By Flavia Nassaka
Dependence on drugs that bring short-lived efficacy starts when you disobey prescription orders
Sania Benezeri is diabetic and at one time she had so much pain in her legs that she could not sleep. In addition to her diabetes dose, the doctor prescribed for her some valium, medically known as Diazepam. The drug which has sedative properties enabled her to finally sleep.
After spending several sleepless nights, Benezeri was surprised that she could now sleep without so much trouble.
She made taking valium her daily routine to the extent that she diverted from the doctor’s recommendation of taking one tablet per night to swallowing two. She reached an extent of hiding her medicine from her family since her doctor has discouraged it. At times she has to wake up in the night and take more.
Like Benezeri, one in five Ugandans report misusing a prescription drug at least once in their life time, according to Dr. Julius Muloni, a consultant Psychiatrist at Butabika National Mental Health Referral Hospital in Kampala. In most cases, prescription drug abuse surfaces when one makes the first attempt to use the medicine against the doctors’ orders. Fortunately, Dr Muloni says, the majority put the medicine away with no lasting harm.
So how does painkiller abuse progress to full-blown medicine addiction?
«Some people have a genetic predisposition to addiction,” says Seggane Musisi, Professor of Psychiatry College of Health Science at Makerere University, “Taking pain killers can lead to an intoxicating rush that makes the brain want more. Responding to the urge reinforces the cycle, and sets the stage for drug addiction.”
Prof. Seggane says pain killers are often prescribed for the treatment of too much pain and sleeping problems.
He explains that these drugs mask the pain for which they are taken but don’t cure anything. Using them frequently leads to an increased tolerance to the drug as higher and higher doses are required to achieve the desired euphoric feeling. The chronic use can lead to dependence on the drug and when one stops using the drug abruptly, withdrawal symptoms occur. They include restlessness, muscle and bone pain, insomnia, diarrhea and vomiting.
Dr. Muloni says noticing the signs and symptoms of a person addicted to painkillers is not always an easy because they will vary from person to person yet some addicts may be good at hiding their addiction. The common signs, according to him, are uncontrollable craving for pain killers, obsessive thoughts about pain killers, secrecy about their use, hallucination, confusion, and forgetfulness. Others are increased sensitivity to sounds, anxiety, mood swings, and poor work performance, among other symptoms.
Painkillers prescribed in Uganda that have addictive contents include valium used as a sleeping pill, vicodine a narcotic pain reliever that is typically only prescribed for severe pain caused by an injury or disease, morphine, oxycodone, and codeine all of which can be accessed over the counter.
According to Dr Muloni, these drugs work by attaching to a person’s brain receptors and changing the messages received. He says they should only be prescribed for chronic pain and not for pain that can be healed by normal medicines such as paracentamol.
“Doctors are aware of the addictive qualities of these medications and try to control the dosages appropriately to minimize the risk of addiction. Addictions often arise when the patient tries to control their own dosages to manage pain or when unused pills are given away to acquaintances for medical use”, he explains.
He recommends that the medicine should be used under medical supervision as over dose can lead to disastrous effects that come with addiction like slowed pulse, lowered blood pressure, cancer, risk of respiratory distress, heart disease, trauma, stroke and eventually death.
Addiction is a chronic disease that requires ongoing treatment and management. Long-term disease management for addiction can include medications or therapies to help individuals suppress symptoms and prevent other associated diseases.
“Although there is not yet a cure for addiction, there are effective treatments and ways to manage it. This can include helping people reduce and eliminate their use of addictive substances through counseling”, says John Amanya, a Counselor at National Care Center, a drug rehabilitation Center. He says people on treatment for addiction need close medical observation to avoid relapse.
The experts that The Independent talked to do not know exactly how many people are addicted to prescription drugs today, but all agree it is on the rise.