Substance Awareness: Opioids
When you feel a headache intensifying or your sciatic nerve starts to flare up again, what is the first action you will likely take? For many, grabbing a bottle of painkillers is commonly a first move towards achieving relief for a variety of painful ailments. Does this classify you as an addict or dependent, just because you want relief from your pain? If we frequently use painkillers, does that mean we are at risk of developing a dependency or an addiction to opioids from pain medications?
Many people in North America are not aware that there are a variety of common prescription pain medications available that contain highly addictive opioid substances, such as Tylenol T1-T4, Dilaudid, OxyCotin, Percocet, or Percodan. Uninformed and habitual use of these doctor prescribed medications can lead a person down a spiral towards dependency and addiction so quickly that a person may never recover from this slippery slope of a journey that they never intended to embark on from the outset. Why are these highly addictive substances in pain medications to begin with? How do they work on the average person?
Receptors of Pain
Most of us would agree that the following sensations are emotional states that nearly everyone wishes to enjoy:
- Relief of pain
- Feeling of reward
Despite how hard we may try, these feelings can at times be difficult to maintain. Sometimes even the initial challenge to attain them is a constant hardship for some. Aside from being positive feelings, these sensations actually have something in common: they are all linked to receptors found in the brain and spinal cord. They are now known as opioid receptors.
These brain receptors are with us almost from birth, and they are continually sending and receiving signals to our brain for the rest of our life. You most likely go about your day without giving these receptors a second thought, yet they can be the driving force in our subconscious for many of our reactions. Most of the time, these receptors do not give you any hassle, that is until something bad happens.
Disease, injury, and surgery are all potential causes of chronic pain. This kind of pain can be with a person constantly and can make it extremely difficult to focus on work, enjoy recreation, and can even make it difficult to sleep. Some of these painful experiences can feel so intense that they can even hinder basic day to day thinking ability as well as short and long term memory. Many people find themselves unable to cope with this severe pain on their own and they need external assistance.
The solution for all of these pain issues can be found in a class of drugs known as opioids. This classification encompasses any natural, partially synthetic, or fully synthetic drugs derived from the poppy plant or chemically synthesized in laboratory settings. This class of drugs includes both legal and illegal forms, but in this article we will generally be referring to the legal but controlled opioid medication that is usually prescribed for pain.
Due to their widespread use, you are most likely familiar with these forms and uses of legal opioids:
- Occurs naturally in opium, a tar-like substance collected from the seed pod of the opium poppy
- The name ‘Codeine’ comes from the Greek word that refers to the head of the poppy plant
- Used to treat mild to moderately severe pain
- It is most often used as an ‘as-needed’ pain relief, prescribed to those who suffer from ongoing or reoccurring pain
- It is the least addictive of all the opiate drugs prescribed today, leading it to become the most widely and commonly used opiate in the world
- Occurs naturally in opium, a tar-like substance collected from the seed pod of the opium poppy
- Used to treat severe pain
- It should not be used to treat short term pain after surgery, with exception for patients that were receiving morphine before surgery
- Most commonly prescribed as an extended-release medication and is intended to provide continuous relief of pain
- The extended release morphine medication should not be considered as an as-needed relief for temporary pain
- A semi-synthetic opiate manufactured by modifying the chemical thebaine, an organic chemical found in opium
- Similar use and effects as morphine
- An active ingredient in many popular pain relief medication such as OxyContin, Percocet, and Percodan
- Intended use of most oxycodone prescriptions is for long-term relief (up to 12 hours) of moderate pain
These opioid drugs function by binding themselves to our brain receptors. They operate to the point that they can efficiently and effectively mimic specific chemicals that are associated with the emotional feelings of pain relief, pleasure, and reward. When legal opioids are used correctly, they can prove to be one of the most effective bearers of pain relief, even when the pain is severe. Opioids are also very effective because additionally, besides relieving pain, they also have a strong positive psychological effect on our brain’s receptors.
The Path to Addiction
Not everyone taking some form of legal opioid medication is an addict just looking to keep their high. For many users, when their pain has finally subsided, they can receive a lesser prescription dosage and eventually stop taking the drug altogether. A dangerous situation can arise when some users feel added stress or extra pain and begin to take an extra dose. They may think that it is no big deal, it’s just this “one time”. When they later return to their usual dosage, they find it no longer has the same effective relief as their initial dosage. People in this situation will soon discover that they have developed a tolerance to typical opioid based pain medications.
Because of the close interaction between opioids and the brain’s receptors, even if the pain does goes away, the end user may already feel heavily reliant on their opioid medications and that they cannot go on without them. They may start exaggerating their pain to the physician, or even go to multiple physicians in an effort to “double doctor”. When these physicians realize what is happening and flag that patient in their database thereby cutting off their legal opioid medication supply, that is when things can turn ugly for the patient.
Due to the extreme withdrawal symptoms they will undoubtedly suffer as a result, they may go to extreme lengths to attain these legal drugs but this time from the black market or another illegal source. They may begin stealing opioid drugs or medications from their friends or even from their family member’s medication cache. Next, they may turn to buying stolen or illegal opioid narcotics from the street simply to keep their fix going. Finally, when their money supply dries up from the endless pursuit of seeking another fix, they may turn to dealing the illegal opioid drug on the open street in order to secure a cheap supply of these opioids for their own use. This gutter-living lifestyle is definitely not where most prescription opioid users ever thought their lives would end up, and this is certainly not where we want anyone to end up much less our loved ones.
It is sad that the origin of this scenario all stemmed from what seemed like an innocent, legal relief for intense pain. This teaches us that though these prescription medications are legal, they are definitely not a force to underestimate. The soaring number of prescriptions being given out by physicians since the 1990s until today seems to be unlocking the dangerous gateway to other illegal opioid narcotics such as doda and afeem, illegally traded morphine, and one of the more popular and dangerous opioid that is dealt illegally on the streets: heroin. We will discuss this opioid and its killer effects further in a future substance awareness article.
Concern for Truck Drivers
Many professions have some potential health risks that come with the job. Long haul truck driving is no exception as it is demanding on the body and can result in increased mental, physical and emotional fatigue. These conditions can arise from sitting behind the wheel for extended hours, continuous vibrations when driving, and lifting or moving heavy objects very soon after a long drive. In flatbed trucking alone, some heavy items might include lifting or applying heavy tarpaulins, water logged wood dunnage, load securement chains or frozen tire chains; Any of these could cause a driver to develop chronic pain in their knees, lower back, shoulders or neck.
In addition to routine exercise and stretching, the natural remedy is simply for the driver to take some time out of their schedule for extra rest and relaxation, but that means they would have to take time away from making money or possibly causing them to worry or stress over their finances. As some opioid medications can provide up to 12 hours of pain relief, there are truck drivers that see this as an ideal answer to their pain issues with an add beneficial feeling of euphoria. Taking these prescription drugs thus can continue to allow them to work, minimizing any time lost for sick days. However, what if a driver’s employer insists that he take the time off needed in order to properly deal with any pain?
Many of the opioid medications discussed in this article are relatively easy to acquire both through legal prescriptions and illegal trade supplies. Seeing as opioid medications are in such common supply, for truck drivers who travel across the country and into the US, there may be increased temptations and opportunities to pick up and use these drugs along their route without thinking about how it negatively affects their safety and the eventual bad consequences of their actions.
In line with CSA-OHS prohibitions and FMCSA standards, it is our policy that no hired or contracted vehicle operator of T&P Trucking may possess or use any drug or medication at any time, whether controlled or not and whether on active duty or off duty, without the express approval from our Safety Department. Any driver found in violation of this policy will be immediately suspended without pay and, depending on the outcome of our investigation, could result in the immediate dismissal from our company. Where the incident involves the driver having possession of an illegal narcotic contraband, this will be reported to the local police for further criminal investigation that could lead to criminal charges and prosecution, which would prohibit a Canadian truck driver from being able to enter into the USA for any reason.
T&P Trucking takes the safety of the public, our employees and the law very seriously. We plead with all employees in the transportation and other industries to please turn away from and say a resolute “NO” to any type of opioid substance that could put you, your family, your fellow employees or the public at risk.