By John M. de Castro, Ph.D.
“The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide, with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin. The consequences of this abuse have been devastating and are on the rise.” – Nora D. Volkow
The over prescription of opioid painkillers in the United States has become a major problem. The number of prescriptions for opioids (like hydrocodone and oxycodone products) have increased from around 76 million in 1991 to nearly 207 million in 2013. This creates a major problem because of the strong addictive qualities of opioids. As a result, opioid addiction has become epidemic in the United States. It is estimated that over 2 million Americans abuse or are addicted on opioid painkillers. These addictions have stark economic costs. It is estimated that the abuse of prescription opioids costs around $60 billion a year, with 46% attributable to workplace costs (e.g., lost productivity), 45% to healthcare costs (e.g., abuse treatment), and 9% to criminal justice costs.
Opioid abuse, however produces even worse consequences than those created by addiction. It is deadly. It has become so bad that drug overdose is now the leading cause of injury death, causing more deaths than motor vehicle accidents. This is a problem both of illegal drug use but even more so of abuse of legally obtained prescription drugs. Of the over 44,000 drug overdose deaths in the United States 52% were from prescription drugs. It would help if doctors were more judicious in prescribing opioids. But, there will still be a need to assist those who abuse or become addicted.
It appears that to some extent opioid abuse occurs from a desire to escape from negative emotions. The abuser then self-medicates with opioids to help them feel better. Hence, it may be helpful to better understand this self-medication to better design treatments for abuse and addiction. Mindfulness training has been shown to be helpful in recovering from addictions. So, it would seem reasonable to investigate the relationship of mindfulness to self-medication. In today’s Research News article “Low Dispositional Mindfulness Predicts Self-Medication of Negative Emotion with Prescription Opioids”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310788/
Garland and colleagues examined the characteristics, including mindfulness and self-medication, of opioid abusers who were seeking treatment. Remarkably they found that 95% of the abusers reported using opioids to self-medicate from the negative emotions of anxiety, fear, depression, sadness, anger, or frustration. Importantly, the higher the abuser was in mindfulness the lower the use of opioids for self-medication from negative emotions.
These findings suggest that mindfulness may be an antidote for self-medication use of opioids for the relief of negative emotional states. But, we cannot jump to this conclusion as the study was observational and did not manipulate mindfulness. So, mindfulness may lower self-medication, or self-medication may lower mindfulness, or some third factor such as intensity of addiction may be related to both. It will require further research to determine causation.
One of the key effects of mindfulness is that it appears to heighten emotion regulation. The individual then experiences the emotions fully, doesn’t suppress them, but is able to respond to them appropriately and adaptively. So, when experiencing negative emotions, a highly mindful person would be able to respond appropriately and not try to escape them with opioids.
Regardless of the explanation it is clear that when mindfulness is high, self-medication with opioids is low. So, stop self-medicating with opioids with mindfulness.
“We can teach people to use mindfulness to appreciate and enjoy life more, and by doing that, they may feel less of a need for addictive drugs.” – Eric Garland
CMCS – Center for Mindfulness and Contemplative Studies
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