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Meloxicam Abuse

Meloxicam Abuse

Table of Contents

What is Meloxicam?

Meloxicam, or Mobic, is a drug that is used extensively in the treatment of symptoms associated with arthritis. The symptoms it’s used to control or treat include pain and inflammation without the use of opioid painkillers, like hydrocodone or oxycodone.

Boehringer Ingelheim developed meloxicam, and it received a patent in 1977. However, it was only in the year 2000 that the drug received clearances for medical use.  It’s generally considered as a safe alternative to opioid medication, reducing the chances of needing addiction treatment.

Legally, it is available as prescription medicine. It is produced in three basic forms, all for oral consumption only – in tablet, disintegrating tablet, and capsule forms.

In tablet form, the medication is available in both generic as well as brand variants. However, the orally disintegrating tablet is only available as a branded medication. Generic variants of Mobic cost less than the branded versions.

Treats Inflammation and Pain

As an effective remedy for inflammation and pain, Mobic is used to treat arthritic health conditions such as osteoarthritis and rheumatoid arthritis. The medication is also used in treating an arthritic condition in young children aged two and above, known as juvenile idiopathic arthritis (JIA).

Meloxicam is safe when used following a doctor’s prescription. But its misuse or abuse can lead to potentially dangerous side effects. Many people also worry about this drug’s ability to cause addiction. Since meloxicam is used as a pain killer, many people believe it could be a gateway to opioids.  In some cases, meloxicam addiction may necessitate treatment in a rehab facility.

Statistics

In 2017, a total of 19,793,507 meloxicam prescriptions were issued in the U.S.A.1

In 2016, meloxicam was the 36th most frequently prescribed drug in America.1

In 2006, a total of 48,928 meloxicam prescriptions were issued to active duty soldiers in the U.S. Army and in 2014, the number stood at 91,048.2

How Does Meloxicam Work?

Mobic belongs to the class of drugs that are known as non-steroidal anti-inflammatory drugs (NSAIDs). It received approval for use in April 2000.  The drug is primarily used in the treatment of conditions such as pain and inflammation that are associated with arthritis. These pains are caused by the inflammation induced by the presence of chemicals known as prostaglandins in the body.

By blocking the enzymes responsible for prostaglandin production and reducing their levels in the body, meloxicam reduces inflammation and associated symptoms of arthritis.

Is Meloxicam Safe?

Mobic is viewed as a drug with the potential to replace opioid-class painkillers in the treatment of moderate- to severe-grades of physical pain. Compared to opioids, the risks of physical or psychological dependence is not severe in Mobic users. The fact that Mobic does not induce the kind of euphoria that opioids do is partly responsible for this. However, the risk of acquiring a Mobic dependence does exist and could occur when the drug continues to be taken even after it is no longer prescribed by a doctor.

Ironically, many instances of Mobic dependence and abuse occur on account of its reputation as a prescription painkiller. Some people mistakenly believe that because Mobic is a prescription pain killer, it must contain opioids, resulting in substance abuse.

USDA Guidance

The US Food and Drug Administration discourages medical practitioners from prescribing the drug, both – branded as well generic variants, for patients known to be at risk of acquiring psychological dependence through the use of psychoactive medications.

Although meloxicam is itself relatively harmless, it has the potential for misuse by being combined with substances such as alcohol. Its pain-alleviating properties mean that meloxicam is frequently used to treat hangovers after a binge-drinking session. Such practices could lead to long-term damage such as liver damage or heart disease.

How is Meloxicam Used?

Meloxicam is prescribed for patients who have arthritis, a medical condition wherein the joints experience pain and swelling. Mobic is primarily used in the treatment of symptoms related to osteoarthritis and rheumatoid arthritis — two of the common types of arthritis.

Medical practitioners also rely upon Mobic for use as an alternative to conventional opioid pain medications. To reduce the intensity of symptoms of opioid withdrawal, doctors often prescribe it before starting an opioid taper on their patients.

The method of Mobic use depends on the type of formulation a patient takes. Currently, three formulations are available in the market:

Oral tablets (immediate release action) available in 7.5mg and 15mg specifications. Brand name: Mobic tablets 7.5mg and 15mg.

Oral suspension in 7.5mg/5mL specifications.

Orally-disintegrating tablets in 7.5mg and 15mg specifications.

Although Mobic can be taken on an empty stomach, it is recommended to take it with food to reduce the chances of suffering an upset stomach.

The orally-disintegrating tablets must be placed on the tongue immediately after the pack is opened. Since the tablets are meant to dissolve on coming in touch with the tongue, water should not be consumed as long as the tablet is on the tongue. While in the mouth, care should be taken to see that the tablets are not crushed, broken, or chewed.

In the case of meloxicam in oral suspension form, the container has to be shaken well before use. The recommended dosage must be taken with the help of the measuring device included in the product packaging.

Effects of Meloxicam

Short-Term Effects

Some of the short-term side effects of meloxicam are:

Upset Stomach

An upset stomach is the most common side effect of meloxicam.  That is why taking it with food is recommended.

Allergic Reactions

Asthmatics are at a higher risk of experiencing serious allergic reactions to the drug. Similarly, people allergic to NSAIDS, are also susceptible to allergic reactions such as feeling shortness of breath.

Skin Reactions

Typical skin conditions arising from Mobic use include Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and exfoliative dermatitis. 

Dizziness

Dizziness, drowsiness, and blurred vision are some of the side effects on the central nervous system.

Long-Term Effects

Ulcers

Long term use of meloxicam can cause bleeding or ulcers in the stomach, which can turn fatal if left untreated. The intestines also face similar risks from long-term usage of Mobic.  People who are older, especially those who regularly consume significant quantities of alcohol or suffer from poor health, face a higher risk of developing such problems. These issues could appear without any warning signs, or they may appear in the form of symptoms such as heartburn, stomachache, bloody vomit, bloody stools, or tarry stools.

Hypertension

Meloxicam use can lead to the worsening of hypertension in patients with a history of hypertension. While, in others, Mobic could cause the onset of high blood pressure. That’s why it is important to monitor blood pressure when meloxicam is prescribed.

Fluid Retention

Fluid retention or edema (swelling) is another likely side effect of meloxicam usage, and therefore people with heart conditions are generally not prescribed the drug.

Stroke

Even people with no history of heart disease are in danger of suffering a stroke when prescribed the drug. Therefore, NSAIDs are not to be prescribed nor used for the treatment of pains arising due to coronary artery bypass graft (CABG) surgery.

Insomnia

Insomnia is another potential adverse effect of meloxicam use over the long-term.1 Insomnia is a health condition where the person is unable to fall asleep and thus feels sleepy during the daytime, and a corresponding lack of energy.  Insomnia can also lead to feelings of depression, anxiety, or irritability, difficulty in focusing, learning, and remembering things.

Kidney Damage

While long-term usage can damage the kidneys, often, ending use results in reversal of such damage.

Liver Damage

Liver damage is among the major effects that long-term usage of meloxicam can cause. 

Can You Overdose on Meloxicam?

While meloxicam is considered a safe drug, it is possible to overdose, if more than the maximum recommended dosage is taken. 

The factors influencing the Mobic dosage that your doctor prescribes include the type, severity, and condition for which the medication is being used, the age of the patient, the form of meloxicam being taken, health, and medical conditions involved.

Meloxicam is available in tablet and orally disintegrating tablet form, both of which are produced in 7.5 grams specifications. Initial dosage usually begins at 7.5 g and could reach a maximum dosage of 15 g for adults. So, technically speaking, anything above 15 g is considered an overdose.

The symptoms of meloxicam overdose include drowsiness, nausea, lack of energy, vomiting, stomachache, bloody or tarry stool, breathlessness, seizures, and coma.

What is Withdrawal From Meloxicam Like?

Withdrawal from this medication is generally not difficult, and may be safely stopped without any tapering. However, there may be some symptoms that are unmasked by stopping the medication, and it may be wise for people to take precautions to avoid any discomfort. An awareness of meloxicam helps people anticipate any potential problems.  You should always discuss your medications with a healthcare provider before discontinuing any drug.

Detox Recommended

However, discontinuing the drug, all of a sudden, could cause uncomfortable symptoms to emerge.  It is advisable to consult a healthcare provider for necessary advice on keeping such problems at bay while undergoing detox.

Pain and Inflammation May Return

Typically, the withdrawal from meloxicam usage would lead to a return of the symptoms for which the medication was prescribed for in the first place – pain and inflammation. After discontinuing Mobic it’s possible to suffer from withdrawal symptoms such as stiffness, redness, swelling, and heat.

In actual terms, there are no withdrawal symptoms associated with meloxicam. But it takes the body between 15 and 20 hours to metabolize and expel half the drug out of the system. This is also the time frame for Mobic withdrawal. Since it is not an opioid class drug, meloxicam withdrawal does not result in the worsening of symptoms after stopping the drug intake. But the symptoms treated initially by the drug could resurface once use is discontinued.

Is Treatment for Meloxicam Dependence Needed?

Meloxicam withdrawal management usually does not require any kind of medical intervention or alternate drug therapy. This is because, unlike the case of alcohol or substance dependence, meloxicam withdrawal has no specific safety concerns associated with it.

The only medical intervention may be in terms of drugs, prescribed by the health provider, to address the problems that meloxicam was prescribed in the first place. In this case, alternative such medicines would be medicines prescribed for suppressing pains and inflammations related to arthritis. The alternatives include pain treatments involving physical therapy, acupuncture, ice-application, heat-application, and adequate rest.

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