Opiate Addiction – A Hidden Epidemic

Cliffside Malibu drug and alcohol rehab center
Let’s be specific.  Opiates are drugs derived from opium, such as heroin.  Opioids are synthetically created drugs that mimic natural opiates.  Prescription pain killers in the class of opioid analgesics fall into this category.  The term opioid is now commonly used to refer to natural opiates in addition to synthetic drugs.

That said, YES – opioid use is significantly on the rise.  It’s being called a hidden epidemic by medical, public health, and public policy professionals.

The LA Times recently reported that based on their analysis of Centers for Disease Control and Prevention (CDC) statistics, drug overdoses are now the leading cause of accidental death, surpassing motor vehicle accidents in 2009.

The Clinical Journal of Pain reported that in 2006, nonmedical use of prescription opioids (pain medications) cost the United States $53.4 billion dollars in lost productivity, addiction treatment, and medical complications.

Dr. Len Paulozzi of the CDC writes that the accidental overdose rate for opioids analgesics (prescription pain medications) is now greater than deaths attributed to heroin and cocaine overdoses combined.

At Cliffside Malibu, we too are receiving more requests than ever before for prescription medication treatment.  This increased need is one of the reasons we specialize in treating prescription pain killer addiction.


The simple answer is that prescription pain killers are stronger than ever, they are easily accessible, and people inappropriately believe them to be safe because they are prescribed by doctors.

This last aspect is really important.  When approaching someone who is a prescription medication addict, they very often deny their problem for two reasons.  First, they believe that they couldn’t be a person with substance use disorder because their drugs were at least initially prescribed for them by a doctor.  Second, they always argue that they need drugs for their pain.  This may once have been true and may or may not be true any longer.  In either case, the difficulty is helping the addict see the opioids as a drug, not a medicine.

 Is there a certain demographic that is in danger?

Unfortunately no.  If there was a specific group more in danger than others, we could educate that one group about their risks.  But we’re seeing a phenomenal increase in opioid addiction across the board.  In teens and young adults, we’re seeing people who once might have been drug “dabblers” – kids who liked to party but would outgrow their drug use – become hardcore addicts, even with no family history of addiction.  We’re also seeing an increase in addiction levels among the elderly.  Johns Hopkins Medicine Health Alerts states, “A study in Annals of Epidemiology projected that the number of people age 50 and older abusing prescription drugs could increase 190% over the next two decades from 911,000 in 2001 to almost 2.7 million by 2020.”  Prescription pain medication is readily available and highly addictive.  We’re seeing astronomical increases in addiction rates to these drugs.

What are the opiates most people are addicted to?

People are addicted to a wide range of opioids.  These include but are not limited to codeine, hydrocodone, oxycodone, hydromorphone, oxymorphone, and meperidine.  You would know these by the brand names: Tylenol 3, Vicodin, OxyContin, Percocet, Dilaudid, Opana, and Demerol.  We’re also seeing addiction medications such as Ultram and Suboxone.

More troubling, we’re seeing an incredible increase in the number of people who are taking more than one prescription medication, specifically people mixing benzodiazepines with opioids.  Benzodiazepines are some of the most commonly used medications in psychiatry and include the brand names Xanax, Valium, Klonopin, and Atavan.  While they can have legitimate anti-anxiety effects, they are also sedatives.  When used in combination with analgesic opioids (prescription pain killers), the results can be disastrous.  Accidental overdoses using combinations of medications are increasingly common.  Unfortunately, they can also result in death.

How are they getting them?

This may surprise you, but according to Dr. Paulozzi at the CDC, three-quarters of all people who use pain relievers non-medically got them from a friend or relative.  The line is always the same, “Oh, your back hurts?  I have some pain killers left over from my surgery; let me give them to you.”

Those people who were with a medical problem are getting these medications, at least initially, from their physicians.  Let’s remember, prescription pain killers have legitimate medical uses.  If you have your wisdom teeth pulled, for example, you very well may appreciate having a pain killer for a few days.  The problem is that physicians, not wanting to see patients in pain, can be too liberal with their prescriptions.  Alternatively, patients with longer-term pain conditions find themselves addicted before they know it – and before their pain has diminished to the point where they can be completely comfortable without their pain killers.

How addictive are they?

These medications are extremely addictive.  Keep in mind, they act on the brain in the same way that heroin does.  They are also strong.  Depending on the dosage, tolerance can begin building in as little as a few days.

The problem isn’t only that the drugs are addictive.  The issue is that they are taken differently than prescribed.  Let me give you an example.  A sixty-year-old woman has knee surgery.  She’s given an opioid pain killer.  A week after her surgery, she finds that she’s having break-through pain.  Instead of calling her doctor to report this problem she says to herself, “I’ll just take an extra pain pill.”  This is where addiction can begin.  People incorrectly assume that if one is safe, two is fine too.  The doctor wouldn’t give you anything dangerous!  Haven’t you, with a really bad headache, maybe taken an extra aspirin?  These medications are much, much stronger than aspirin and cannot be taken other than prescribed without opening the door to addiction.

People also share their medications with friends and family members, assuming that because they were doctor prescribed, they are safe.  This simply isn’t the case.  Your grandmother might have had cancer and needed the medication in the dose prescribed.  That doesn’t mean the same medication and dosage is safe and effective for your bad back.

What is interesting is that many addicts, when the cost of prescription pain killers is too high or their source dries up, turn to heroin.  Across the board, these addicts report that their heroin is not as strong as their prescription opioids – and subsequently have to take massive doses of heroin just to maintain their habits.

How are they deemed different than ‘street drugs’?

Drugs are drugs.  Whether prescription or “street,” drugs can be addictive.  Prescription pain medications are sold on the streets – purchased illicitly or stolen.

What people want me to say is that prescription medications are “cleaner” or “safer” than their street counterparts.  That simply isn’t true.  When taken other than as prescribed by a physician for a short term pain problem or as relief from a terminal illness, prescription opioids are as, if not more, addictive than street drugs.  Just look at the accidental overdose rates for proof.

Do you see more pregnant women addicted to opiates?

At Cliffside Malibu, we see more women after they’ve given birth than while they are pregnant.  However, opioid addiction among pregnant women is a significant and growing concern.  Women may be abusing or addicted to pain killers before they know they are pregnant.  Even those who are honest with their doctors when they learn they are pregnant are faced with a terrible choice – curb their habit with the help of drugs like methadone and have a child that likely will be born addicted, suffering terrible withdrawal symptoms, or go off the drugs and potentially lose the pregnancy.

What happens to the babies?

Babies born addicted to prescription pain medications can suffer terrible withdrawal symptoms.  They scream in pain.  They have diarrhea.  They can’t sleep.  They can have seizures and sometimes die if not weaned off the drugs carefully.

How are the babies being born? Side effects?

This question would be better put to an MD.  Since CM is not a hospital setting, this is far beyond your scope of experience.

Can we compare this to the Crack Craze of the ’80s?  Why or Why Not?

The epidemic of opioid abuse is far worse in scope than the “crack craze” of the 1980s if one looks at overall death rates.  People are dying in alarming rates due to accidental overdose from prescription medications.  Also, there is no demographic untouched by prescription medication abuse.  This problem literally affects every group – rich/poor; every race; every age group – everyone.

What are some of the risk factors involved; how might someone know they are developing or have developed a person with substance use disorderion to opioids?

Any combination of these factors could indicate a problem:

Are you taking medication without a prescription or in doses other than prescribed?

Are you taking your medication in a way other than prescribed?  For example, are you snorting or injecting pills a doctor intended for you to take orally?

Are you taking medications for which you do not have a prescription?  Do you get these medications from family or friends or purchase them on the street?

If your physician will not prescribe for you as desired, do you “doctor shop?” – Do you go to several doctors until you find one who will give what you want or do you make up symptoms to get what you need?

Are you refilling your prescriptions early or increasing your dosage?

Do you take more of your prescription than prescribed?

Are you combining more than one type of medication, particularly different drug classes that have sedating effects?


How hard is it to break this addiction?

Breaking a person with substance use disorderion isn’t a question of easy or hard – it’s a question of being committed to the process of recovery and getting the right treatment.  At Cliffside Malibu, we have an extremely high success rate helping people overcome prescription medication addiction.

Cliffside Malibu is unlike any other treatment center in the world.  At Cliffside Malibu we utilize a multitude of different therapies to peel away the layers of addiction. The foundation of our program is the Stages of Change model.  This psychotherapeutic tool allows our therapists to gauge when a client is ready to move through the cycles of the change process, and ultimately to know when they have reached the maintenance stage of the recovery.

What sets Cliffside Malibu apart from other facilities is that we use the Stages of Change model as the basis for making decisions about therapeutic interventions for clients.  People overcome addiction by going through a series of changes, primarily having to do with mental preparedness and willingness to take new actions.  Understanding this process is the key to Cliffside Malibu’s treatment success. We’ve been so successful in using the Stages of Change model that James Prochaska, one of the model’s creators, has endorsed our book, Ending Addiction for Good.

We also incorporate a host of wholly integrated, holistic, evidence-based treatment protocols with intense one-on-one psychotherapy, physical activity, and rejuvenation, to foster recovery for the whole person. The formula for choosing which protocols a person with substance use disorder receives is highly individualized.  Our choices are made based upon an evaluation of each person’s current state of willingness to change and their personal preferences.  We then take the modalities best suited to evoke change in that person and put them together in a personalized treatment program.

Cliffside Malibu is honored to be one of only 6% of the treatment facilities in the country to be accredited by the Joint Commission as a behavioral health care provider. The Joint Commission, previously known as JCAHO, is the gold standard of all the accreditation agencies in our industry.  The Joint Commissions’ seal of approval assures our clients that they will receive the highest quality of care at Cliffside Malibu. Only those facilities that meet certain performance standards receive this symbol of quality and safety.

We are a boutique 18-bed facility, located on a private, serene estate nestled between the Santa Monica Mountains and the Pacific Ocean. Our goal is to create the best possible experience that anyone could have under the trying circumstances that bring them into a treatment setting. That means providing the finest clinical care you can get anywhere in the world combined with the same comfort and convenience you would receive at a five-star hotel.  Our facilities have an understated elegance, offer healthy cuisine using organic foods whenever possible rivaling the best restaurants in LA, and provide luxurious accommodations. The attention to detail is unrivaled.

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