Prescription Opioids – How Much Is Too Much?

Aug 9, 2022

It all starts innocently. Your loved one gets injured in a car accident. His doctor prescribes oxycodone for pain management post-surgery. He has a legitimate need for the medication, but you worry. Will he develop an opioid use disorder? Will he need to go into a detox facility near me just to handle withdrawal from his prescription? We’re in the middle of an opioid epidemic, after all.

Are your concerns justified? Yes … and no.

Prescription Opioids

(Artyom Lisov / unsplash)

What are Opioids?

Opioids represent a class of mind-altering drugs that are naturally derived from the opium poppy plant and synthetically formulated. They act primarily as painkillers. Prescription opioids include:

  • Oxycodone
  • Oxymorphone
  • Hydrocodone
  • Morphine
  • Codeine
  • Fentanyl

And while cycling off prescription opioids after a limited period of time may involve some discomfort, that certainly won’t rise to the level of needing detox services.

Legal Ease for Legal Use

Like any drug, opioids have significant risks associated with their use. While the ongoing opioid crisis continues to shine a light on widespread abuse, it also has frightened doctors into limiting or altogether ceasing to write prescriptions for opioid painkillers because of liability issues. As a result, many patients who justifiably require prescription opioids have had to suffer needlessly because their providers are deathly afraid of being sued for negligence in cases where use develops into addiction.

In late June, the U.S. Supreme Court set an important precedent for medical providers, granting them increased legal protection. The justices wrote that a person legally “authorized to dispense controlled substances” cannot be found liable unless the government can “prove beyond a reasonable doubt that the defendant knew that he or she was acting in an unauthorized manner, or intended to do so.”

Having to prove “intent” means that those doctors caught in the crossfire between aggressive lawsuits and overabundant caution can go back to considering the needs of their patients without worrying about legal repercussions.

Don’t Worry, Stay Vigilant

I have discovered over the years that worrying doesn’t do anybody any good. Knowing the risks and planning for them, however, represents a much better approach. Anytime you or a loved one begins taking opioids, it’s critical to know how to recognize the signs of potential abuse. Patients who meet at least two of the following 11 criteria set forth by the American Psychiatric Association within 12 months would qualify as having an opioid use disorder:

1. You take more opioids than prescribed initially or for a longer time. Your chances of developing an addiction increase considerably when you misuse opioids or justify taking them longer than necessary. Most medical providers prescribe controlled substances pretty conservatively, but that doesn’t mean you leave your opioid use entirely in their hands.

Consider some self-reflection when you think you need more: Why do I feel I need this? Is the pain still really unbearable? Am I to the point where I can handle some discomfort? What are some other things I can do to relieve my pain and help my healing process along?

2. You continually try and fail to quit or cut down on use.

3. You spend most of your time getting the drug, using it, and recovering from its effects. Opioids are hard to come by when working with a responsible medical provider. It takes a fair amount of time and effort to go from doctor to doctor trying to game the system to get additional prescriptions. That doesn’t include the amount of time you’re either checked out on opioids or recovering from the crash afterward. You begin to see how there’s not much space for anything else in your life.

4. You experience intense cravings for the opioid, and you can’t control those cravings. Your brain literally has one focus: get more and use more.

5. You cannot follow through on home, work, or school obligations. Opioids interrupt your sleep patterns and can bring on lethargy, making it difficult to focus on work or other necessary daily activities. You miss appointments, you can’t keep up at work, or you neglect your children. All of these add up and suddenly, your life spins out of control.

6. You keep using even though it’s damaging your relationship with friends and family. In addiction, your brain’s amygdala – the ‘fight-or-flight’ response – takes over, and getting your next hit becomes a life-or-death situation. Unfortunately, our family members often feel the direct impact of our addiction response: we lie to them, steal from them, or even abuse them verbally or physically. We can see the damage we’ve done when we’re sober, but it’s still not enough to stop us.

7. You stop doing the things you enjoy, like exercise, travel, or socializing, and focus more on opioid use. Isolation and depression represent big red flags for suspected addiction. Your loved one seems increasingly detached and distracted and seeks to spend more time alone.

8. You put yourself in dangerous situations while using, such as driving or having unprotected sex.

9. You recognize all of the adverse effects opioid use has on your physical health and mental state, but you keep using anyway. Anxiety, depression, excessive sleepiness, weight gain, improper hygiene, etc. – all these things mean nothing when the amygdala’s in control and your substance is the only thing that matters for survival.

10. Your tolerance level for opioids changes; tolerance is defined as an increased need for the opioid in order to feel good or a significant lack of satisfaction when sticking with the current dose.

11. You go through uncomfortable withdrawal symptoms when you interrupt use, such as erratic mood changes, increased perspiration, anxiety, nausea, vomiting, or diarrhea. You believe your only option to stop these symptoms is to use more opioids.

Something that might also ease your concerns is that there are ways for both substance abusers and non-substance abusers to take opioids as prescribed without falling (or relapsing) into addiction. You can check out our previous blog, Pain Management and Opioid Use During Recovery, for more information.

As substance abuse center counselors, we have first-hand experience with all forms of addiction, including opioid abuse. While addiction can be heart-wrenching for everybody involved, it’s essential to remember that you have various critical resources available to help you or your loved one get clean. These include community support groups, medication-assisted detox, therapy, and addiction recovery center programs.

If you struggle with an opioid use disorder or know someone who seems to be in trouble with opioids, please call us at (855) 736-7262. Our experienced drug rehab specialists can help.