Painkillers and Addictive Substances Witness a 70% Surge

In a country like Israel, the feelings of stress and anxiety are part of the daily routine, and since the beginning of the war on October 7 – the situation is many times worse. The need for immediate relief alongside the limited psychological support provided in the community, leads many Israelis to choose other, less desirable ways to deal with the pressures: alcohol, drugs, sleeping pills and sedatives or strong painkillers. Although these substances may provide relief in the immediate term, in the long term they may cause real damage to the body and mind.

A report published by the Israeli Center for Addictions and Mental Health paints a worrying picture of Israeli society since the beginning of the war – 1 in 4 Israelis makes dangerous use of addictive substances such as pain relievers and opioid drugs – a 70% increase compared to last year. The report also shows that 1 in 10 Israelis uses sleeping pills and tranquilizers in a way that could endanger his health.

“Prolonged treatment of chronic pain may lead to addiction”

“When we talk about addictive drugs, we need to separate 3 categories of drugs,” explains Prof. Shaoli Lev-Ran, the academic director and founder of the Israeli Center for Addictions and Mental Health, to Mako Health. “The first category includes drugs used for sleep and relaxation; in the second category are drugs for the treatment of attention and hyperactivity disorders, also called stimulant drugs; the third category are the pain relievers – drugs from the opioid family.

Despite the risk of using these drugs, Lev-Ran does not rule out their use at all. “The question is for whom, for what indication and for how long” he says, “Painkillers from the opioid family, for example, are suitable for two main cases: acute, acute pain as a result of surgery or a medical procedure that the patient has undergone, or a drug given to those suffering from terminal illnesses such as terminal cancer. In these cases, the treatment is effective, but when it comes to other cases, such as prolonged treatment of chronic pain, for weeks or months, it may lead to addiction.”

The report of the Addiction Center shows that more than 200,000 Israelis use prescription drugs and opioid painkillers in a way that could endanger their health. “The findings are alarming. The situation was not alarming even before, but now it is more than 4% of the adult population in Israel who report excessive or problematic use: an attempt to cut down on taking pills without success, use also in risky situations such as while driving, taking a larger amount than recommended given to them or obtaining the drug in a non-controlled way, through friends or family members.”

Could it be that the doctors’ finger is too light on the trigger?

“I wouldn’t say that they have an easy hand on the trigger, but there is a lack of training for professionals with regard to drugs that can lead to addiction. According to health insurance reports, there is a significant increase in the prescriptions that patients receive for sleep and sedative drugs, for example. Doctors need to know which drugs are more addictive and which are less, what follow-up should be observed when prescribing a drug with addictive potential, how to recognize at an early stage that there is a problem, and how to effectively intervene in such a situation. We deal with this at the Israeli Addiction Center every day.”

“It is also important to take into account the situation of the population that is in distress, the extent of which we did not know. Many experience post-traumatic symptoms, more stress and sleep disorders, and there are fewer torturers. In the end, the doctors want to help the patient, that woman who needs to sleep tonight or that man who doesn’t manage to relax. Their motivation to help is high.”

The distress appears at any age and in different degrees – many Israelis witnessed the events and experienced them themselves, others were exposed to verbal or graphic content that is not censored continuously and with high frequency, there are those who are in a family, friend or professional relationship with the victims of the war and they experience secondary trauma, and there are Israelis who simply woke up on the morning of October 7 to the most difficult war the country had ever known. In each of these categories, an increase in distress was observed, and as a result, an increase in the use of addictive substances. “Let’s take, for example, the soldiers who were injured and are now in the hospitals receiving opiate drugs after their surgery,” says Prof. Lev-Ran. “The opioid painkillers blur not only the physical pain but also the mental pain and we know about the close interrelationship between the body and the mind – the more I am in mental distress, the physical pain increases and the more severe the physical pain, the mental state is undermined. The problem is that as time goes by passes, the effectiveness of the painkillers decreases, and people may increase their doses because of this, and this is already a cycle that can lead to addiction. The longer the drugs are used, the more people will become addicted to them.”

Consequences of the use of drugs: “Each drug may have different side effects”

According to Prof. Lev-Ran, addiction may lead to physical, social and functional damages – whether it is parental, marital or occupational functioning, “there are short-term or long-term damages, but apart from the damages of the addiction itself, each drug may have different side effects – physical or mental. Prolonged use of sleeping pills, for example, may increase the risk of dementia among those aged 65 and over. Some of the medications blur, which may cause people to be more injured from a fall or an accident.”

According to him, it is possible to reduce the dangerous use of sleeping and sedative drugs and opioid painkillers – “we need to act in two ways – the first is at the level of the health system. The system needs to understand that where there is mental distress, people are looking for solutions, and they need to be provided. The medical teams need to know what excessive use is and how it is taken care of. On an individual level – I would advise people not to keep large quantities of addictive drugs at home, and also to ask the doctor when receiving the prescription if it is a drug to which they may become addicted. Another and necessary step is to understand what are the causes of the distress: Is it the endless watching of the news? Is there certain places that constitute a trigger? It is important to know that the treatment of distress can have other alternatives besides drugs. For example, physical pain can be alleviated through physical therapy, relaxation exercises or physical activity can be performed to reduce stress. No one uses addictive substances for nothing, the use comes from distress, and it is necessary to get a response in some way.”

Despite the troubling findings, Prof. Shaoli Lev-Ran remains optimistic: “Most people will heal naturally from traumatic events, just as wounds go through and heal. If I’m scratched, I usually won’t need more than disinfecting the wound so that it doesn’t get infected, and the same is true in a trauma situation – just need to take care not to harm the natural recovery, and not to use addictive substances to deal with the distress. For those who do feel that they are in a problematic situation, it is recommended to seek counseling and treatment.”