East Texas Has an Opioid Problem, From Prescription

If you think that the drug abuse trend in the great state of Texas has anything to do with its closeness to the Mexican border, you are right. Texas shares a 1,254-mile border with Mexico, which is a big factor in the state's drug problem, especially with the illegal drug heroin.

According to the National Drug Intelligence Center, Texas Drug Threat Assessment, this border area is widely used by the cartels to smuggle illicit substances to the United States. That’s because most of is open, including state parks and this makes it difficult to constantly be monitored by enforcement agencies.

Large quantities of cocaine, heroin, marijuana, and meth are trafficked to the country through the border. Federal-wide Drug Seizure System (FDSS) research shows that the amount of drugs seized by officers in the state – most confiscated near or at the US-Mexico border – consistently surpasses that of any other region in the United States

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But despite the law enforcement effort, cartels still find creative ways of ferrying the drugs across the border, whether it’s through roads, air, rail, water, or underground tunnels. And while smuggling happens anywhere across the border, commercial smuggling is prevalent in the Gulf of Mexico and the Rio Grande River.

Prescription opioids in East Texas

Illicit substances aren’t the only drug problem in Texas. The seemingly safe prescription medicines are also frequently abused and can cause serious issues, like overdose and death. In 2018, there were 14,975 deaths involving prescription opioids in Texas, according to the National Institute on Drug Use. Although the national prescription opioid-involved death rates decreased by nearly 7% from 2018 to 2019, the Centers for Disease Control and Prevention reveal that more than 70% of the 70,630 deaths in 2019 involved opioids.

Prescription drugs produce feelings of calmness and euphoria when taken in large doses. And while they aren’t meant to be taken this way, people may become tolerant over time and begin taking larger doses to feel the effect. This is part of the reason Texas law limits opioid prescriptions for acute pain to 10 days – with no refills allowed. A separate law also mandates physicians to check a state database to track whether patients with moderate to severe pain have already gotten the drugs elsewhere.

The regional needs assessment showed that the lifetime use rates for codeine syrup, Adderall, and benzodiazepines in the south- and northeast Texas were 15.5%, 4.4%, and 4.1%, respectively. Additionally, there were 7 prescriptions per 10 people in northeast Texas compared to 5.2 per 10 people statewide, according to the assessment.

Examples of commonly abused prescription drugs in East Texas include:

Misuse of prescription medicines is widespread, especially among adults and teens. Xanax is particularly prevalent for teens. Houston, which lies in Southeast Texas, near the Gulf of Mexico and Galveston, is a source city for bulk quantities of pain medicines. Most of the supply comes from diverse activities at Houston’s many illegal pill mills, organized pharmacy theft, and prescription fraud.

Counterfeit pill production

The rise of counterfeit pill production makes the prescription drug situation even worse. Fake Xanax and hydrocodone pills containing fentanyl and other synthetic opioids are increasingly being seized. These impure drugs can have severe side effects and lead to overdose and death in worse cases. In fact, reports show that misused opioids accounted for more deaths than any other drugs save for cocaine.

According to the DEA, fentanyl-laced counterfeit pills remain a leading cause of overdose deaths in East Texas and across the country. As cheap, potent fentanyl infiltrates the heroin markets, the drug will augment and supplant white powder heroin in different markets.

Texas is in the top five states for a total number of opioid-related deaths. It also has the second-highest opioid abuse-related health care costs, amounting to over $1.9 billion, according to the City of San Antonio Metropolitan Health District’s overview. Hundreds of people die of overdose every day, and deaths involving schedule II drugs have outpaced those of heroin and cocaine combined since 2002. The crisis has led several East Texas counties, like Upshur, Titus, and Bowie, to hold drug manufacturers like Pfizer Inc., Purdue Pharma, and Johnson & Johnson responsible for the economic burden of opioid addiction.

Opioid addiction

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Opioids such as fentanyl, heroin, and pain medications are highly addictive because they activate powerful reward centers in the brain. These drugs activate opioid receptors on cells situated in many areas of the spinal cord, brain, and other body organs, particularly those involved in feelings of pleasure and pain. When they attach to these receptors, they block pain signals and flood the body with dopamine. This effect can reinforce the act of using the drug, making one want to repeat the experience.

Long-term use of opioids can cause some people to develop tolerance. In this case, they’ll need higher and more frequent doses to achieve the desired effect. But this causes neurons to adapt so that they only work normally when the drug is present. The absence of the drug causes withdrawal symptoms, some of which are life-threatening. At this point, one is likely to rely on the drug to keep these symptoms at bay.

Treating opioid addiction

Chronic pain patients who develop opioid addiction need medical support to quit using the drugs. There are many inpatient and outpatient facilities in Trinity, Newton, Polk, Port Arthur, Tyler, Texas, etc., dedicated to treating people with addiction. Other programs, like the Deep East Texas Opioid Response Program, can also help with addiction care. Many of these programs use medications like buprenorphine or methadone to help individuals get off of opioids. In cases of opioid overdose, patients are given Naltrexone to flush out receptors to reverse the overdose.

Take advantage of the many resources available in the region to ensure you or your loved one is free from opioid addiction. The East Texas Council on Addiction and Drug Abuse is one such resource that acts as the first step for those seeking help. But you can also contact us today to learn how we can help you get off drugs and lead a clean, healthy life.

How Chronic Pain Can Lead to Drug Abuse

Pain is a normal part of life. It is our body’s reaction to illness or injury – a warning that something is wrong. Usually, pain lessens as soon as the body recovers. The hurting stops and things go back to normal. But this doesn’t happen all the time. Not when it’s chronic pain.

Chronic pain is a persistent pain that’s ongoing and lasts longer than three months. It lingers on even after the illness or injury has gone away. Chronic pain can limit mobility and reduce strength, endurance, and flexibility. This may make it hard to get through daily activities and tasks.

Chronic pain may last for months or even years. It may feel dull or sharp, causing an aching or burning sensation in affected areas. The pain may be intermittent, steady, or on and off. According to the Centers for Disease Control, 20.4% of adults in the US had chronic pain in 2019.

Currently, it’s the leading cause of long-term disability in the country, affecting about 100 million Americans. Studies show 1 in 4 people with chronic pain will develop chronic pain syndrome (CPS). This occurs when they experience mental health issues like anxiety and depression, on top of the pain.

Chronic pain symptoms

Chronic pain, like other long-term health issues, leads to complications beyond the physical symptoms. It causes depression, feelings of guilt, poor sleep, loss of interest in sex, suicidal thoughts, exhaustion, stress, and anxiety. The consistent pain makes it hard for one to manage tasks, keep up with work or attend a social gathering. This leads to problems with relationships and work. Some studies suggest that the severity of these issues is directly proportional to the pain.

How chronic pain leads to addiction:

Chronic pain intensifies mental health issues that cause addiction

Many studies show a strong link between chronic pain and mental health issues. In one of these studies 10-87% of chronic patients had depressive and anxiety symptoms. Personality disorders are also common among these types of patients. Chronic pain and mental health disorders are linked because they both share neural pathways, making it hard for the brain to distinguish them.

In addition, chronic pain has some profound social and behavioral effects that feed into a mental health condition. Prolonged chronic pain causes social isolation that intensifies issues like anxiety and depression. That’s where addiction comes in.

Experts are learning more and more about the strong link between mental health issues and addiction. According to NIDA, people who develop mental disorders are also diagnosed with substance use disorders. Another report by the National Bureau of Economic Research says that mental issues are responsible for the consumption of the following: 40% of cigarettes, 44% of cocaine, and 38% of alcohol.

Self-medication is by far the most common culprit behind most dual diagnoses. For example, a chronic pain patient with low energy takes crystal meth to increase their drive to get things done. Meth addiction can happen the first time it’s used. To make things worse, the drug can cause horrible side effects on the body. Meth mouth is one of the most common physical side effects of meth use.

Treatment involves prescription opioids that can be highly addictive

Prescription opioids are one of the common drugs that doctors prescribe for chronic pain issues. Since the early 1990s, doctors have been prescribing opioid painkillers like morphine, hydrocodone, codeine, and oxycodone for pain problems. These medicines manage pain well and can improve quality of life when used correctly. But unfortunately, anyone who uses opioids is at risk of developing an addiction.

Short-term use of opioid pain relievers rarely causes addiction. However, when a patient takes them for a long time (or incorrectly), they are likely to abuse the drug, develop tolerance and end up with addiction.

Opioids are highly addictive. They make the body and brain believe that the drug is necessary for survival. So the chronic pain patient will want to keep taking the medication. But as they develop a tolerance to the prescribed dose, they may find that they need even more medication to relieve the pain. This may lead to dependence.

This is why patients have to adhere to their doctor’s recommendations at all times. Opioids are not only addictive but also potentially life-threatening. On average, opioid overdoses account for 90 deaths in America every day.  According to WHO, 70% of drug use deaths are opioid-related – with over 30% of these deaths arising from an overdose.

Withdrawal symptoms cause patients to continue using drugs

Many chronic pain patients become dependent on prescription opioids to avoid pain. But when one takes the medication for a long time, they become tolerant. Over time, the body needs more drugs to achieve the same effect. Extended use alters the way neural pathways work in the brain. And these neurons start depending on the drug to function.

As a result, the patient becomes physically sick when they stop using opioid medication. So, they use more drugs to avoid pain and withdrawal symptoms.

Patients try out alternative drugs to relieve pain

Prescription opioids are hard to obtain. Some patients may opt for alternative drugs that are cheaper and easily accessible – like morphine and heroin. Research suggests that misuse of opioid pain medicines like Vicodin and OxyContin may open the door for heroin use.

According to NIH, about 4-6% of those who misuse opioid medicines switch to heroin. But a staggering 80% of those who use heroin, begin by misusing prescription opioids.

Managing chronic pain

Prescription opioids are often the last resort for chronic pain management among non-cancer patients. Most patients benefit from psychological treatments, exercises, physical therapy, lifestyle changes, and NSAIDs. But in cases where opioid medications have to be prescribed, it is crucial that they work closely with their doctor to prevent it leading to drug abuse.

Patients who end up with drug use issues will benefit from addiction treatment. Treatment centers have qualified health care professionals who help address behavioral addictions.  The best ones adhere to the guidance of the American Society of Addiction Medicine when treating co-occurring addiction and chronic pain issues.