With time, our bodies adapt to the effects of the drugs. We override acclimation by taking more. That’s the vicious cycle, and depending on how long we use it, it is the exact same drug effect that’s used with anesthesia. It’s how we cannot feel pain during surgery, but we keep breathing while the operation goes on. Opioids cause respiratory depression.
We don’t think about breathing on a day-to-day basis, but the number-one cause of death in opioid use is respiratory depression. It causes our breathing to stop. It puts the back of our brain to sleep and literally puts our breathing to sleep as well.
Women are more likely to have chronic pain and be prescribed prescription painkillers, be given higher doses and use them for longer time periods than men. Evidence suggests that for some reason, women may be more likely than men to take these drugs without a prescription to combat pain and also to treat other problems like anxiety or tension.
But there may be other factors that make women more vulnerable to the pernicious effects of the drugs, having to do with biological differences between men and women. We know, for example, that women, in general, have a higher body fat percentage and lower percent of body water. Body fat and water content can affect the volume distribution of certain drugs, such as opioids, and with chronic use, can lead to an increased load of drug in the fatty tissues, and potentially have a toxic effect.
There are 2.1 million people suffering substance use disorders related to opioid pain relievers, according to a report to Congress by Nora Volkow, M.D., director of the National Institute on Drug Abuse. According to Volkow, there is an ongoing epidemic of prescription drug abuse and overdose deaths in the United States. The first step to reducing this problem across the country is to reduce the availability of opioids and limit their use.
Dr. Volkow also points out that while efforts have begun to make that happen, the availability of heroin has been increasing, but experts are not sure whether increased supply or increased demand is to blame. Either way, people have reported choosing heroin because it is cheaper, more available, and provides an even better high, she adds. “In a recent survey of people in treatment for opioid addiction, almost all—94 percent—said they chose to use heroin because prescription opioids were ‘far more expensive and harder to obtain.’”
Heather Healey, LCSW-C, Director of the Employee Assistance Program Association of Flight Attendants-CWA, AFL-CIO, says that aside from doctors pushing opioids, our society conspires to lead people—especially women—to addictive behavior by failing to provide the support they need. Employers expect them to get back to work quickly after an injury. Insurance companies pay for medications, but not for alternative treatments like yoga, meditation or physical therapy. And we have come to believe in our doctors as infallible.
“Everyone is put on narcotics,” says Healey, an addiction expert. “There is a time and a place for narcotics…but we don’t challenge our doctors, we just follow orders,” she says. “We’ve gotten so desensitized to taking medication. We think it’s an easy solution. But we’ve become numb to the risks associated with it.”
If you have chronic pain and your doctor prescribes opioids, ask about other options. “Many people don’t think of medication as a drug of abuse,” Healey says. “They think of it as a drug of use when they are following doctor’s orders.” But the Centers for Disease Control have recently issued new guidelines for treating pain, recommending that doctors start with the lowest pain relief possible.
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