How Is Demerol Abused?

According to the textbook Pharmacology for Health Professionals, Demerol (meperidine) is an opioid drug that has primary use for controlling moderate to severe pain. Like most opioid drugs, such as heroin and morphine, Demerol affects a particular neuron in the brain known as the ?-opioid receptor(pronounced mu o-PE-oid receptor). These neurons in the brain are associated with control of the experience of pain.

Demerol is available in several forms, including pill form, as a liquid syrup, and as a liquid that can be injected. At one time, Demerol was the narcotic pain medication of choice for most physicians because it was thought to be more effective at controlling pain and have less potential for the development of abuse and addiction.

However, it was found that Demerol was potentially highly addictive, and the development of newer pain medications changed its status as a primary narcotic prescription medication.

Demerol is listed as a Schedule II controlled substance by the Drug Enforcement Administration, indicating that it is a high potential for the development of physical dependence and abuse, even though it does have medicinal purposes. It can only be acquired legally with a prescription from a licensed physician. This places Demerol in the same category as most prescription narcotic or opioid pain medications.

Demerol Abuse

There are several important things to understand about abuse of Demerol:

• Drug abuse is an umbrella term that describes a large number of drug-related activities. Any use of Demerol outside of its prescribed use and intent qualifies as a type of drug abuse. Anyone obtaining Demerol illegally, using more Demerol than prescribed, using it more often than prescribed, or using it for purposes other than its prescribed intent is engaging in a form of drug abuse or Demerol abuse.
• Demerol abuse often occurs when individuals crush the pills and snort them, or mix them in water and drink or inject it. Individuals who chew the pills are also abusing Demerol.
• Demerol abuse often occurs in conjunction with abuse of other drugs, including alcohol, stimulant medications, other narcotic pain medications, marijuana, and/or benzodiazepines.
• According to a research study published in the Journal of Pain and Symptom Management, there was a downward trend in cases of Demerol abuse between 1997 and 2002.
• Despite the above study, the Substance Abuse and Mental Health Administration reported that emergency room visits associated with the abuse of Demerol increased between the years 2010 and 2011.
• There remains a significant amount of thefts involving individuals stealing Demerol from drug stores, private homes, etc.

Thus, while the overall trend may indicate that Demerol is being abused by fewer people, it is still a significant drug of abuse that obviously carries significant risks.

Who Abuses Demerol?

It is virtually impossible to reliably predict who will abuse a certain type of drug. Numerous influences and conditions most likely lead up to the development of a substance use disorder. Typically, when clinicians and researchers discuss these types of factors, they refer to them as risk factors. A risk factor is a specific condition, experience, or other factor that increases the probability that an individual will develop a type of disorder or illness. Risk factors are not absolute; just having a risk factor does not ensure that one will develop a specific type of disorder or disease. Risk factors simply increase the possibility that one might develop an issue, and the more risk factors a person has, the higher the probability that the person will develop the disorder in question.

Risk factors for abusing a drug like Demerol include:

• Heredity or genetic associations most often assessed by the presence of a first-degree relative with a substance use disorder (although having any close relative, such as aunts, uncles, cousins, etc., with a substance use disorder is a sign of increased risk). Although having a first-degree relative with a substance use disorder is not a definite sign of a genetic association because a person can pick up or learn habits from their parents or siblings, it is a fairly good measure of some type of genetic vulnerability. Certain types of genetic propensity studies have indicated that there is some evidence that the development of substance use disorders is associated with genetic influences.
• Specific types of experiences can increase the risk for the development of a Demerol use disorder or other substance use disorder. Such experiences often include a lack of social support, having some type of abuse issue or abandonment issue especially as a child, experiencing certain types of stress or stressful events, peer pressure, being in a lower socioeconomic status group, and being exposed to drug use at an early age.
• Certain psychological or medical conditions may also increase the risk for the development of substance use disorder, such as a Demerol use disorder. Individuals who have been diagnosed with psychological disorders are more likely to develop substance use disorders than individuals who have never been diagnosed with a psychological disorder. Individuals with medical conditions that involve a great deal of physical pain or emotional pain, such as depression, may also be at risk for developing substance use disorders.

There is no one path to the development of a substance use disorder like a Demerol use disorder. There are many different types of associations that increase the risk. Moreover, in pairs of individuals who have very similar sets of risk factors, it is not uncommon to find one individual who has developed some type of substance use issue and the other with no such issues.

Treatment

Demerol abuse carries a high risk for the development of physical dependence along with the other formal symptoms of a substance use disorder. Physical dependence refers to the development of both tolerance and withdrawal symptoms. When someone who abuses a particular drug is also physically dependent on the drug, once the person stops taking the substance, they will inevitably experience very negative physical and psychological withdrawal symptoms. The person will be motivated to take the drug once the withdrawal syndrome begins due to physical and emotional discomfort, and cravings for the substance.

Fortunately, there are a variety of treatment options that can help to negotiate the withdrawal process. For opiate addictions, medical detox that includes the use of opioid replacement medications, such as Suboxone, administered under the supervision of a licensed addiction medicine physician, is often recommended. This medication, or others like it, will reduce the negative effects of withdrawal and allow the physician to slowly reduce the dosage of the medication over time to wean the individual off it. Individuals also have the option of engaging in a tapering program without the use of opioid replacement medications, using other medications to address withdrawal symptoms, and even attempting to use other types of interventions, such as exercise and meditation or herbal remedies (although the majority of herbal remedies have very little empirical evidence to support their use). People can also negotiate the withdrawal syndrome by going “cold turkey”; however, this last method is not advised as there is a high potential for relapse.

Following detox, further treatment is needed, ideally in a structured, professional treatment program that includes individual and/or group counseling, medically assisted treatment for psychological and medical conditions that may increase the risk of relapse in the future, social support groups (e.g., 12-Step groups like Narcotics Anonymous), and complementary treatments that will benefit the specific individual. Recovery from a Demerol use disorder is an ongoing process, but with comprehensive help, it is within reach.