Healthcare

Reducing the risk of prescription painkiller addiction in migraine sufferers

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The abuse of and addiction to painkillers is a global problem, impacting the health, social environment, and economy of societies everywhere. According to the Addiction Center, there are an estimated 4.7 million people dependent on painkillers in the United States alone. 

Of course, not everyone who uses these types of prescription drugs develops an addiction. However, there’s no way to know for sure who will become addicted. We know that people prone to substance abuse are at higher risk, as well as those with a familial history of addiction.

{mosads}The simple fact is that the wide availability of these drugs has made them increasingly accessible, and more people die today from prescription medication overdose than from illegal drugs like heroin or cocaine.

The path to addiction can be as simple as suffering from migraine headaches. Physicians often prescribe strong painkillers for migraine sufferers — including teenagers — in an effort to mitigate the severe and often debilitating pain and discomfort.

While the goal is always to improve the quality of life of their patients, the reality is that some people will find themselves taking their medication more frequently than prescribed.

Jason X, for instance, first became addicted to painkillers when he was just 16 years old and prescribed hydrocodone for his migraine headaches. “It took care of the migraine, but I found myself taking [the painkillers] even when I didn’t have the migraine, because I just enjoyed that euphoric numbness,” he said.

Before too long, Jason was popping 45 prescription pills a day, mostly of hydrocodone, but he also abused tranquilizers like alprazolam and diazepam.

This is all too common: patients are prescribed drugs for medical reasons, but end up abusing their medication to chase the high. And even in situations for which abuse is not the issue, migraine sufferers will frequently use drugs to chase the headache.

Oftentimes piling on abortives will marginally dull headache pain, but actually lead to a higher frequency in headache incidence. However, it’s not easy for people in pain to break their medication habits, and they become dependent on drugs to get whatever small relief they can find from their pain.

Our use of prescription medication has become increasingly problematic in other ways besides the risk of addiction, abuse, and over reliance. Many of the most common drugs create undesirable side effects, like fatigue, weight change, constipation, and stomach ulcers. 

Even more serious risks include damage to the kidney, liver, and heart, and even rebound headaches from medication overuse. Drugs like Fioricet (which is banned in most European countries) can pose withdrawal risks that include seizures, while drugs like triptans can cause cardiovascular risks, not to mention the most common risk of increase in headache: medication overuse.

What are the alternatives to prescription medication to treat migraines? Many people create drastic lifestyle changes in an effort to minimize their chances of getting migraines. This often means that certain work, social, and travel activities are off limits, such as spending time outside in the sun or being around certain smells. Certain foods, like aged cheeses, have also been known to trigger migraines. Many migraine sufferers become prisoners to rigid sleep, food, and exercise routines as preventative measures. Imagine not being able to watch your kid’s little league game or take a tropical vacation, for fear of getting migraines. 

Another alternative to medication are so-called all natural regimens, but these are often costly and ineffective. Oftentimes, going this route involves taking multiple individual supplements, which can be tedious and inconvenient.

And while these are touted and labeled as all natural, read the fine print: some actually contain unnecessary and ineffective additives that can increase the cost or cause undesirable side effects or medication interactions. Alternative regimens might also include any combination of herbal supplements, biofeedback, and acupuncture treatments. The effectiveness of these methods is variable, however, and not necessarily reliable or proven in alleviating migraine symptoms for all patients.

It can be both tricky and expensive to find the right mix of remedies that will actually help a person’s migraine headaches. However, it is most helpful to pinpoint clinically proven substances that can actually help, and eliminate all of the other fillers and additives that only work to increase the cost or create unwanted side effects. There are, in fact, a select number of ingredients that are clinically proven to reduce both the frequency and intensity of migraines.

For example, Coenzyme Q₁₀, also known as CoQ10, is an enzyme naturally found in the human body. There have been a few studies that have shown CoQ10’s effectiveness in helping to treat migraines, with promising results. In one trial, 61 percent of the patients had a greater than 50 percent reduction in the number of days with a migraine. CoQ10 can be found in some food sources like oily fish (salmon and tuna), liver, and whole grains, though of course in lesser amounts than provided by a supplement.

Melatonin is another substance naturally produced in the body by the pineal gland that can be used as a supplement. It has been shown to help migraineurs not only by promoting sleep, but using anti-inflammatory effects that are similar to indomethacin (a common non-steroidal anti-inflammatory drug used to treat migraines), but without as many unwanted side effects. One study showed that a daily 3 mg dose of melatonin was effective in reducing migraine frequency, with over 75 percent of the participants experiencing at least 50 percent fewer migraine attacks.

Magnesium plays an essential role for multiple physiologic processes in the body. It’s naturally found in food sources like nuts, grains, coffee, cocoa, tea, spice, and leafy vegetables. It has been demonstrated in several studies to reduce migraine frequency and intensity, as well as aura and photophobia by decreasing abnormal neuronal firing patterns and stabilizing blood vessels. Interestingly, both melatonin and magnesium have been found to be deficient in people who regularly suffer from migraines. 

By using truly natural ingredients that demonstrate clinical effectiveness, we can work to minimize the reliance of migraineurs on NSAIDs, opioids, and other prescription drugs, and reduce the risk of prescription drug abuse and addiction. We can also help patients avoid the hassle of experimenting with endless combinations of other so-called natural remedies, which end up being costly and ineffective.

In addition, we can work to create better, more effective solutions to migraine headaches that reduce the need for drastic lifestyle changes and adjustments, as well as complicated multi-component treatment methods.

Dr. Patricia Scripko is a neurologist, with a specialty in migraines she’s also the chief scientific advisor to Headaid. 

The views expressed by contributors are their own and not the views of The Hill.

Tags Addiction Healthcare migraines pain killers

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