FAQs About the Center for Addiction Recovery at UPMC in Central Pa.

A narcotic is a medicine used to alleviate pain. This may be prescribed by your provider if you have had a recent surgery or experienced an injury. These medicines are legal when prescribed by your provider, but are not to be taken without a prescription. Other common names for narcotics include prescription pain pills or opioids.

Some commonly prescribed narcotics include:

• Oxycodone (Oxycontin®, Roxicodone®)
• Oxycodone and Acetaminophen (Endocet®, Percocet®)
• Hydromorphone (Dilaudid®)
• Hydrocodone (Zohydro®)
• Hydrocodone and Acetaminophen (Lortab®, Vicodin®)
• Fentanyl

When you take a narcotic medicine, you may feel dizzy, drowsy, experience nausea or vomiting, have trouble concentrating or feel grouchy. These side effects typically go away over time, but can return if you temporarily stop or decrease the amount of medicine you are taking. You are may also experience these symptoms again if your provider increases your dose. One side effect that commonly occurs and will not go away over time is constipation. Health care professionals refer to this as “opioid induced constipation”. The only way to resolve opioid induced constipation is to stop taking the narcotic. Your provider may recommend you take another over the counter medicine to help produce bowel movements while on the medication.

Talk to your provider if you experience any of the above side effects while taking your narcotic.

Taking a narcotic can make you more likely to experience more severe side effects. These are called risks. Risks associated with taking narcotic medicines include:

• Respiratory depression: Narcotics can make your breathing slow and shallow, resulting in inadequate oxygen consumption. This can ultimately lead to brain damage, coma, or death.
• Tolerance: Tolerance occurs when your body adjusts to the narcotic you are taking. As you continue to take the medication, your body becomes dependent on it. Although you continue to take the same medication and same dose, you may feel as though the narcotic is no longer helping you. As tolerance develops, you may feel as though you need to take more medication just to experience pain relief. Tolerance can lead to addiction.
• Addiction: Addiction occurs when your body becomes dependent on the medication. You may feel as though you have to take the medication in order to function throughout the day. If you were to stop taking the medication, you would experience withdrawal symptoms. It is important to understand that anyone can become addicted to narcotics.
• Withdrawal: Withdrawal can occur when you stop taking your narcotic. Over time, your body becomes dependent on the medication. Once you stop taking the narcotic, there is a chemical imbalance resulting in withdrawal. Withdrawal symptoms can include sweating, tremor, heart palpitations, anxiety, headache, insomnia, irritability, nausea or vomiting, or difficulty breathing.
• Overdose: Overdose can occur if you take too much of the narcotic medicine or you are taking a narcotic in combination with other medicines such as benzodiazepines. Overdose from prescription narcotics can ultimately lead to death. According to the CDC, the total number of narcotic overdoses in the United States reached 47,055 in 2014.
• Drug Use: If a person does not have access to or develops a tolerance to prescription narcotics, they may be tempted to take other drugs to help with their pain. Heroin is an illicit street drug that people may be tempted to take. Using other drugs such as heroin to alleviate pain can lead to overdose and death.

44 people a day die from prescription opioid overdose. The majority of deaths occur in people ages 25-54 who are non-hispanic whites.

How long you take your narcotic medicine will depend on the reason you are taking it. Your provider may decide to stop or slowly taper off your narcotic medicine if it is no longer helping you or you are at increased risk of side effects. If you begin taking a narcotic and do not experience pain relief within 1 month, it is very unlikely that you will experience pain relief with long term use. For most patients, 3 days of treatment or less is typically long enough to experience pain relief (unless pain is caused by major surgery).

Your provider will work with you to stop or slowly taper off your narcotic medicine. Do not abruptly stop taking your medicine unless your provider tells you to do so.

Depending on how much of the medicine you take and how long you have been taking it, you could experience withdrawal symptoms when you stop taking the medicine. Withdrawal occurs when your body becomes dependent on the narcotic and is then stopped abruptly. This can be very uncomfortable and may influence you to take the medicine again.

Having a family history of addiction increases your risk of becoming addicted as well. It is important that you tell your health care provider if you or a family member has a history of drug or alcohol addiction.

Risk factors for addiction include (NIH):

• Unhappy at home or had an unhappy home growing up
• People who have clinical depression, anxiety or ADD. These people tend to use drugs to help them feel better.
• People who have a history of alcohol or other substance abuse. (CDC)
• Having problems at work, school or with family or friends. This may cause people to abuse drugs in an effort to get their mind off of the tough times
• Spending time with friends/family who use drugs
• Trying drugs when younger increases risk of addiction when older
• Person specific. Not everyone is the same and not everyone enjoys the way narcotics make them feel. Those who enjoy the effects of narcotics are more likely to become addicted.
• Living in rural areas and having low income (CDC)

Risk factors for overdose (or addiction) include (CDC):

• Obtaining narcotic prescriptions from multiple doctors
• Taking high doses of narcotics
• Patients who take benzodiazepines and a narcotic are four times more likely to overdose.
• Using long acting or extended release formulations for acute pain

NO. Sharing of your narcotic medicine is illegal and when taken by someone other than yourself could be life threatening. People who take a narcotic medicine that was not prescribed for them are more likely to become addicted and abuse heroin, an illicit street drug. It is very important that you do not share your medicine with anyone.

MedReturn is a service available for safe disposal of unwanted medicine. These units are available throughout the state of Pennsylvania. Be sure to remove of any personal information prior to disposing of the medicine. This includes your name, address, or phone number.

For more information and to find a unit in your area.