How serious painkiller withdrawal can cause muscle aches, panic attacks and anxiety and what really happens if you want to give them up

I felt nauseous and agitated, as though I was trapped inside my own body, until I suddenly woke myself up screaming, sure I was dying.

My husband Chris rushed me to hospital, where doctors told me I was in the grip of severe pharmacological withdrawal after I’d stopped taking a heavy-duty painkiller called pregabalin, which I’d been prescribed to deal with my endometriosis.

I’m not alone in suffering such horrific side effects when trying to come off long-term pain medication.

According to the UK Addiction Treatment Centres (UKAT), its admissions for commonly used prescription drugs, such as codeine, morphine, pregabalin and tramadol, have risen by 33% in the last two years.

“A hidden danger with painkillers is the misplaced belief that they are completely safe because doctors prescribe them,” explains UKAT founder Eytan Alexander.

“But what must be understood is that these drugs are classified as prescription-only specifically because they are addictive and/or dangerous, which means withdrawing from them can be extremely unpleasant.

“While GPs are there to help, they’re under a huge amount of pressure, and time constraints in appointments mean that some people end up being prescribed pain relief as the easy option.”

Of course, this isn’t just a UK problem.

America is currently in the grip of an even bigger crisis, with patients who were given drugs such as tramadol and fentanyl in the 1990s now misusing them 20 years on.

At the time, doctors – and therefore patients – didn’t understand how addictive these medications were.

More than 300,000 Americans have died from overdoses involving prescribed opioids since 2000, and in 2016 alone that toll reached 64,000*, prompting President Donald Trump to declare it a national public health emergency.

But if more isn’t done, experts warn it could become an epidemic here, too.

“There is a growing significant public health concern associated with the long-term use of opioid painkillers in the UK for chronic pain,” says Adam Todd, a reader in pharmaceutical public health at Newcastle University.

“As a society, we tend to focus a lot more on using medicines than alternative therapies. When patients are coming off these medicines, there should be plans in place to help support them.”

In fact, recent NHS figures show that one in 11 adults have been prescribed potentially addictive drugs in the past year, with a 50% rise in prescriptions over the last 15 years. And two-thirds of those on “dependence-forming medicines” are women.

“Studies have shown that women experience more pain than men, so as a consequence they’re more likely to take medication for it,” says Adam.

I began taking prescription painkillers in 2003, when I was 19. I didn’t realise it at the time, but I was suffering from endometriosis – a painful illness in which tissue grows outside the uterus – and I’d been experiencing extreme and debilitating labour-like pains constantly.

I ended up in hospital, being given a dose of codeine phosphate to help take the edge off. No warning was given that my body would become dependent on it, and my GP gave me a repeat prescription.

Even so, by my early 20s, the pain had worsened and regularly made me collapse.

During one bad episode when I was 23, my friend phoned an ambulance. When the paramedics arrived, they gave me a shot of morphine, which made the pain disappear in an instant. But the whole experience was terrifying.

I told myself it was just a one-off, not realising it would get so bad I’d need morphine regularly.

In September 2008, a year after my diagnosis, I met and married my husband Chris, now 34.

He was hugely supportive about my condition, even though I told him my fertility was probably affected. Somehow, though, we did manage to conceive and we had our children in June 2009 and December 2011.

However, after I’d had my second child, I was in more pain than ever, and left with no choice but to take an increased dose of codeine phosphate as well as the anti-inflammatory drug naproxen.

Every morning I would stand in front of my bathroom mirror and wash back a handful of pills just so I could face the day.

Life was extremely hard, as I juggled work as a freelance writer and looking after the children while in agony.

“As a society, we tend to focus a lot more on using medicines than alternative therapies. When patients are coming off these medicines, there should be plans in place to help support them.”

I relied on supportive friends who could help me out when I needed to simply lie down and rest, and would have been completely lost without Chris.

Despite hormone treatment, several operations to try to ease the endometriosis and being regularly rushed to hospital for morphine drips, by the time I was 29, I was taking a concoction of tablets prescribed by my pain management team, including pregabalin, oral morphine and morphine sulfate.

There was no question I needed them, as they did help lessen my excruciating pain, but not once was I told what would happen if I wanted to come off them.

Despite the fact they made me feel woozy and didn’t completely alleviate the pain, there didn’t seem to be any alternative.

'I began to get panic attacks, muscle aches and anxiety'

THEN, in 2013, my consultant suggested that I have a hysterectomy to help manage my symptoms.

It took two years for me to get my head around such a life-changing procedure, but I finally agreed and underwent the op in December 2015, aged just 31.

When I came round from the surgery, it felt like someone had removed a lump of lead from my pelvis, and as the pain began to improve I decided I wanted to wean myself off my cocktail of painkillers, starting with morphine, as I was scared of becoming addicted.

I spoke to my GP, who told me to cut down slowly, so I did. But within just two days the withdrawal symptoms kicked in, and I began to get panic attacks, muscle aches and anxiety.

I’d over-analyse conversations in case I had said something weird, and then breathe a sigh of relief when it hit me that the paranoia was probably caused by morphine withdrawal. When I went back to my GP to check, he simply reassured me it was all normal.

But my mental health suffered massively. Phone calls or texts with friends left me reeling as I spent hours dissecting what I’d said.

When I tried to explain to someone the horror of drug withdrawal, they couldn’t understand, telling me to take paracetamol, as if that would somehow help. All my husband could do was hold my hand and try to calm me when I had anxiety attacks through the night.

In January 2016, I saw my GP about coming off the rest of my painkillers, and again was told I just needed to make sure I gradually decreased the dose. Not once in all the years I’d been on medication did he warn how horrendous I’d feel as my body craved the drugs it now depended on.

Because of the sheer amount of medication I was taking, it took me over six months to withdraw from them one by one, and each one brought horrific symptoms, from a prickling sensation on my skin to nightmares.

“It can cause significant mental trauma, as well as muscle and bone pain. You can also suffer irritability, restlessness, insomnia, vomiting, sweating, shaking and loss of appetite. It’s a lot to go through.”

Every time I decreased the dose of pregabalin, for example, I was struck down with flu-like symptoms. I remember having to rush out of my son’s swimming lesson, convinced I was about to pass out by the pool.

On top of being rushed to hospital, one of my darkest days was halfway through the withdrawal. I sat sobbing on the floor after a shower, shaking because my muscles hurt too much to hold the hairdryer.

I felt like I still had so far to go. I struggled to even make the kids’ dinner, but thankfully my husband and friends were amazing, arranging play dates and picking up shopping for me.

The entire process was hellish, but somehow I reached the other side of withdrawal in June 2016. No longer was I unreliable and flaky, panicked at the thought of being around a lot of people, and the relief was indescribable.

According to Eytan, the problem lies in a lack of information and support for people wanting to come off painkillers.

“The psychological and physical side effects are so difficult to manage on your own, which is why patients need proper expert help,” he explains.

“It can cause significant mental trauma, as well as muscle and bone pain. You can also suffer irritability, restlessness, insomnia, vomiting, sweating, shaking and loss of appetite. It’s a lot to go through.”

Adam adds that part of the problem is also down to how much support medical experts receive in this area.

“It’s very easy to blame GPs,” he says. “But prescribers need more assistance, and cases like these should perhaps involve a multidisciplinary team to share their expertise.”

'Withdrawal can cause severe mental trauma'

FREELANCE fashion editor and blogger Pixie Tenenbaum, 39, has fibromyalgia, a chronic condition that causes severe widespread pain all over the body.

In 2004, she was initially prescribed tramadol by her GP to alleviate the symptoms, but it wasn’t until 2007 that she was given an official diagnosis and prescribed pregabalin to help with the pain.

By that time she was married to her husband Bo, 39, and had a son, Oscar, now 11, but her condition meant even simple things like writing with a pen could often be impossible.

“It was my physio who first suggested pregabalin to me,” remembers Pixie. “He said it was great at soothing chronic pain, and when I mentioned it to my doctor, he happily prescribed it over the phone without any warnings. I didn’t have a clue just how dangerous it might be.”

However, Pixie’s weight slowly began to balloon, and by March 2015 she’d gained 4st, and weighed 14st 4lb. After routine blood tests with her GP to investigate the weight gain, she was told the pregabalin dosage had affected her metabolism as well as her white blood cell count, and she had the immune system of a leukaemia patient.

“For 11 years, since that first tramadol prescription, no one had monitored me on the medication,” says Pixie. “The drugs had left my immune system so fragile, a simple cold would land me in hospital. I felt so angry – all I wanted to do was get the drugs out of my system as quickly as possible, so my GP put together a weaning-off plan.”

For three months Pixie was left housebound and in tears as the withdrawal took hold. She pretended to friends and family that she’d had surgery so she could avoid them, and told her clients she was stepping back from work for a while.

Pixie’s joints became so stiff that her husband had to help her sit down. Even a gentle breeze sent painful chills through her body. “Everything felt so extreme,” she says.

“I can vividly recall the cold air making it feel like every hair on my head was blowing off. My mum helped me shower, as I couldn’t even stand up. The water felt like pins on my skin.”

By July of that year, Pixie had got through her withdrawal and hasn’t taken pregabalin since, although she still relies on a low dose of codeine and paracetamol to help manage her excruciating symptoms.

Thankfully, changes are slowly being made in the way some medications are being prescribed.

Next April, pregabalin and gabapentin (commonly used for nerve pain, epilepsy and anxiety) are set to be reclassified as Class C, which means they’ll be in the same category as ketamine, tranquillisers and anabolic steroids.

This law change will mean that although the drugs are still available for legitimate use on prescription, prescribers and dispensers will be under stricter guidelines, plus possession without prescription will be illegal.

Earlier this year I began taking a small amount of pregabalin again as my endometriosis pain had returned. At first I felt frustrated and defeated, having gone through such a huge withdrawal.

But for people like me, pain relief is essential, and this time round I’m on a much lower dose. I now have regular check-ups with my GP to make sure I don’t go through the same horrific experience again.

“The bottom line is there needs to be more guidance from beginning to end when you’re given that first prescription,” adds Pixie. “I went into it blind and really regret it. But the reality is we cannot survive without strong painkillers, as our conditions leave us in incredibly severe pain.

“We’re not saying: ‘Don’t give us them,’ we’re just saying: ‘Please look after us a bit better.’”

  • For help or more information, visit UK Addiction Treatment Centres
  • To see Pixie's site visit Fashion Voyeur 
  • Source: Centers For Disease Control And Prevention

Source: Read Full Article