
Benefits. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106581/
MinnesotaDHS (2013, July 30). Heroin at home: rise of opiate abuse. Retrieved from
https://www.youtube.com/watch?v=nXAu_pWg0ss
Patrice A. Harris (2015, July 29). What physicians can do to stop the opioid overdose epidemic?
AMA Viewpoint. Retrieved from http://www.ama-assn.org/ama/amawire/post/physicians-can-stop-opioid-overdose-epidemic
Prescription Drug Abuse. What are the possible consequences of opioid use and abuse? (2014,
November). National Institute of Drug Abuse. Retrieved from
http://www.drugabuse.gov/publications/prescription-drugs-abuse-addiction/opioids/whatare-possible-consequences-opioid-use-abuse
Scott Glover, Lisa Girion & Liz O. Baylen (2012, November 11). Legal drugs, deadly outcomes.
Retrieved from http://graphics.latimes.com/prescription-drugs-part-one/

COMMUNITY PROBLEM REPORT

Sean E. McCabe, Chrisitan J. Teter & Carol J. Boyd (2005, January 7). Illicit use of prescription
pain medication among college students. Drug and Alcohol Dependence, Volume 77,
Issue 1, Pages 3747. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0376871604002054
Sean E. McCabe, Chrisitan J. Teter, Carol J. Boyd, & James A. Cranford (2007 March). Motives,
diversion and routes of administration associated with nonmedical use of prescription
opioids. Addictive Behaviors, Volume 32, Issue 3, Pages 562575. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0306460306001705