Propoxyphene Addiction

Addiction to prescription painkillers such as propoxyphene is a growing problem in the United States. This rise in prescription drug abuse is due, in large part, to the fact that Americans take more narcotics than another other nation on earth. Even though Americans represent only about 5 percent of global population, they consume 80 percent of the world's supply of prescription painkillers, according to the Institute of Addiction Medicine.

The Definition of Addiction

The American Society of Addiction Medicine says that addiction is "a primary, chronic disease" that affects the brain's reward circuitry in a way that leads to physical and behavioral changes. Addiction causes you to crave propoxyphene and pathologically pursue this drug.

A doctor will diagnose you as having a propoxyphene addiction if you cannot consistently abstain from using this drug, crave propoxyphene, or use propoxyphene despite knowing the dangers associated with drug abuse.

Propoxyphene addiction will also interfere with your ability to recognize problems in your own behaviors or personal relationships.

Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment, addiction is progressive and can result in disability or premature death.

Addiction versus Dependence

Propoxyphene addiction and dependence on propoxyphene are two separate medical conditions. With continuous use, especially at high doses, anyone can become addicted to propoxyphene, dependent on it, or both.

Your body responds to foreign substances, such as food, cigarette smoke or medicine like propoxyphene. Your system adapts to the long-term presence of some compounds by adjusting its own chemistry in an effort to maintain a safe chemical balance. If you use propoxyphene continuously, your body starts to depend on a certain level of propoxyphene to feel "normal." When propoxyphene levels drop, your body works to regain chemical stability. You feel the struggle for chemical balance through unpleasant, flu-like withdrawal symptoms. Doctors call this process as detoxification.

A physician will diagnose you as being dependent on propoxyphene if you experience withdrawal symptoms when the levels of propoxyphene drop quickly in your system. You can cause this rapid decline by skipping a dose, taking an insufficient dose or by using a medicine like naloxone, which doctors use to reduce opioid levels in overdose patients.

For a drug-dependent person, detoxification causes unpleasant, flu-like withdrawal symptoms a few hours after the last dose of propoxyphene. Propoxyphene addiction causes behavioral symptoms such as cravings and drug seeking when supplies run low.

Symptoms of Propoxyphene Addiction

Symptoms of propoxyphene addiction include:

  • Inability to Consistently Abstain from propoxyphene Use
  • Other Behavioral Control Problems
  • Cravings for propoxyphene
  • An Inability to Recognize Significant Problems with One's Own Behaviors and Interpersonal Relationships
  • Inappropriate Emotional Response

You can be dependent a substance but not addicted to it, or vice versa. For example, you may depend on an anti-hypertensive; if you do not take your medicine, your blood pressure will rise but you would not feel cravings for your medication or engage in drug-seeking behaviors.

On the other hand, if you abuse cocaine for a long time, you can develop an addiction to it but not dependent on it. In other words, you will crave cocaine but will not suffer the flu-like symptoms typically associated with withdrawal from drugs such as propoxyphene.

It is possible for you to be both physically dependent and addicted to propoxyphene.

Drug seeking activity

Propoxyphene addiction causes drug-seeking behavior, which may include presenting phony prescriptions at pharmacies or altering prescriptions to get a stronger dose or more propoxyphene in each bottle. Another tactic is to pretend to lose your prescriptions, tamper with written prescriptions to get more pills in a bottle or go "doctor shopping" to get as many written prescriptions as possible. Some people get propoxyphene free from friends, relatives or buy it on the black market.

The DEA calls these types of activities "diversion" because of the way abusers divert medicine from legally prescribed use to illicit purposes.

Addiction: What Family Members Should Know

Addiction is a neurological disease and not necessarily an indication of weak moral character or poor upbringing. As with any medical condition, your family member needs love and support for effective recovery to take place. Since addiction is a chronic condition, family members should prepare themselves for many cycles of relapse and remission. Recovery may take months or even years of rehabilitation.

Scientists believe heredity plays a large role in the development of addiction; everyone related to the addicted individual faces an increased risk for developing an addiction at some point in life. Researchers have also established that stress within the home increase the risk for addiction for everyone who lives there.

Stress and Other Environmental Factors

Stress within the home or workplace increases the risk for addictive behaviors for everyone within that environment. Common environmental stresses include chronic arguing or violence between individuals, unequal workloads, financial troubles or other substance abuse. Research shows some individuals are hypersensitive to stress, which increases the changes for developing an addiction. Parents may pass this hypersensitivity onto a child.

Children also learn behaviors from their parents, including using drugs to relieve stress. Adults pass along coping mechanisms, good or bad, onto their children. If you watch a parent deal with stress by drinking or taking drugs such as propoxyphene when you were a child, you are more likely to cope with pressure the same way when you grow older.

Lower your risk for developing propoxyphene addiction or other substance abuse problems by decreasing the ambient environmental stress within the home or office. Learn how to resolve conflicts without resorting to arguments or violence. Reduce environmental stress by reassessing each person's household responsibilities.

Collateral Damage

One person's propoxyphene addiction endangers your entire family. Every person, including your spouse, parents and children, suffers from the collateral damage of addiction.

Propoxyphene addiction robs the family of much-needed funds that were supposed to buy groceries, medicine or pay the rent, but instead went for more drugs. Propoxyphene addiction also steals time and compassion from family members. Propoxyphene addiction renders the individual unable to give the guidance, support and financial care a child needs.

Addiction interferes with job performance. Left untreated, your long-term propoxyphene addiction may result in reduced hours or even loss of a job.

Propoxyphene addiction causes you to do things you would not have done in the past, such as associating with people you would have previously avoided. Doctor shopping, filing phony prescriptions or other drug-seeking behaviors stop working after a while, forcing you to get propoxyphene from drug dealers.

If propoxyphene addiction results in job loss, you may have to resort to crime to pay for your drug habit. Long-term criminal activity usually ends in arrest, jail time and conviction, which is expensive and time-consuming.

Propoxyphene addiction drives up medical costs, especially if it results in overdose or an infectious disease commonly associated with drug use.

Addiction: What Parents Should Know

More teenagers and young adults are using prescription drugs such as propoxyphene than ever before. In a recent national survey, 3 percent of youths aged 12 to 17 said they had used psychotherapeutic drugs such as propoxyphene in the month before. Most of the respondents said they got the drugs free from the family medicine cabinet and from friends or relatives.

Opioids such as propoxyphene are widely prescribed, and many people keep leftover painkillers "just in case." There is less of a social stigma attached to prescription drugs than to illicit ones, making propoxyphene seem less dangerous than cocaine or heroin.

Parents should look for warning signs of addiction including:

  • Unusual loss of interest in things that once were important
  • Drop in academic performance
  • Loss of motivation or energy
  • Finds ways to sneak off
  • Money issues
  • Items missing from the home

Caring for a Family Member with a Propoxyphene Addiction

The family is an important part of rehabilitation from propoxyphene addiction. As when facing any challenge, family members work together to develop a strategy. Every member of the family should participate in the development of the recovery plan and encourage the addicted individual to seek help and complete treatment. Family members often locate the treatment center the addicted individual eventually attends.

Hold group meetings to discuss treatment plans. The individual battling propoxyphene addiction does not have to participate at first. He may even be angry when he first learns the family has been communicating about his disease, but his anger will subside as he goes through the process of recovery.

When to Suggest Treatment

Suggest treatment early and often. It is possible to stop the progression of propoxyphene addiction at any time. Like other serious illnesses, rehabilitation may be easier with early intervention and treatment, before the disease can make significant changes to the nervous system.

Do not let your loved one hit rock bottom before you encourage him to seek treatment. The rock bottom of propoxyphene addiction might be prison, disease, toxic overdose, divorce, unemployment, homelessness or even death. Any one of these terrible consequences of hitting rock bottom makes recovery from propoxyphene addiction that much more difficult.

Recovery often starts when you allow your loved one to experience the full force of negative consequences of propoxyphene addiction. Sometimes, caring family members cushion their loved one from the consequences of propoxyphene addiction, which just allows the addictive behaviors to continue. Family counseling can teach you how to support a loved one without enabling his propoxyphene addiction.

Signs of Addiction

Propoxyphene addiction makes neurological changes that affect the way you behave, think and feel. Doctors look for these changes when diagnosing propoxyphene addiction in a patient.

Behavioral, Cognitive and Emotional Changes

Behavioral:

When you are addicted to propoxyphene, you may use this drug more frequently or at higher doses than you intend. You may express a desire to stop using or cut back on your propoxyphene use, even as you take more propoxyphene. You may try to quit propoxyphene several times; it may seem to others that you are unwilling or unable to quit.

As the disease of propoxyphene addiction progresses, you lose an ever-increasing amount of time looking for propoxyphene, getting high or recovering. Soon, there is not enough time for friends, family, work or school.

Propoxyphene addiction affects your reward circuitry, making everything you used to care about seem less rewarding. You lose interest in your passions so that, eventually, nothing but propoxyphene brings you happiness.

Cognitive:

Propoxyphene addiction changes the way you think. If you continue to use propoxyphene, preoccupation with propoxyphene will push everything else out of your mind.

Propoxyphene addiction changes your understanding of the relative benefits and risks of drug use. Addiction blinds you to the negative effects and risks associated with propoxyphene. Additionally, you blame your problems on other people or events, rather than as a predictable consequence of your propoxyphene addiction.

Emotional:

Many people begin taking propoxyphene and other drugs to relax, feel euphoria and to relieve pain. Propoxyphene addiction causes you to feel the exact opposite emotions: increased anxiety, dysphoria and emotional pain. Some individuals have trouble identifying feelings or expressing emotions to other people.

Propoxyphene addiction increases sensitivity to stress. Many people suffering from opioid addiction say life with propoxyphene seems more stressful.

Symptoms of Addiction

Propoxyphene addiction causes predictable physical and psychological symptoms. These symptoms may be obvious or subtle. Symptoms may vary between individuals and depend on duration of the addiction and the average dose the individual would take.

Physical Symptoms

While doctors usually look for behavioral symptoms when diagnosing a patient has having a propoxyphene addiction, addiction does cause a variety of characteristic physical symptoms.

Physical symptoms of drug addiction include:

  • Unexplained Weight Gain or Weight Loss
  • A Change in Sleep Patterns
  • Deteriorating Physical Appearance - Looks Sickly
  • Nagging Cough
  • Diminished Hygiene Care
  • Body or Clothing May Have an Unusual Odor
  • Bloodshot Eyes with Large or Small Pupils
  • Tremors
  • Slurred Speech

Psychological Symptoms

Psychological symptoms may be difficult to identify because addiction typically causes a person to become socially isolated, away from those who might notice telltale changes in personality. Psychological manifestations of addiction perpetuate drug abuse and interfere with treatment. Left undiagnosed, untreated or undertreated, psychological symptoms of propoxyphene addiction may prevent you from seeking or completing treatment.

Psychological symptoms of addiction to opioids include:

  • Inability to Abstain Consistently
  • Impairment in Behavioral Control
  • Cravings for Drugs or Intense Reward Experiences
  • Diminished Capacity to Recognize Significant Personal or Relationship Problems
  • Dysfunctional Emotional Response

Gender Differences

According to the 2010 National Survey on Drug Use and Health, more men abuse drugs and alcohol than women do. In 2010, 5.9 percent of female respondents said they used illegal drugs. In that same survey, 11.6 percent of males admitted to illicit drug use.

While fewer women abuse illegal drugs such cocaine or heroin, females are more likely to abuse prescription drugs, such as propoxyphene. Females are also more likely to use prescription drugs like propoxyphene along with alcohol, marijuana or other opioids.

Men and women abuse drugs in different social settings. Males tend to get high in groups while females do drugs by themselves. Women with drug problems have smaller social circles than men who abuse drugs. It seems to be relatively socially acceptable for men to do drugs, whereas there is a social stigma against drug use among women.

Men and women begin to abuse drugs in different ways. Males start using drugs such as propoxyphene to get high, whereas women start using drugs recreationally after receiving a psychoactive drug to treat an illness.

Treatment Options

According to the American Society of Addictive Medicine Addiction, addiction to propoxyphene or other drugs causes "disability or premature death, especially when left untreated or treated inadequately. Addiction to drugs such as propoxyphene increases your risk for contracting an infectious disease, such as HIV/AIDS, tuberculosis or hepatitis. Treatment reduces your risk for overdose, adverse reactions and the spread of infectious diseases.

According to the CDC, 27,000 people died in the United States from accidental drug overdose. Statistically, this works out to about one person every 19 minutes. Since 2003, more people now die from prescription painkiller overdose than from cocaine and heroin combined. For each unintentional overdose, hospitals admit nine people for substance abuse treatment.

You can expect two phases of treatment for your propoxyphene addiction: detoxification and rehabilitation. Detoxification is the medical process of lowering the level of propoxyphene in your body. Rehabilitation addresses the behavioral aspects of your addiction to propoxyphene.

Detoxification treats your dependence on propoxyphene; rehabilitation treats propoxyphene addiction through behavior modification and other therapies. Rehabilitation teaches you how to live without propoxyphene by changing the behaviors associated with propoxyphene addiction. Rehabilitation helps restore your neurological function and your reward circuitry.

Detoxification

Self-detoxification or "going cold turkey" means going through the withdrawal process alone, without the help of medications. Cold turkey refers to the pale, bumpy, cold and clammy appearance of your skin, similar to that of a plucked bird.

During self-detoxification, you can expect several days of intense withdrawal symptoms and an increased risk for complications. One complication is aspiration, which means you have vomited and then inhaled the stomach contents. Aspiration can result in fluid in your lungs and lung infections. Excessive diarrhea or vomiting may result in dehydration. When left untreated, dehydration may result in electrolyte imbalances and other serious medical conditions.

The foremost complication of detoxification is the relapse to propoxyphene abuse. You may experience countless cycles of relapse and remission in your efforts to overcome your dependence on propoxyphene. Overpowering withdrawal symptoms and uncorrected addictive behaviors interfere with your recovery efforts, especially without the help of medicine and the expertise of trained professionals.

Withdrawal

Withdrawal symptoms occur several hours after your last dose of propoxyphene.
Symptoms of propoxyphene withdrawal include:

  • Yawning
  • Anxiety
  • Increased Heart Rate and Blood Pressure
  • Restlessness
  • Nervousness
  • Muscle Aches
  • Tremor
  • Irritability
  • Chills Alternating with Hot Flashes
  • Salivation
  • Anorexia
  • Severe Sneezing
  • Watery Eyes
  • Runny Nose
  • Dilated Pupils
  • Sweating
  • Goose Bumps
  • Nausea
  • Vomiting
  • Abdominal Cramps
  • Diarrhea
  • Insomnia
  • Weakness
  • Depression

Your withdrawal symptoms will subside with time. You may also reduce symptoms by taking medicine that mimics the affects of propoxyphene, or by taking another dose of propoxyphene. Without medicine to ease detoxification, many people relapse to propoxyphene just to make the overwhelming symptoms disappear.

There are homemade treatment plans that use prescription drugs and over-the-counter medications to reduce withdrawal symptoms. One remedy is The Thomas Recipe, in which you take valium or some other benzodiazepine that reduces anxiety and helps you sleep. Imodium curbs diarrhea. Mineral supplements and hot baths soothe your achy muscle. Tyrosine with B6 combats fatigue and malaise.

As your symptoms fade, wean yourself from valium by taking successively smaller doses further apart.

The Thomas Recipe will reduce some of your withdrawal symptoms but it still leaves you vulnerable to aspiration, dehydration and relapse. Using propoxyphene after even a short detoxification period can cause toxic overdose. This is because detoxification makes your body less tolerant of propoxyphene. As a result, you can overdose on a smaller amount of propoxyphene than you used to take.

Overdose

Propoxyphene overdose can cause death. If you think you or someone you know has taken too much propoxyphene, seek emergency assistance immediately by going to the emergency room or calling an ambulance, whichever is fastest. If you need immediate help, contact your local poison control center at 1-800-222-1222.

Symptoms of propoxyphene overdose include:

  • Breathing that Stops
  • Cold, Clammy Skin
  • Confusion
  • Extreme Drowsiness
  • Fainting
  • Pinpoint Pupils
  • Shallow Breathing
  • Weak Pulse

While you are in the emergency department, doctors will administer naloxone and other medications to reduce propoxyphene to safe levels quickly. The toxic effects of opioid overdose often outlast the benefits of naloxone, so doctors monitor your opioid levels and administer more naloxone if your opioid levels begin to rise again.

Meanwhile, nurses watch for complications, establish an airway to help you breathe and monitor your vital signs. Nurses may pump your stomach or administer charcoal to absorb any excess propoxyphene. When necessary, nurses and doctors perform CPR or other procedures to save your life.

If you are not in a life-threatening situation, you might benefit from or Drug Replacement Therapy, or DRT, which replaces propoxyphene with methadone, Suboxone or buprenorphine. DRT drugs interact with your body in the same way as propoxyphene so you will not experience withdrawal symptoms, but DRT drugs will not get you high. DRT allows you to engage in rehabilitation for your propoxyphene addiction before going through the detoxification process for your dependence on propoxyphene. At some point, you will still need to wean yourself from the replacement drug or goe through the detoxification process.

If you are like many people, you will have trouble quitting the replacement drug. Harvard Medical School says that about one-quarter of methadone DRT patients eventually quit using drugs altogether while another 25 percent continues to take the replacement drug. About half of all those who use methadone use this DRT for the rest of their lives.

DRT is just one type of Medication-Assisted Treatment, or MAT, approved for use in treating propoxyphene addiction. Medications reduce the overpowering symptoms of withdrawal, helping you tolerate the process long enough to successfully detoxify your system.

Rehabilitation professionals say that MAT is an important and effective treatment approach because it:

  • Improves Survival Rates
  • Increase Retention in Treatment
  • Decreases Illicit Opioid Use
  • Decreases The Risk for Hepatitis and HIV
  • Decreases Criminal Activities
  • Increases Employment
  • Improves Birth Outcomes for Pregnant Women Battling Addiction

Detoxification

Standard inpatient detoxification requires a long hospital stay. During standard detoxification procedures, doctors administer naloxone and other medications to reduce propoxyphene levels, and more drugs to ease your withdrawal symptoms. Regular inpatient detoxification procedures relieve the strength and duration of your withdrawal symptoms but you may still struggle with those psychological symptoms of propoxyphene addiction that can cause relapse.

Rapid detox is the most humane detoxification procedure available today. During rapid detox, board certified anesthesiologists give you the usual detoxification and anti-withdrawal drugs but they also give you sedatives and anesthesia, so you doze in a restful "twilight sleep." When you awaken, you will have no recollection of the difficult detoxification process. You are ready for meaningful behavior modification in a few hours instead of a few days. Rapid detox improves your detoxification experience and puts you in a better psychological position to participate in meaningful rehabilitation.

Detoxification is only the first stage of treatment for your addiction to propoxyphene. Detoxification, by itself, will do little to change your long-term drug use or addictive behavior. It is critical that you engage in rehabilitation and behavior modification.

Rehabilitation

The Substance Abuse and Mental Health Services Administration reports the U.S. admission rate for opioids other than heroin skyrocketed by 414 percent in only ten years. In 1997, hospitals admitted about seven people in every 100,000 for drug abuse. By 2007, rates jumped to 36 admissions for every 100,000 people.

Each of people in these cases experiences addiction in a slightly different way - no two addictions are alike - so rehabilitation specialists have developed a wide variety of treatment plans that fit the complex needs of each individual. No single treatment is right for everyone.

Treatment facilities vary from outpatient counseling centers to long-term, residential programs. Most programs will include individual, family and group counseling and other behavioral therapies. Many therapies include medications combined with behavioral modification and counseling. It is common for those facing propoxyphene addiction also struggle with other mental issues, such as depression, that could benefit from medication. Rehabilitation will address your multiple needs, just your propoxyphene addiction.

No matter what form of therapy or facility you choose, treatment must be readily available and convenient to encourage you to participate long enough to restore neurological function that results in meaningful physical and behavioral changes.

Your counselor is a valuable asset in your rehabilitation. Your counselor will assess and monitor your condition and modify your treatment plan accordingly. During the course of your treatment, your counselor will continuously monitor for drugs, as relapses do occur.

Your rehabilitation specialist will request testing for the HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases. She will also help modify or change behaviors that increase your risk of contracting or spreading infectious diseases.

Treatment does not need to be voluntary to be effective. According to NIDA, individuals under legal coercion tend to remain in treatment longer than and do better than those not under pressure.