We live in a world of quickened expectations. No one has patience to wait for anything. If we click and our computer takes more than a millisecond to bring up a file we are yelling at it angrily. When we feel the slightest discomfort we are at our medicine cabinets searching for immediate relief. Our TV ads insist it’s possible to live this way and thrive. We expect it. We demand it. So of course we support an industry that provides us with chemical solutions to seemingly every possible cause of human distress. Unfortunately, some of these chemical solutions cause worse problems than they solve. And above all, they woo us into believing we don’t need to understand why our head hurts, as long as a little pill will make it feel better. How else are the share holders of the pharmaceutical company going to enjoy a prosperous investment if people don’t have to keep buying the product again and again because they don’t know how to change the conditions or behavior that is causing the discomfort?
On the other hand, a nation in emotional pain does need relief. Here are the pharmaceuticals Americans are reaching for in staggering numbers. In a Kaiser Family Foundation survey in 2015 more than half of Americans have been personally touched by painkiller abuse, with 16 percent knowing someone who has died from an overdose. In fact 63 percent of white respondents, 44 percent of black respondents, and 37 percent of Hispanic respondents either had personally abused the drugs, knew someone who had taken painkillers without a prescription, been addicted to them, or died in an overdose.
And painkillers are just one segment of the massive pill popping going on right this minute in houses and street corners where you live. Here are descriptions of the major drugs used with and without prescriptions in America today:
Acetaminophen: The generic name for Tylenol. A pain reliever (analgesic) and fever reducer used as an alternative to aspirin. Can cause severe, even fatal, skin reactions and liver damage. Symptoms of overdose are often delayed and are a result of liver damage. Symptoms include: stomach pain, nausea (upset stomach), unusual tiredness, dark-colored urine, light or clay-colored stools, jaundice (yellow skin and eyes), fever, and rash.
Adderall: A combination of amphetamine and dextroamphetamine used for ADHD and narcolepsy (to help the person stay awake during the day). How it actually works for ADHD is unknown. It is thought to block reuptake of norepinephrine and dopamine. It takes about 3 hours to reach its full concentration in the blood. Under normal circumstances, as much as 40% of the dose is recoverable as amphetamine in the urine. Remember that the next time someone teases you for taking vitamin C and claims you are just creating expensive urine. Adderall is sold by students diagnosed with ADHD to fellow students in high school and college.
Benzodiazepine: Anxiolytic, hypnotic, sedative, and anticonvulsant. This class of drugs includes Valium, (diazepam), Xanax (alprazolam), Klonopin (clonazepam), Ativan (lorazepam). Used for panic attacks, anxiety, alcohol withdrawal, seizures, insomnia, and depression. Works on one of the three kinds of GABA receptors in the brain. Highly addictive, especially Ativan and Xanax. A difficult and lengthy withdrawal. Not recommended for the elderly. Schedule IV. Two systems that have been successful helping people detox are Heather Ashton in England and Jim Harper in Southern California. Their websites are www.benzo.org/uk/manual and www.theroadback.org
Buprenorphine: Buprenorphine is a semi-synthetic drug derived from thebaine, an organic compound extracted from the opium poppy. Also found in Suboxone, which is buprenorphine and Naloxone.
Buprenorphine is a legal addictive opiate prescribed by physicians for opiate abusers to keep them from the physical, legal, and emotional morass of heroin or Oxycontin addiction. Since the Drug Enforcement Administration (DEA) doesn’t require the same level of control over buprenorphine prescribers as over methadone clinics and since buprenorphine is commonly used 3-4 times a week rather than daily, it can be part of a “risk reduction” program for patients at home. This means if a person can afford to pay a trained private physician to prescribe and monitor the dose, he or she doesn’t have to appear daily at a drug treatment program as is necessary with methadone.
Another benefit: Buprenorphine is a partial agonist, which means it activates the opioid receptors (mu receptors) in the nervous system only up to a point, even if the dose is increased. Since it occupies the opiate receptor site, if the user takes a dose of opiates along with it in an attempt to get high, it is unlikely to result in the desired high.
Buprenorphine is a Class C drug in pregnancy, meaning there doesn’t seem to be a risk for the fetus but there isn’t enough research to be sure. It can cause breathing problems and moves into breast milk so breastfeeding is contraindicated. Also contraindicated is taking buprenorphine with certain other medications such as benzodiazepines and sedatives, including alcohol.
As with any opiate buprenorphine causes constipation and can cause headache, sweating, or insomnia. Overdose symptoms include pinpoint pupils, blurred vision, slowed breathing, and extreme drowsiness. Schedule III.
Hydrocodone: Synthetic generic narcotic. See Norco and Vicodin. Often combined with antihistamines in prescription medication for cough. Can treat pain from injury, surgery, cancer, arthritis. Highly addictive. Can cause constipation, stomach pain, nausea, dry mouth, drowsiness, shallow breathing. Opioids can cause birth defects. Also not for nursing mothers. Schedule II.
Methadone: Called “an imperfect but essential tool” by the Washington Post. A legal alternative to heroin, distributed by special clinics on a daily basis. It lasts longer in the body than heroin and according to users is more difficult to stop using. At least those folks using methadone can stop hiding from the law, be present for their children, avoid preterm infants, keep a job, stop criminal activity, and live a life (the death rate of methadone maintenance participants is a third that of heroin users) instead of their life revolving around seeking a hit. Their life is restricted somewhat since many must show up at the clinic for a daily dose. Some are allowed to take doses at home but there are still restrictions on freedom of movement away from clinic supervision. Used as a part of a “risk reduction” program.
Methadone takes 2 to 4 hours to reach its full effect and therefore doesn’t produce the “rush” sought by heroin addicts. However, it accumulates in the body. It takes a while to figure out the right dose that will stop withdrawal symptoms. Some people continue to use methadone for years. Some work at getting off it. The best time to detox if pregnant is the second trimester, but often the woman is advised to stay on the drug until after delivery and then slowly detoxify from it.
Methadone is a synthetic opiate, a narcotic that removes the high from heroin but also removes the withdrawal symptoms of stopping using heroin because it occupies the same receptor sites. It is frequently prescribed to non-heroin users as a pain reliever. Since it has an effect on breathing people with asthma are advised against using it. Like every narcotic it also causes constipation. In addition, it sometimes causes a heart arrhythmia.
Norco: Brand name of one company’s combination of hydrocodone plus acetaminophen. Has same two ingredients as Vicodin but less acetaminophen. Schedule II.
Oxycodone: Generic name of strong narcotic pain reliever in same category as morphine and codeine. Oxycontin is a long acting form of Oxycodone used for people suffering severe, chronic pain such as with cancer or rheumatoid arthritis. Percocet is a combination of Oxycodone with acetaminophen. Acetaminophen, in large doses, as you may recall, is toxic to the liver. Percodan is a combination of Oxycodone and aspirin. Oxycodone is dangerous to the fetus in pregnancy and to the baby if breastfeeding. Schedule II.
Opiate use is right now of epidemic proportions in the US as I detailed earlier. Two years after a couple of steroid-using construction workers in Florida put an ad on Craig’s List for doctors willing to prescribe opiates and purchased a case full of Oxycontin wholesale they had made $40 million. Their clinic, ironically called American Pain, was directly responsible for thousands of addicts across Appalachia who moved from the more expensive pills to less expensive heroin to keep themselves from going through withdrawal. A journalist and college professor named John Temple wrote a whole book on the phenomenon named American Pain.
Ritalin: Brand name for methylphenidate hydrochloride. Concerta is the extended-release form of Ritalin. Both versions are central nervous system stimulants. However Ritalin’s action on the dopamine system is almost immediate while Concerta’s is slow, making it less likely to be abused.
Ritalin contains D&C Yellow No. 10 and FD&C Green No. 3 as well as lactose, sucrose, talc, and polyethylene glycol. These ingredients themselves can cause allergic reactions in some people.
Not to be used for people with tics, Tourette’s, or severe anxiety. Long-term use can stunt a child’s growth. Can pass into breast milk. Fetal effect unknown. This drug is sold among students and used for its stimulant effects. Schedule II.
SNRI: Serotonin and Norepinephrine Reuptake Inhibitors are antidepressants that are also used for anxiety and chronic pain. They stop the recycling, through reabsorption, of two neurotransmitters, calming serotonin and stimulating norepinephrine. Brand names are Cymbalta (duloxetine), Effexor XR (venlafaxine), and Pristiq (desvenlafaxine). Common side effects include nausea, dry mouth, dizziness, sweating, and headache. Sexual dysfunction may also result as well as loss of appetite, insomnia, tiredness, or constipation. Cymbalta can influence blood sugar in people with diabetes. Though not addictive, it, like other psychoactive drugs, should never be abruptly stopped but rather the dose slowly reduced.
SSRI: Selective Serotonin Reuptake Inhibitors act exclusively on the serotonin presynaptic nerve endings, preventing re-absorption of serotonin that has been released into the synapse. This allows more of the neurotransmitter to be around longer and to find its receptor site on a nearby nerve which allows the feel good message to continue through the nervous system. These drugs are used for panic, depression, and PTSD. However, if the nervous system is genetically set to produce too little serotonin eventually the system doesn’t work because even the small amount produced isn’t recycled and reused.
At the beginning it takes several weeks for an SSRI to kick into action, unlike the amino acids 5HTP and L-tryptophan, which work in fifteen minutes. Ditto for ear acupuncture. In our study of research we will go over a study that found ear acupuncture helped improve the results of SSRIs.
Some SSRI generics followed by their Brand name: Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil, Pexeva), and Sertraline (Zoloft).
SSRIs have multiple side effects like sexual dysfunction, insomnia, nausea, headache, irritability, anxiety, and constipation. In 2008 a study found this class of drugs was no more effective than a placebo except in the most severe cases of depression. Paxil can cause birth defects and suicide, especially in the young.
Seroquel: An antipsychotic for schizophrenia or bipolar disorder. Not for children under 13 if for schizophrenia and only for those over 10 if for bipolar. Can be used with antidepressants for adults with depression. Long-term use leads to tremors that can be permanent. Can lead to suicide especially in the young.
Sleeping pills: Ambien, Sonata, and Lunesta are non-benzodiazepine Schedule IV controlled substances. In 2012 research suggested regular users were five times more likely to die as non-users and the heaviest users were more likely to develop cancer than non-users. This study follows others showing high death rates in Canada, Sweden, and Norway. Less tragic side effects include depression, next-day grogginess, allergic reactions, and confusion.
Steroids (anabolic): Synthetic versions of the male sex hormone testosterone. Anabolic indicates they are used for muscle building. They are abused by athletes and bodybuilders who want to enhance their performance or improve their appearance by a greater definition of male sexual characteristics. They may be swallowed, injected, or rubbed on the skin in doses ten to 100 times greater than normally prescribed by a physician. Abusers cycle their use to avoid tolerance or negative effects. Some of those negative effects can be mood swings and a resistance to stopping their use so as to avoid withdrawal symptoms. Withdrawal can include depression to the point of suicide attempts, insomnia, reduced sex drive, and fatigue. Steroid use in men can lead to kidney damage, liver damage, heart problems, reduced sperm count, breast development, shrinkage of the testicles, and increased risk for prostate cancer.
Suboxone: A sublingual tape that treats opiate dependence. It contains both buprenorphine and naloxone. Buprenorphine sits on the opiate receptor and stops the user from getting high. Naloxone, called “The Second Chance Drug,” is designed to quickly reverse an opioid overdose. As long as the person uses the Suboxone as prescribed, dissolving it under the tongue, the naloxone won’t be activated and there are no withdrawal symptoms. If a user of Suboxone attempts to abuse the drug by injecting opiates the Naloxone immediately kicks the person into withdrawal that cannot be reversed by taking heroin or any other opiate and the symptoms are extremely uncomfortable. It is because of the Naloxone that specially trained private physicians are legally allowed to prescribe Suboxone in their offices. Schedule III.
Tramadol: Generic for Ultram. An opiate pain reliever. Can lead to shortness of breath or seizures. Addictive. Drinking alcohol while on Tramadol can cause death. Tramadol is dangerous to a fetus and can pass into breast milk. Schedule IV.
Trazodone: Generic for Desyrel. Anti-depressant that works in in several ways. It blocks serotonin receptor sites as well as receptors for histamine and adrenaline. Used for insomnia at low doses and as an antidepressant at higher doses. Can lead to suicidal ideation. Not approved for children. Not a controlled substance so widely prescribed.
Vicodin: Addictive pain killer combining hydrocodone and acetaminophen. Schedule II.