Opiate painkillers now kill more Americans than cocaine or heroin, reports this article in Harvard Mental Health Letter. Prescriptions for opiate drugs like OxyContin have increased tenfold in the U.S. since 1990 and the 2009 National Survey on Drug Use and Health found that nearly two million Americans were abusing prescription pain relievers – almost twice as many people as are addicted to cocaine.
Unlike other forms of pain management, opiates activate the pleasure receptors in the brain, causing euphoria and leading to a high likelihood of addiction. According to the article, this risk makes prescribing painkillers such as OxyContin and Vicodin for moderate pain controversial.
The article also reports that certain characteristics make a person predisposed to abuse, such as age (teenagers and young adults are more likely to become addicted) and a family history of addiction. Because opiate addiction creates long-term changes in the brain and users are prone to relapse, treatment for addiction is most successful when it is completed in two phases: detoxification from the painkillers, followed by a longer or indefinite maintenance phase.