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February 22nd, 2012
02:15 PM ET

Dr. Sanjay Gupta: The truth about prescription medication addiction

Whenever I hand a prescription for pain pills to a patient, I tell them, “Remember not to drink any alcohol when taking these medications.”

For years, we in the medical community thought that simple message was getting through. It turns out we were wrong.

Every 19 minutes someone dies because of misuse of prescription medications. Sometimes it is because they take too much. Many times it is because they forget or ignore the warning their doctor gave about combining the medications with alcohol. And tens of thousands of people die every year as a result.

As much attention as we pay to illicit drugs such as cocaine or heroin, the truth is prescription medications kill more people in this country than those illicit drugs combined. Perhaps it is a perception issue: “It came from a pharmacy, therefore, it must be safe.”

They certainly can be safe, but they can also be incredibly addictive, with more than 1.9 million Americans hooked on prescription pain medications alone.

These painkillers are particularly dangerous because they depress the central nervous system, slowing down breathing and the brain stem’s responsiveness to CO2 to the point where someone abusing these medications can simply stop breathing. Combine these painkillers with alcohol, another depressant, and you’ve got a recipe for disaster.

Researchers are racing to find something that can help, and there are a few promising things in development. A recent study, the first large-scale trial aimed at painkiller dependence, offered some hope.

Almost half of those addicted to painkillers - 49% - were able to reduce their drug abuse when taking Suboxone for at least 12 weeks. The drug works by reducing withdrawal symptoms and relieving cravings.

Unfortunately, the success rate dropped to less than 10% [8.6%] once patients stopped taking the drug. In the study, patients receiving intensive addiction counseling did no better than those who didn’t.

Naltrexone – sold under the brand names Revia and Vivitrol, an injectable, long-acting formulation – has also been used for prescription painkiller abuse. But naltrexone only has the potential to work in patients who are already off the painkillers long enough that the drugs are out of their system.

Truth is most of the researchers I have interviewed over the last decade all seem to agree on one thing: addiction is a brain disease. The latest science shows how the dependence on drugs or alcohol can change the brain chemistry, altering pain and reward centers. As a result of this latest science, the idea of therapy alone to treat addiction is waning.

I should point out that millions of patients use prescription pain medications every year safely, without becoming addicted, and certainly without dying. For nearly 30,000 people a year though, they pay the price with their lives.

As a doctor, I will look my patients in the eye every time I hand them a prescription to tell them the concerns about the pills they will take. It won’t just be a casual reminder about not taking the medications with alcohol, but a forceful warning backed up with scary but forceful statistics. I will remind them that they could become addicted, and they could die. That is our jobs as doctors, and it is one way to save thousands of lives.


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    November 12, 2015 at 23:12 | Report abuse | Reply
  2. Elaine

    Hi Im a female and Im 45 years old. I've been having problems with tolerating medicines that are given to me by doctors. It does not matter for what reason they are given to me. My body can not take any of them. The first time was maybe 5 years ago or more I dont remember. My doctor gave me a med for my high blood pressure. it was the kind that takes out the water from your body. Within 30 to 40min i was dehydraded to a point that i could not lift my head up without feeling like i was going to pass out. my heart rate was like i was running a marathon. When i was taken to the ER after suffer a whole day. The ER doctors were shocked that I waited that long to come in cause they thaught cause of my heart raising i was having a heart attack.I knew that it was the medicine cause that is what i took in the morning and all hell broke loose. The ER specialist could not understand why this happened to me so she spoke to a science prof. I quiess who deals with meds. She told him what happened to me. He told her there are few people like me that my body responds to meds within 30 to 40 min which in most people that same med might respond over a week. Through out the years I've been very careful and letting my doctors know but it is very hard for some to understand what happens to me and they still give me a med and tell me i will be alright and then i end up in the ER again. Just a year ago I caught a virus and i took a total of 4 to 5 Tynol and i ended up in the hospital cause my liver enzymies went up and they said it was from the Tylinol. They gave me the reverse Tylinol serum and that was choking me and I thought I was going to swollow my tongue. They told me to just be pastient and deal with it. But I was deing from this medicine that they were putting in me. Finally, a doctor told them that that they can mix it into the IV flood which will make it a little easier for me to handle. It felt the same but a little lighter not as horrible when they gave it in full. I went through hell and at the end they could not figure out why my liver was damaged or why my blood was poisened. I spoke to a liver specialists and he didnt think it was the Tylynol nor he knew what had happened to me. When i told him that my body is very sensitive to any meds he said then maybe even with a little dose of Tynol it damaged your liver. Just Two day ago I got sick again with a virus and my doctor told me to take Anibotics. I told him that i had some left over from last year and I took one and I felt like i was going to pass out and feel sick to my stomach. I asked if he can give it in a lower dose. He laughted and said that is the lowest i can give you. I told him my problem with meds. cause Im sure he doesnt remember everyone patients problem he said go ahead and take it nothing will happen. Guess what I ended up calling the ambulence because i did not want to pass out infront of my children. I when to the ER and explained my problem. They gave Me IV flood and meds to keep me from vomiting and something to relax me cause i was so scared of what if i had something more serious then this and if i can take a med that will save my life because it might kill me anyways terrifies me. Please, Please help me. I need to know where to go who can i talk to about my problem.

    November 22, 2015 at 12:06 | Report abuse | Reply
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  8. Joy

    I am a chronic pain patient. I follow all the rules. 1 dr. 1 pharmacy. No alcohol. But, you are still treated like a pill popper. I have tried all the alternative medications Drs. have recommended, unfortunately, only opiates work. Until you are in chronic pain. Think of the worst pain you've had, and then try to imagine it every second of every day! You do not realize how bad it is. I do not want to live in my bed when I'm only in my 40's, but that is what I am doing. Why, because there are people out there that don't use the medications as directed. But then alcohol or even cell phones while driving are just as deadly. Who is looking out for the patients that really need this help? No one.

    March 29, 2016 at 14:12 | Report abuse | Reply
  9. David W. Hamilton

    I TOTALLY agree with Joy's comments!! My wife was crippled by a doctor's malpractice, trying to cure migraines with steroids. She lost both shoulder joints and both hip joints. Prior to her first surgeries, she entered psychological counseling for pain management and has been trained in Bio-feedback and all other non-opiate forms of pain management, including the Tens unit, spinal tap, etc. All these methods, while helping to a small degree, did not and do not eliminate her daily pain.
    During a replacement surgery, she was infected by a doctor who did not use gloves to inspect her incision and lost her artificial hip and will not receive another. She now lives without a hip joint! She has also lost her artificial shoulder joint this year. She has had 10 surgeries in the past 2 decades and is now in process of getting 3 more surgeries. A new shoulder replacement, then the other shoulder and then her one artificial hip will have to be replaced.
    She has had one of her surgeries this past year and the extreme pain she had to endure after surgery, has made her afraid of the torture of another surgery.
    Why you ask? It is because of this opiate addiction thing. You people have gotten the medical community so paranoid (by fines and threats of jail time) that they are not giving their patients what they need. This has happened to my wife after her shoulder replacement surgery, in a hospital here in Oregon, and has also been happening with her pain management doctor. He has been the greatest salvation for us, these past decades, prescribing pain management so my wife could function in our society with an acceptable amount of pain. Her pain management doctor is now being forced to wean her off of the opiates that made her life livable.
    So now what is she to do? She has been abandoned by the medical community that really caused all this grief!! Trust me...I do understand that there is a BAD problem with opiate addictions, but you must allow doctors to do their jobs to help these people who have to live with chronic pain! The other alternative is not good.
    I have to now deal with convincing my wife that live is still worth living.
    Dr. Sanjay Gupta, what is a person supposed to do? We are between a rock and a hard place!
    I have no idea how I could live with that much daily pain! Oh, by the way, Teresa has always followed doctor's orders regarding pain medication and has never had any kind of an overdose or bad reaction, and she is only 56 years old!
    BUT SHE IS THE ONE BEING PUNISHED FOR THESE OTHER PEOPLE'S ADDICTIONS!!!!!!!!!!!!!!!

    March 29, 2016 at 17:02 | Report abuse | Reply
  10. Feel Like a Stranger

    I myself think that unless only prescribed for less than a week, one will be able to move on & forget about the pills & move on. I also feel that someone whom is motivated to not let a pill to overcome their minds, bodies, & receptors that become drenched in pills due to long periods of using pills for chronic pain relief can also move it on down the road. The mind is a much more powerful tool than people often give credit for, but these folks are often mislead by some of the things that they read, hear of, or maybe their doctors warn them of. I have to say it's defiently going to take someone more time to get off that has been on them for years & years due to chronic pain, but one has to have self control & take as prescribed or they will pay the piper each month or whatever schedule your on. It's just the nature of the beast, go back to the times of the west Indie traders, & all the Pure Opium used both for conditions of pain, ie: surgery, etc., but got hooked because off the buzz from pure opium because it was more full spectrum (containing all the major known alkaloids, like morphine, codeine, Thebaine, etc . ) but their was also the dens & those that grew the beautiful poppies on their property long before Uncle Sam decided to claim the war on drugs, WHAT A JOKE THAT'S BEEN, & always will be, man wants to get high or drunk etc., he/she will find a way, I find it so crazy here in 2016 that we still have this BS war going on, truth is the governments need it, it brings in monies to the jails, courts, rehab centers, big politicians, & pharmacutical companies TRULLY need this war, or if all was legalized, one had to go to schooling to get certified to do their drug of choice, we would have a much more peaceful world, but to do that now after the world has built such a structure system, to continue to keep them illegal. I'm sorry if I seem to be getting off topic, because in due reality I'm not off topic it all comes down to the monies. I see so many lives ruined by drugs & it's sad but if they were legal & one had to attend classes to get these drugs, eliminating the black market, people want pharacutical grade drugs if it's even just grass, long story short pills are here to stay, I think certain symptoms will be done with like that new morphine like drug w/ all the pain relief & everything except the constipation. I would like to see people think of alternatives to these crazy & highly addictive drugs, theirs so much that's actually good for you & completely legal yet giving both pain relief & the buzz or the depression kicker, like Kratom for example or sceledium & catchiuba another great one. I don't condone the recreational use of RX pain meds because their are truly to many folks out in the world that TRULLY need them & the junkies give everyone a bad name, yeah you I'm talking to you, I've never seen heroin more less done it, but I hear it's everywhere. In the early 1900's when Bayer ( Merck ) made heroin as likely to be in ones medicine cabinet as aspirin is today, again it's all about big business. Look at the CIA they admit to flying in tons of cocaine for certain cartels in exchange for another cartels info, it's both political & sad. Then as you were stating you got lil johny popping grandmas percosets, & he ends up addicted & why, lack of education & not being scared to inform because the youth will find out regardless. I pray for all whom are struggling w/ addiction & I pray for you all & to those who know what I'm speaking, get involved help to teach the youth, it all starts their, they are our future. Cheers to all of you, thanks for reading my post.

    March 30, 2016 at 22:25 | Report abuse | Reply
  11. Name*Pam Armstrong

    My son has the worst form of PSORIATIC ARTHRITIS that there is, they began treating him with opiates and now he's addicted too them!! HE IS GOING TO DIE, PLEASE HELP ME!

    April 26, 2016 at 09:28 | Report abuse | Reply
  12. Name*kjm87

    I am a 29 year old disabled veteran. I have arthritis in my neck and back from the Army. The worse is that I have a spinal cord tumor in the center of the nerves of my spine. I lost my career as an Officer because of it. I am on opioid medication and it kills me that I have to feel like a drug addict because of it. I have never abused my medication and I even tell my PM doctor I don't need anymore if I still have some. I live with 7-8 level pain daily, what am I suppose to do? Addicts and abusers will get these medications no matter what or move to stupid stuff like huffing paint. I have seen 3 neurosurgeons but none want to take the chance opening up my spinal cord. I use to be crazy in shape, now it's a struggle to get out of bed. One thing I would like to add is that you don't ever see in these anti opioid posts. It's the tylenol/APAP aka acetaminophen in the opioid medications that kills people before the opioid. Mixing acetaminophen with alcohol is the major issue. It will kill your liver extremely fast because they are both toxic and are metabolism the same way. One thing I do agree with is if you don't have a severe maladie then you shouldn't be prescribed a strong narcotic medication. There is a happy medium with everything and before my spinal cord tumor I never even took one tylenol, advil, alive ect... I hope everybody gets to live a happy and healthy pain free life. Pain will ruin a person, I was a motivated individual who worked,did Army ROTC and obtained two college degrees. I still hold on to hope that I will find a Surgeon who will help me. I hate medication, I want to keep my liver and kidneys healthy. Going to get off my soapbox now.

    April 29, 2016 at 21:32 | Report abuse | Reply
    • Name*tom

      First Thanks for protecting this country and it's a shame that you can't have a better life than that after all that you and all vets have to sacrifice sorry man hope the best

      May 13, 2016 at 22:34 | Report abuse |
  13. ToM

    If only we had a doctor or someone that could understand people and the drugs that people gets prescribed in half of the hospitals and clinics then I believe we could control abuse and help the people with chronic pain like they need to be treated but that is a big if

    May 13, 2016 at 22:21 | Report abuse | Reply
  14. mipaji1upsurvivor

    Dear Dr. Gupta, I think you diagnosis of addiction being a brain disease is only half right. Knowing you have never had to endure the physical withdrawal symptoms makes that understandable. I had a doctor who I constantly reminded of my concern about becoming dependent on the 20mg Oxycodone he was prescribing for my pain issues. At first I thought that while I was talking and he was typing that my concerns were being entered into and becoming a part of my record there. I finally realized that he did not even listen to what I was saying until such time as I informed him that I was taking time off my medications. That, he heard and immediately dropped me saying I was in violation of our contract. The withdrawals were horrible. I was not given medication to taper down. I was not counseled in other treatments like the Suboxone you mentioned. What I physically suffered was in no way just a brain disease. It is a total body war that you wish at some point would just kill you. It is that bad. The next problem is, you still need pain management because there is no other treatment for your condition. There should be, as a part of contract pain management a required and monitored detoxification period that treats the patient with such medications that stave off the horrible, physical symptoms. The patient would probably require a lower dose of narcotics when starting back on their pain management plan.

    June 4, 2016 at 15:13 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.