Autoimmune Disorders and Opiate Addiction

Autoimmune Disorders and Opiate Addiction

As more is known about autoimmune disorders, their diagnosis and treatment becomes more common if not always safer or more considered. Because of this the overlap between these disorders and addiction grows, yet this growth can be combated with awareness, effective addiction treatment and appropriate long-term care. The American Autoimmune Related Diseases Association[1] (AARDA) states, “The National Institutes of Health (NIH) estimates up to 23.5 million Americans suffer from autoimmune disease and that the prevalence is rising. We at AARDA say that 50 million Americans suffer from autoimmune disease…The NIH numbers only include 24 diseases for which good epidemiology studies were available. Researchers have identified 80-100 different autoimmune diseases and suspect at least 40 additional diseases of having an autoimmune basis. These diseases are chronic and can be life-threatening.” Some of the better-known autoimmune disorders include HIV/AIDS, multiple sclerosis, lupus, Crohn’s disease, fibromyalgia and rheumatoid arthritis, but the complete list of autoimmune disorders is much, much longer. Symptoms of many of these diseases include pain, and pain and other symptoms may arise long before underlying conditions can be diagnosed and proper treatment begin. AARDA explains that an autoimmune disorder diagnosis and treatment is difficult to achieve because, “Symptoms cross many specialties and can affect all body organs. Medical education provides minimal learning about autoimmune disease. Initial symptoms are often intermittent and unspecific until the disease becomes acute.” When patients are in pain, are experiencing unexplained symptoms and are worried about their health, doctors want to help them feel better. Before a diagnosis can be made, doctors may treat pain generically and with a quick prescription for increasingly powerful opiate drugs.

Long-Term Opiate Use and Autoimmune Disorders

Doctors and pain specialists often write prescriptions before a diagnosis is made, and they are even more likely to write or continue to renew prescriptions after an autoimmune disorder has been identified. The New York Times[2] reports, “The long-term use of opioids to treat chronic pain is relatively new. Until about 15 years ago, the drugs were largely reserved for postoperative, cancer or end-of-life care. But based on their success in those areas, pain experts argued the medications could be used to treat common kinds of long-term pain with little risk of addiction.” Even as doctors began to suggest using opioids for long-term pain management in autoimmune and other chronic illnesses, there were questions. One doctor, “who championed the drugs’ broader use, said the new data about the potential high-dose risks was concerning. But he added that the medications were extremely valuable and that their benefits needed to be factored into policies.” Most medications come with side effects, and while some of these are worth experiencing for the benefits the drugs provide, this is rarely the case with long-term opiate use. The benefits of these drugs quickly wane while the downsides escalate.

Autoimmune disorders are chronic by definition, meaning symptoms progress over time and the underlying condition can be managed but not “cured.” The long-term nature of autoimmune disorders makes opiate addiction an even more likely risk than when these drugs are prescribed for short-term pain such as that following injury or surgery. The New York Times explains, “Doctors often increase opioid dosages because patients can adjust, or develop tolerance, to the drugs and need greater amounts to get the same effect. Pain specialists…had argued that it was safe to increase dosages so long as doctors made sure that patients were improving.” Patients with chronic diseases may have periods of remission or some alleviation of symptoms, but as a whole these disorders continue to develop much like addiction itself. Since pain increases in time and opiates decrease in effectiveness in time, when opiates are prescribed for autoimmune disorders, dosage can reach staggering and dangerous levels without an overall improvement in patient health. In fact long-term opiate use has just the opposite effect on mental and physical health.

Autoimmune Disorders and Mental Health

Another reason combining autoimmune disorders and opiate use is risky is that these long-term disorders are often accompanied by understandably high levels of depression or anxiety. The Centers for Disease Control[3] reveal, “Mental illnesses — most specifically, depressive disorders — were associated with increased prevalence of chronic diseases. This association between depression and chronic disease appears attributable to depressive disorders precipitating chronic disease and to chronic disease exacerbating symptoms of depression. The complex interrelationship between depressive disorders and chronic disease has important implications for both chronic disease management and the treatment of depression.” Depression, anxiety and other mental health issues can worsen the actual or perceived experience of pain and autoimmune disorders, and these disorders can in turn increase mental health symptoms. This is a cycle that can be managed and reversed through therapy and various skills, techniques and practices such as meditation and yoga, but when opiates are added to the mix, management of mental health, physical health and addiction can become overwhelming. Opiates are central nervous system depressants, and addiction is also tied to a cycle of cause-and-effect with mental health. Wellness comes when patients and doctors work together to address addiction in conjunction with mental health and autoimmune disorder symptoms. When opiate use become problematic, specialized substance abuse and addiction treatment programs that include pain management services and medical supervision offer a way forward.

Manage Autoimmune Disorders and Move Forward from Addiction

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[1]https://www.aarda.org/news-information/statistics/. “Autoimmune Statistics.” American Autoimmune Related Diseases Association. Web. 27 Apr 2016.

[2]    http://www.nytimes.com/2012/04/09/health/opioid-painkiller-prescriptions-pose-danger-without-oversight.html?_r=0. “Tightening the Lid on Pain Prescriptions.” New York Times. 8 Apr 2012. Web. 27 Apr 2016.

[3]    http://www.cdc.gov/pcd/issues/2005/jan/04_0066.htm. “The Vital Link Between Chronic Disease and Depressive Disorders.” Centers for Disease Control. 4 Jan 2005.