Updated on January 28, 2019. Medical content reviewed by Dr. Richard Koffler, MD, Board Certified Physiatrist
When we think of addiction and abuse, our minds tend to think of illicit drugs first. But, addiction can happen at home, starting in the medicine cabinet — prescription opioids such as Exalgo are just as addictive as their illegal counterparts. While the opioid epidemic certainly includes people who use illegal drugs like heroin, it also impacts medical patients who are simply trying to live without pain.
Exalgo is a branded medicine that contains the opioid hydromorphone and comes in the form of an extended-release tablet. Doctors prescribe it to patients who don’t respond to other painkillers with a built-up tolerance to opioids. They may also have tried the non-extended release form of hydromorphone without success. The patient must have severe chronic pain from a condition like cancer or neuropathy to warrant a prescription.
Patients must take Exalgo exactly as directed to avoid overdose. Milder side effects include dry mouth, stomach pain and anxiety. Symptoms like difficulty breathing, seizures and fainting need medical attention as soon as possible. Since Exalgo has such high potency, many patients who take it keep a rescue medicine on hand in case of emergency.
Hydromorphone medications like Exalgo can cause addiction even when taken correctly. The risk of addiction becomes even higher when misused. Making a dosage error or taking another pill too early can increase someone’s dependence or cause an overdose. Some addictions begin when a patient experiences calm or euphoria as a side effect and seeks out more.
When someone gets addicted to an opioid like Exalgo, their brain begins to depend on the substance to keep the user feeling normal.
Despite Exalgo’s strict recommendations for prescribing, plenty of doctors still write prescriptions for it. Patients received more than 3.9 million prescriptions for hydromorphone medications in 2012. Doctors are starting to prescribe it less frequently, but ER visits related to hydromorphone abuse increased by almost 6000 between 2008 and 2012.
To get a more intense high, many addicts try methods like snorting that let them get more of a dose at once. Exalgo features a crush-resistant design to prevent misuse, but plenty of drug abusers find a way to get it in their systems as quickly as possible.
The logical conclusion to these facts is that we need to reduce the amount of hydromorphone prescribed. But since pain patients usually take hydromorphone when they have no other option left, what alternative can they use? We want to stop opioid addiction to help patients, but without leaving them in pain.
Medical marijuana doesn’t have the dangerous side effects and risk of addiction that opioids do, yet it could easily take their place in many cases. Drug researcher Philippe Lucas outlined how medical cannabis could help us prevent and relieve addiction to opioids like hydromorphone in the 2017 Harm Reduction Journal.
He proposed three ways that medical cannabis could reduce our reliance on opioids:
These methods would not only lower the risk of addiction, but they would also put fewer prescription opioids on the market in the first place. Medical marijuana’s high effectiveness and low risk could bring on a health revolution.
To learn more about medical cannabis as a solution to opioid addictions such as Exalgo, read our condition guide on the subject.
Check out our resources on specific opiates and medical marijuana: