Narcotic Drug Dependence

Narcotics change your response to sensations. Narcotics also produce mood changes, unconsciousness, or deep sleep. The primary medical use of these drugs is to reduce pain. Narcotics are also available illegally and are frequently abused. Sometimes people become dependent on narcotics that are prescribed for pain and continue to use and abuse them when they are no longer needed to manage pain.

Examples of narcotics are:

• codeine
• heroin
• hydrocodone (Vicodin, Lortab)
• methadone (Dolophine)
• morphine (MS Contin)
• oxycodone (Percocet, OxyContin).

Narcotics may make you dependent or addicted when you take them over time to reduce pain or for the pleasant, drowsy, floating feeling they give. Also, if you take these drugs repeatedly you may develop a tolerance to them. Tolerance means you need to take ever higher doses of the drug to produce the same effects.

If you are dependent on a drug, you feel a need for the drug when it is stopped. If you crave the drug, or feel distressed without it, you are psychologically dependent. If you have bodily changes such as hot and cold flashes or tremors when the drug is stopped, you are physically dependent.

The factors that increase your risk of dependence include:

• personality (such as low self-esteem, and being easily frustrated)
• environment (such as people, places, or objects you associate with drug use)
• psychological factors (such as stress, depression, or loneliness)
• chronic pain
• whether it runs in your family
• how sensitive your body is to drugs
• the addictive qualities of narcotic drugs
• easy access to narcotic drugs.

Besides causing feelings of well-being and reducing pain, narcotic drug use may cause:

• constipation
• nausea
• flushing
• low or high blood pressure
• slowed thinking and movement
• sleepiness
• slurred speech
• confusion, poor judgment, decreased memory, trouble concentrating
• slow breathing
• needle marks on the skin
• itching skin
• small pupils.

Sometimes you may have symptoms of shock, such as weakness and pale skin.

Your health care provider will take a complete history and examine you. A sample of your urine may be tested for drug use.

Your health care provider may test you for narcotic abuse by injecting a drug called naloxone hydrochloride into one of your muscles and recording your body's response. If you are using narcotics, your test will show some of the signs of a withdrawal reaction, including:

• faster pulse
• lower body temperature
• larger pupils
• sweating
• watery eyes
• high blood pressure
• yawning
• insomnia
• muscle aches
• runny nose
• diarrhea
• chest hair standing up
• craving for a narcotic.

If you have taken an overdose and have trouble breathing, the health care provider will clear your airway and keep it open with a breathing tube. You may need treatment in the intensive care unit in the hospital. When you're breathing normally, the health care provider will give you a shot of naloxone hydrochloride and watch you for 48 hours. Naloxone hydrochloride blocks the effects of a narcotic overdose.

Your health care provider or counselor will help you to admit that you have a drug problem. He or she will also help you identify the stresses in your life and find ways to better handle stress and anxiety.

Your health care provider will recommend community self-help groups, usually led by former addicts, as well as individual counseling for you. Narcotics Anonymous (NA) offers outpatient treatment but cannot take the place of starting your treatment at a hospital or outpatient treatment program.

Your treatment program will emphasize staying away from all narcotic drugs and other drugs of abuse for the rest of your life. Depending on your particular situation, treatment with methadone may also be part of the program.

Parents, family, and friends should attend counseling sessions to form a support group. These sessions will encourage speaking about feelings. You may also get information about nutrition, exercise, relaxation, and deep breathing techniques.

Withdrawal may last from a couple of days to 2 weeks. Recovering from narcotic dependence is a long-term process. Breaking the habit of dependence is difficult. The first step is to admit that you have a drug problem.

Follow your health care provider's treatment plan. In addition:

• Find resources to help you cope with problems and try to reduce stress in your life.
• Seek counseling for emotional problems.
• Join a self-help group such as Narcotics Anonymous.
• Develop social activities.
• Exercise on a regular basis and eat well for general good health.
• Follow your health care provider's advice for treatment of any other medical problems.

• Stay away from illegal drugs.
• Do not borrow other people's medications.
• Use prescription drugs exactly as your health care provider directs.
• Try to take the lowest dose possible of narcotics prescribed for pain.

For more information, contact:

NARCOTICS ANONYMOUS
PO Box 9999
Van Nuys, California 91409 USA
(818) 773-9999
Web site: http://www.na.org/index.asp