Laying around on his sofa after damaging the cartilage in his knee during a sports match, Jack popped another white pill into his mouth.
Like everyone prescribed with opioids post-surgery, Jack thought they were going to help him get back to normal after his accident.
And like many, he underestimated the strength of opioids and quickly succumbed to their effects – from then on Jacks ‘normal’ was very different.
Many well-known celebrities have succumbed to the addictive nature of opioids such as Ant McPartlin and Robert Downey Junior.
“You don’t just stop any addiction. You have to hit some kind of bottom where it’s the better option,” Jack says.
“It’s not one moment, but after a while, you take a step back and look at your lifestyle, and say to yourself ‘what are you doing’, when you’re lying half-conscious all day achieving nothing and forcing the people around you to watch you do that.”
After having surgery to help repair cartilage damage in his knee, Jack was prescribed with the painkiller tramadol which he then became dependant on.
Jack began taking tramadol after his surgery in August 2018 and says his addiction started once he returned to university a month later.
He says: “It was that persistent pain that just kind of wears you down. It hurt to do my normal routine because I needed to walk to do everything, and it hurt to walk.
“I remember I took a pill because I had nothing to do with my day, so I think that’s probably where the problem started.”
At first, Jack did not want to admit to himself that he was addicted – facing the truth meant quitting and Jack did not want to quit.
“A big part of it is denial I suppose, once you get past that then you’re golden,” Jack laughs.
He adds: “It wasn’t something I wanted to think about, so I just didn’t. I was meant to be taking, I think, three a day maximum, but when I was bad, I was taking well over double that.
“Sometimes, I would take less and just mix with alcohol instead, especially if I was anxious about running out.”
But, eventually, that day came.
Jack had to go back home for a check-up at his doctors but soon realised that he could not keep up the lie anymore.
“It was when I ran out that I knew that I wasn’t going to be able to blag another prescription out of my doctor, and I had a massive panic attack.
“My mum heard me freaking out in my room and came upstairs and found me. There wasn’t really any escaping it then.”
Tramadol is less potent than its fentanyl and oxycodone siblings and is supposed to have a relatively low risk of addiction.
However, unlike its siblings, tramadol is similar to antidepressants as it increases the levels of serotonin, feelings of happiness, in your brain.
“It’s happiness or chemically stimulated happiness,” says Jack, and despite these ‘happy’ chemicals, the side-effects as Jack experienced, can range from drowsiness and nausea to constipation.
Jack’s university work suffered significantly due to the opioid effects making it hard for him to motivate himself to do anything, let alone work.
“I wasn’t doing great in my classes. My grades definitely suffered, and I never wanted to go out, not even to university.
“I didn’t really see my friends besides the ones I live with, but then again, there’d be some days when I just wouldn’t leave my room,” Jack says.
Jack is now receiving counselling but says that at first, he was sceptical of the process.
“In terms of family and friends, it’s not nice for them to see you deteriorate.”
Jack adds that it is not easy, but you get to a point where something needs to change.
Often, counselling can be this positive change, after first consulting with your doctor about your prescription.
Jack also says that supportive friends and family are crucial to the success of recovery.
“They’re the ones who supported me to go to the counselling and to seek help. They were in the dark for quite a long time, not as long as I thought they were though.
“There’s a slight history of it in the family so they were actually a lot more supportive than other families could have been,” Jack says.
Jack believes everyone should be having more open conversation about painkillers, addiction and their impacts.
“I think we need to feel more comfortable seeking help if you do find that you’re becoming dependant on opioids without that shame of drug addiction,” he says.
He adds that the shame of addiction likely prevents others from seeking support, but it should not.
KU student Stephen Hall, 21, tells The River of his experience with co-codamol after a back injury in 2016.
Unlike Jack, Hall has never had a problem with the addictive side to opioid painkillers, but the side-effects instead.
“I was prescribed co-codamol, 30mg which is the strongest dose, to help deal with the severe pain I was in,” Hall says. “The main effects are that it makes you feel really lightheaded and can ramp up anxiety.”
Last year, Hall began retaking co-codamol because of a foot injury, but he limits himself because of the side-effects.
Hall explains: “I only take them if I absolutely have to,” highlighting how sometimes the side-effects of opioids can outweigh their benefits, meaning some people choose to stay in pain.
Taking opioids is not just dangerous for addiction as they can impact and interfere with everyday life. These painkillers can hinder your ability to work efficiently, and as Jack mentioned, an inability to concentrate on your work and assignments at university while under the influence of prescribed opioids.
Hall also found that opioids did hinder his concentration and ability to work efficiently.
He says: “It means that when I try and do work, I can’t think straight and can’t focus. When I have to listen to a lecture, I just can’t concentrate at all.”
Although Hall tries to limit his opioid intake due to the side-effects, eventually there comes a time when his pain becomes too much.
Opioid addiction has destroyed tens of thousands of lives in the US, and the problem is growing in the UK. In January top executives of pharmaceutical company Insys were convicted for fuelling the US opioid crisis.
Lawyers from another pharmaceutical giant, Rochester Drug Cooperative, are fighting prosecutors over another case, claiming the law intended for drug dealers, is being used against CEOs.
The discussion on opioids has highlighted how people can be at risk of severely misjudging the effects of opioids and the impacts on individuals and society holistically.
Chris Shea, an addiction counsellor with over 20 years’ experience, witnessed thousands of people addicted to prescription painkillers and heroin throughout the 2000s in the US.
Shea says: “One of the reasons for the current opioid crisis is the general lack of education in medical schools on the science of addiction.
“This is coupled with the pharmaceutical companies telling prescribers that their opioid pain killers weren’t addictive.
“There are long term side effects to opioid use, and that is part of the crisis we are experiencing today,” Shea adds.
Shea supports the idea of greater monitoring of opioid prescribing.
Shea says that when a prescriber is working with a patient, there is a subjective relationship that may cloud the prescriber’s ability to see the impact of what they are prescribing clearly.
However, the crisis’ culprit remains the pharmaceutical companies, not the prescribers.
Shea says the need for honesty is paramount: “The pharmaceutical companies need to be honest with prescribers about their products. Had there been honesty a couple of decades ago, we might not be in this current crisis.”
Developing an addiction to painkillers is more common than people assume, and it is very easily done. It is essential to recognise the signs of addiction.
Taking more than the recommended dosage
If there is a ‘need’ to take more than what your doctor has advised, then there is a chance that you may have developed a dependency.
Speak with doctors first to ensure that you are on the correct dosage for pain management.
Withdrawal from life
Withdrawal is a key social sign of addiction.
Reluctance or refusal to stick to a usual routine can be a sign of opioid dependency – the side-effects of opioids can make people overly anxious and quiet.
Additionally, if someone you love is pulling away from the relationship and choosing isolation over community, it may also be a sign of dependency.
This is because opioids tend to immerse you in a world that is seldom understood through the lens of sobriety.
Reliance on opioids for emotional problems
Turning to painkillers to dull nagging thoughts or emotions instead of dealing with problems can be a sign of an unhealthy relationship with prescription drugs.
Opioids can affect your mental health and have been known to provoke depression and anxiety, which decreases your ability to deal with emotional issues in a healthy way.
Being dishonest with friends and family about usage
Lying about how many painkillers you have taken can be a sign of addiction.
If you are certain that you are on the right dosage, then there should not be a need for more. Dishonesty is a sign that you believe you have something to hide.
Alternatively, if you notice someone you love needing a repeat prescription earlier than necessary or normal, then their usage may be becoming an issue.
Opioids are controlled drugs and therefore, cannot be taken if you are driving. If you find that someone is driving under the influence of painkillers, then that too can be a sign of dependency.
Any unusual health changes
If the person suffered from mental health issues before taking opioids, and their mental health has worsened since the prescription, it could be a sign that they are experiencing dependency or negative side-effects.
However, unusual health changes are not limited to depression and anxiety. Experiencing paranoia, memory loss, weight loss, mood swings, agitation, insomnia, sexual dysfunction, and attention problems can all be signs of opioid dependency.
A doctor should be made aware.
Moving forward
After recognising that there is a problem, talk to your doctor or an alternative healthcare professional.
Outline the issues you have and ensure you are not only on the right dosage but the right drug for you.
Do not go cold turkey, as this can have detrimental impacts if you have been taking a certain prescription long-term.
If you need further support contact Surbiton-based Addiction Support and Care Agency: 020 8339 9899
Megan Kelly
Maurizio Kayonjo