The Pain of Addiction: Self-Harm and Opioids

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November 14, 2016

The Lengths People Will Go

opioidsDoctor shopping is a common way of trying to score painkillers. People in active addiction will visit numerous doctors and hospitals in an attempt to obtain multiple prescriptions for opioids. But medical facilities are aware of this practice and are suspicious when people present with symptoms for which the doctors can find no cause. In addition, online patient histories alert doctors to multiple attempts to get a prescription.
Some addicts, however, try to circumvent these barriers through self-inflicted injuries, particularly broken bones.
One case is that of Kari Richards, who obtained 190 prescriptions at more than 100 hospitals by repeatedly dislocating her shoulder. Another man, who had originally become addicted to opioids when he twisted his ankle, would re-injure the ankle by jumping up and down on it or hitting it with a hammer so he could obtain additional prescriptions. In another extreme case, a man visited 400 hospitals to obtain drugs while hitchhiking across the country for two years. He reportedly inserted objects into his body that had to be surgically removed, thereby justifying the prescription of opioids.
An episode of the show Fault Lines from 2014 examined the opioid crisis and highlighted this practice. In an interview at a treatment facility in Maine, several patients discussed self-harm as a way of scoring drugs. One man reported punching a truck to break his fingers. Another had nine teeth pulled. And a third knew people who had used baseball bats to fracture their own wrists and arms.
Doctors are aware of this practice and are doing what they can to detect those who engage in such activities. Unfortunately, the data for how often people successfully obtain drugs through self-inflicted injury are not available.
Philip Hemphill, PhD of Lakeview Health points out that “Addiction is self-assaultive. The behavioral pathways used to access substances are not rooted in logic or self-preservation.  The need to feel ‘alive’ albeit pain is a desperate attempt to ground oneself. These misdirected creative behaviors exemplify the powerful biology of addiction.”
Family and friends of addicts have long known to look out for signs of drug use. Changes in behavior, work absences, stolen objects, and a host of other indicators routinely show up on warning lists. Repeated injuries, however, are rarely seen as a sign of addiction. To most people, the idea that someone would cause pain to obtain painkillers is not even considered. But if someone is constantly getting injured, it could be a sign of addiction to painkillers.

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