Opioids can actually make a pain problem worse over time.
If you think your son may be popping painkillers, scare him by telling him he could be lowering his testosterone.
Seriously. Here’s a study: opioids interfere with the endocrine system, including its production of testosterone.
One estimate has it that 13 percent of American high school seniors take painkillers for fun. Most often they get the pills from family or friends, but some 37 percent of this group are playing around with left-over pills from their own prescription — often for back pain or headaches. In one study, using data from 2007 and 2008, around half of teens who complained of headaches got an opioid prescription, and a third received renewals, even though most of them did not have migraine and the researchers excluded anyone with a diagnosis of trauma.
Such apparently overly-frequent prescribing should change as doctors respond to the Centers for Disease Control and Prevention’s (CDC) 2016 guidelines recommending against using opioids as the first or only treatment for a chronic pain not caused by cancer. In August, every doctor received a letter from the U.S. Surgeon General pointing out that since 1999, “opioid overdose deaths have quadrupled and opioid prescriptions have increased markedly — almost enough for every adult in America to have a bottle of pills. Yet the amount of pain reported by Americans has not changed. Now, nearly two million people in America have a prescription opioid use disorder, contributing to increased heroin use and the spread of HIV and hepatitis C.”
In all the stories about the nation’s painkiller epidemic, you may have missed the danger to kids. According to a large study that tracked ER visits across the nation from 1997 to 2012, the number of kids and teens hospitalized for an opioid overdose nearly doubled during those years.
The good news is that the number of new prescriptions — and hospital visits for overdoses — has already dropped a bit, and experts see data suggesting less abuse.
The CDC issued its new guidelines based on evidence that opioids have been prescribed inappropriately: They actually make you more prone to pain over time. In a 2016 study with rats, morphine enhanced the sensitivity of nerves to pain after an injury. Your spinal cord and brain may become more attune to pain signals.
What does this mean for you? If anyone in your family has a pain problem, there are many avenues to try: over-the-counter drugs, exercise, cognitive-behavioral therapy to identify thoughts that trigger pain, and possibly a change in diet.
If you and your daughter’s doctor decide that she does need a painkiller prescription after an injury or surgery, don’t leave her with a vial of unused pills. Flush any extras down the drain.
If you have a stash of painkillers of your own, ask yourself if you really still need it. The decision can feel tricky if you have a recurring problem with pain intense enough to interfere with your functioning. Remember that the prescription may make your ongoing problem worse. There are other risks. At high doses over time, opioids can weaken your bones, as well as interfere with your hormones.
Either way, keep your pills in a place where your teen can’t easily raid them.
You may tell yourself that because you — or your child — really do have a pain problem, you don’t run the risk of abuse or addiction. In fact, the temptation to abuse a painkiller still exists. If your father drank too much, or you got plastered every weekend in college, you might not have thought much about it. But these are danger signs. A competent doctor will ask you those kinds of personal questions before prescribing any addictive drug.
Many of the teens rushed to the ER for an overdose were attempting suicide. If your teen is depressed, that’s one more reason to get those pills down the toilet.
April 06, 2020
Christopher Nystuen, MD, MBA