The risk for addiction is greatest when an opioid produces a great deal of pleasure through the release of dopamine in the brain. If the release of dopamine is small or non-existent, there is little to no enticement to use more. In fact, the enticement is just the opposite—to use as little as possible because side effects, such as constipation, difficulty starting the urine stream, dizziness, and nausea are problematic. Here, the adverse side effects are a barrier to developing an addiction. These individuals, who represent the majority of users of painkillers, have a very low risk of developing an addiction to painkillers.
There is also evidence that genetics controls who releases more and who releases less dopamine when using an opioid …show more content…
If, on the other hand, they were to be used indefinitely, then I would reclassify them as harm reduction strategies.
Do physicians over-prescribe painkillers?
Yes. The problem has been developing over the past twenty years and is now at its highest and most dangerous level. In part, it’s due to the dilemma of how best to treat and chronic pain. Long-acting painkiller formulations, usually dosed twice daily or applied as a skin patch, are now a medically accepted treatment for chronic pain.
Accessibility to painkillers is greatest in communities where the principal industries are physically demanding and are more likely to lead to injuries. In North Carolina, these include logging, farming, and textiles. In West Virginia, the principal industry of coal mining is physically demanding and prone to injuries.
When patients have access to opioids, some may choose to sell part or all of their medication. OxyContin® sells for about $1 per mg, and Opana® sells for $3 or more per