Random Thoughts About Addiction, Delusions and HallucinationsAllan Schwartz, LCSW, Ph.D.
As many readers know, from previous post I recently underwent arthroscopic surgery for a shoulder injury. It goes without saying that recovery from surgery is a painful process. In order to reduce the amount of pain while recovering from surgery, I was prescribed anti-pain medication in the form of Oxycodone. My brief encounter with Oxycodone gave me cause to think about addiction. The fact is that Oxycodone is a synthetic version of heroin and is equally addicting. The reason this or other drugs are prescribed is to hasten the healing process. Extreme pain, if permitted to continue unabated interferes with the ability of the body to fully recover.
I was one of many patients who had a very bad reaction to Oxycodone. In addition to extreme nausea, I also experienced delusional thinking, moved elevation, and a few hallucinations. That is why I was soon taken off of this pain killer and given one much weaker in nature.
What I thought about it after this episode is how and why couldn't people become addicted? At least in my experience, there was nothing pleasant or enjoyable about Oxycodone. In my opinion, nausea, is one of the most awful feelings that a person can have. Yet there are those who deliberately continue to use this drug, despite the nausea, in order to get high. That is just what puzzles me. Where is the high in oxycodone? Yes, I experienced some mood elevation, but my behavior was so unusual that even I was surprised. Hallucinations came in the form of my being certain that I asked for something or said something and got no reply. In point of fact, I had hallucinated the question, having said absolutely nothing.
My question about addiction goes beyond my experience with this drug, and extends to the question of why some people become addicted and others do not. There are those who insist that drug and alcohol abuse are a matter of choice. In other words, people make the choice to use drugs and become addicted. Yet, I know for sure that there was nothing about oxycodone that would ever make me want to use it again. Yet, others become strongly addicted and experience the things I'm complaining about as being very pleasant. It is similar with alcohol. Many people like myself will drink a glass of wine, but never feels the need to have alcohol every day or every night. We do not become alcoholic. Nevertheless, there are those individuals who, once they start drinking, cannot stop. Somehow, this difference reflects not only a lack of choice, but the fact that addiction is a disease. Like most diseases, addiction affects some people, but not others.
One more observation that I've made about my episode with Oxycodone is that experiencing delusions and hallucinations was very troubling. In a horrific kind of way, it was fascinating to observe myself during this period of time without being able to do anything about it. In fact, it did, not occur to any of us that I was reacting to the medication. I now fully understand what is meant by the fact that hallucinations are a person's very real experiences. Auditory hallucinations are not mere thoughts, but are heard with one's ears. There is such a strong feeling of helplessness when this type of thing is happening that it made me really think about what psychotic patients go through. Their world, filled with delusions and hallucinations, must really be frightening.
Finally, this episode, helped me realize in very stark terms, the importance of people dumping their unused drugs in the garbage if there are any left over. When my medication was switched the oxycodone was immediately disposed of. Medicine cabinets filled with unused drugs of any kind are extremely dangerous. It is incumbent on everyone to clean out their medicine cabinets and get rid of unused drugs that are either prescription or non prescription in nature. We know that children and teenagers find their way into their parents, medicine cabinets, remove available drugs, and may possibly become addicted or sell them at school. The National Institute of Mental Health recently reported a fast increase in the number of these drugs, finding their way into schools. Families must become more vigilant about this issue.
Your comments and questions are encouraged.
Allan N.Schwartz, PhD
Views on Oxycodone are Delusional - Lisa - Sep 24th 2010
I'm wondering what kind of Oxycodone "Kenny" gets that causes him to have conversations with people who aren't there? I have been taking Hydrocodone and occasionally Oxycodone for back pain. I am addicted to these kind of pills physically and mentally, but I never get so high that I am hallucinating in any way auditorally, visually etc. Mostly all these pills do to the long term user is give them a feeling of well-being. You just feel better, or "right" when you take them and when you don't you feel bad, not right, not normal and sick. People who never take them tend to get nauseous and I have heard of people having mild hallucinations, when taking a high dose after surgery but that's because they don't normally take them. I can assure you that this nausea is not something Oxycodone users seek. Most drug users work their way up to higher levels and it never gets them nauseous. Some people just don't get that nauseous feeling when they take them even in high doses for the first time. Eating something when taking them is recommended to prevent nausea. I just wanted to correct these inaccuracies. If you've never been an addict it's kind of hard to know what an addict feels or experiences from his drug of choice. And as to the guy whose friend "Kenny" was telling him about drugs, I think he's a little full of it, that doesn't sound like any oxycodone abuser I know but, as to heroine, I know nothing, thank God I was never exposed to it. So maybe that is what "Kenny" was referring to.
Addiction Answers - Terry McLeod - Apr 29th 2010
Late in the Viet Nam conflict, I was loitering around the hootch when one of the troops burst out of the low slung building to spew vomit across the compound. Gross. That was my first-hand introduction to the effects of smoking heroin. It turns out that the nausea is part of the deal, it's necessary if you want to get the most out of the high. This is a physical reality of opiate addiction.
Opiate addiction was an extensive problem for American soldiers. The disease of addiction destroyed morale, took lives, and killed my peers. It was the quest to get out of one's own skin, to be somewhere, to be somebody we were not. Viet Nam was a good training ground for that.
Let's say my recovering friend, we'll call him Kenny, says that explanations of what it's like to be an alcoholic/addict are lost on folks who haven't been in the user's shoes, so those with the disease just give up trying to explain. Delusions and hallucinations are part of the high...they keep it interesting for the user. To lose feelings of inadequacy, the feeling that the user doesn't belong where he is, and get the rosy glow and elevated mood anybody who takes opiates for pain can experience are what the alcoholic/addict thinks they seek. Kenny says that users are really “filling the hole in the soul”, or “getting out of themselves”.
I read a cover story in Time magazine when I was 18 years old that explained that researchers had found the “alcoholic gene”...complete with a spectrograph featuring the twisted, gnarled gene. Appropriate, eh? I was sold, and still agree that alcoholism is genetic.
Kenny's winning me over to the theory that if you drink and use enough drugs, you can warp that gene in a person born a “normie”. This leads to fun in addiction land, as defined by the book Alcoholics Anonymous: a mental craving accompanied by a physical allergy, which gets worse, never better. When an addict or alcoholic uses, a chain reaction is set off. They crave the great drug: MORE! When they don't get their drug, the user gets sick; that's the physical sickness most folks identify as the problem, especially concerning opiates like Oxycodone. Kenny says they have no idea that there's more to addiction than the physical symptoms, and the drive to drink and use is overpowering, the user must fill that hole in his soul.
Kenny has friends who would kill to get the kind of hallucinations you may get when taking oxycodone...they love talking with people who aren't there...people who are there are frequently a pain in the butt who just want the user to quit using drugs and alcohol. Their nightmare is who they have to face after the hallucinations go away...themselves.
Finally, Kenny says the oxycodone and other medications found in medicine cabinets across the country are like heaven in a bottle to an addict. If you don't need them for pain, dump them. Leaving them there is called enabling anybody who has a problem and is driven to look in that cabinet by an unstoppable compulsion, and is called enabling my friend, calls for another story featuring a different friend, we'll call her Marie.