This is the group that’s more likely to be prescribed opioids -- and get addicted

When you picture drug addicts, you probably don’t conjure images of middle-aged women. But that’s exactly who is most likely to be prescribed opioids, and that initial Rx sets them up for addiction, according to a recent study sponsored by Pacira Pharaceuticals Inc. (Here’s what your doctor might not tell you about pain medication.) These facts are alarming, especially considering the nation’s current opioid addiction epidemic. According to the Centers for Disease Control and Prevention, 91 Americans die every day due to an opioid overdose. As you might recall, the White House has declared the opioid crisis a national emergency.

“We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths,” the CDC said in a statement. The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010, the agency notes, yet there had not been an overall change in the amount of pain that Americans reported. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999.

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What opioids do to your health
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What opioids do to your health

Opioid painkillers capitalize on our body's natural pain-relief system. We all have a series of naturally produced keys ("ligands") and keyholes ("receptors") that fit together to switch on our brain's natural reward system — it's the reason we feel good when we eat a good meal or have sex, for example. But opioids mimic the natural keys in our brain — yes, we all have natural opioids! When they click in, we can feel an overwhelming sense of euphoria.

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Opioid painkillers can have effects similar to heroin and morphine, especially when taken in ways other than prescribed by a doctor.

When prescription painkillers act on our brain's pleasure and reward centers, they can make us feel good. More importantly, though, they can work to reinforce behavior, which in some people can trigger a repeated desire to use.

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You may also feel sleepy.

Opioids act on multiple brain regions, but when they go to work in the locus ceruleus, a brain region involved in alertness, they can make us sleepy. Why? The drugs essentially put the brakes on the production of a chemical called norepinephrine, which plays a role in arousal.

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Your skin may feel flushed and warm.

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You'll begin to feel their effects 10 to 90 minutes after use, depending on whether they're taken as directed or used in more dangerous ways.

Some drugmakers design versions of their medications to deter abuse. Extended-release forms of oxycodone, for example, are designed to release slowly when taken as directed. But crushing, snorting, or injecting the drugs can hasten their effects.

It can also be deadly. Between 2000 and 2014, nearly half a million Americans died from overdoses involving opioid painkillers and heroin, a report from the US Centers for Disease Control and Prevention found. The most commonly prescribed painkillers were involved in more overdose deaths than any other type of the drug.

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Your breathing will slow as well.

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Depending on the method used, the effect can last anywhere from four to 12 hours.

For severe pain, doctors typically prescribe opioid painkillers like morphine for a period of four to 12 hours, according to the Mayo Clinic. Because of their risks, it's important to take prescription painkillers only according to your physician's specific instructions.

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Overdosing can stop breathing and cause brain damage, coma, or even death.

2014 report from the American Academy of Neurology estimates that more than 100,000 Americans have died from prescribed opioids since the late 1990s. Those at highest risk include people between 35 and 54, the report found, and deaths for this age group have exceeded deaths from firearms and car crashes.

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Combining them with alcohol or other drugs — even when taken according to the directions — can be especially deadly.

Since they slow breathing, combining opioid painkillers with other drugs with similar effects can drastically raise the chances of accidental overdose and death.

Yet they're often prescribed together anyway, according to the National Institute on Drug Abuse. "Unfortunately, too many patients are still co-prescribed opioid pain relievers and benzodiazepines [tranquilizers]," the institute said. In 2011, 31% of prescription opioid-related overdose deaths involved these drugs.

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Abusing opioid painkillers has been linked with abusing similar drugs, like heroin.

A CDC report found that people who'd abused opioid painkillers were 40 times as likely to abuse heroin compared with people who'd never abused them. The National Institute on Drug Abuse says that close to half of young people surveyed in three recent studies who'd injected heroin said they'd abused prescription painkillers before they started using heroin.

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You may also develop a tolerance for the drugs so that you need more to get the same effect over time.

Tolerance to opioid painkillers happens when the brain cells with opioid receptors — the keyholes where the opioids fit — become less responsive to the opioid stimulation over time. Scientists think that this may play a powerful role in addiction.

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Suddenly stopping the drugs can result in withdrawal symptoms like shakiness, vomiting, and diarrhea.

Taking prescription painkillers for an extended period increases the likelihood that your brain will adapt to them by making less of its own natural opioids. So when you stop taking the drugs, you can feel pretty miserable. For most people, this is uncomfortable but temporary.

But in people who are vulnerable to addiction, it can be dangerous because it can spurn repeated use.

"From a clinical standpoint, opioid withdrawal is one of the most powerful factors driving opioid dependence and addictive behaviors," Yale psychiatrists Thomas Kosten and Tony George write in a 2002 paper in the Journal of Addiction Science & Clinical Practice.

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The study, which looked at data from 600 private hospitals and over 78,000 patients, focused on those most affected by the opioid epidemic—women ages 40 to 59. This demographic has the highest death rate from opioid drugs, according to the report.

Part of the problem is that this group is likely to undergo surgeries—including for hernia, total knee replacement, colectomy, hysterectomy, total hip replacement, sleeve gastrectomy, and rotator cuff surgery—and surgery has been shown to be a “gateway to persistent opioid use and potential misuse,” according to the study authors. In fact, women prescribed painkillers after surgery were 40 percent more likely than men to become persistent opioid users, according to the findings. Surgery-related overprescribing results in 3.3 billion unused pills, which become available for misuse, per the study. In fact, nearly three million patients in 2016 who underwent surgery continued taking opioids beyond their post-surgical recovery period.

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Famous faces of drug overdoses
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Famous faces of drug overdoses
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It’s not surprising that women are prescribed painkillers more often than men, because women and men experience pain differently. (Here are more medical conditions that strike the sexes differently.) According to sciencedaily.com, women are more sensitive to pain due to the fact that they have more nerve receptors to register the sensation. If you are going to take painkillers, especially opioids, here are 13 questions to ask your doctor before taking pain medication.

And before heading off the pharmacy to fill the prescription, consider trying these two mind-body techniques proven to treat pain.

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