Illicit opiate use is currently one of the fastest growing drug problems in America. In 2012, the Substance Abuse and Mental Health Services Administration estimated that some 2.1 million Americans were suffering from opioid-related substance abuse. Of these users, approximately 467,000 were addicted to heroin. In New Jersey alone, the increasing popularity of prescription painkillers is believed to have led to a statewide heroin epidemic that has plagued over the last decade. It has been thought that opioid drugs in particular have gained such popularity over the years due to the fact that painkillers have less of a stigma attached to them than do other illicit drugs. This may be due to the fact that some of these drugs can be prescribed by doctors and that they are therefore more easily accessible. While most prescription opiate users use their medication safely, some users find that these painkillers have introduced them to the “opiate high”, further leading them to future addiction and dependency (some prescription pill users can become hooked as early as a week after use). In some cases, prescription pill dependency has been thought to be a gateway to heroin dependency. Since heroin is often drastically cheaper than pills, some of these users will then say to themselves “why pay in full for a pill when I can get my opiate high for a tenth of the price?”. To them it might seem like the perfect drug, but it comes along with unforeseen life-changing costs.
Quick Facts About Opiates/Opioids:
Opiates/opioids, derived from the opium-containing poppy plant, are referred to as a group of narcotic drugs that are commonly used to treat pain.
Opioid/opiate consumption causes a powerful analgesic (“pain-killing”) effect accompanied by feelings of sedation and euphoria. It influences both mood and pain perception.
Technically speaking, an opioid is anything that will bind to an opioid receptor (can be natural or synthetic) and an opiate is a natural product that acts similarly to an opioid (natural, not synthetic); therefore, “all opiates are opioids but not all opioids are opiates”.
The human body actually produces its own opiates called endorphins; other naturally-occurring opiates can be extracted from the poppy plant.
Many of the opioid street drugs are often chemically synthesized so that they mimic the response of naturally-occurring opiates in the body with increased strength and duration.
Common opioid drugs (listed in increasing strength) include:
Codeine
Vicodin (Hydrocodone)
Demerol
Methadone
Morphine [oral]
Oxycontin/Percocet (Oxycodone)
Heroin (Diacetylmorphine)
Dilaudid (Hydromorphone)
Duragestic (Fentanyl)
[Note: Organized by increasing strength, but each drug varies in duration of effect]
How Opioid Addiction Occurs:
The human body produces its own naturally-occurring opiates in response to reward or pleasure. These natural human opiates are called endorphins, and they bind to opioid receptors located in the brain and spinal cord. When the body receives an external source of opioids, the naturally produced endorphins become depleted over time. In other words, the body stops making them. Since endorphins are responsible for many processes (i.e. respiration, nausea, vomiting, pain modulation, hormonal regulation), the body’s normal functioning becomes disrupted in their absence. This is responsible for the traumatic and uncomfortable withdrawal symptoms that are present when opiate addicts completely stop their drug intake.
Opioid Addiction & Dependency with Symptoms:
Opioid use can cause both addiction and physical dependence.
Addiction is a chronic neurobiological and behavioral disease that is influenced by genetic, psychological, and environmental factors. Opioid addiction is characterized by one or more of the following:
impaired control over drug use
compulsive use
excessive use
continued use despite harm or other negative consequences
craving
Dependence refers to the physical symptoms associated with long-term drug use. Over time, the body adapts to the drug. Therefore, lowering the dosage, ceasing use, or administering an antagonist will signal a decrease in the blood’s drug level causing intense cravings and physical withdrawal symptoms that include:
agitation
anxiety
muscle aches and pains
teary eyes
insomnia
runny nose
hot and cold sweats
goose bumps
abdominal cramping, diarrhea, nausea, and vomiting (for later symptoms of withdrawal)
Possible Consequences of Opioid Abuse:
Social
difficulty in relationships with family, friends, or significant others
personality changes
financial issues
unemployment or difficulty maintaining a job
homelessness
legal issues (e.g. drug possession or distribution, theft, crime, weapons, and other risky behaviors)
Psychological & Cognitive
inability to think clearly
impaired planning and decision making
feelings of losing control
depression
emotional dysregulation
Health
higher risks of infections (e.g. HIV/AIDS, hepatitis B & C)
changes in personal hygiene
heart damage
scarred or collapsed veins
tuberculosis
pneumonia
arthritis
Common Opioid Treatments:
Treatment involves supportive care and medications. The most commonly used medication, clonidine, primarily reduces anxiety, agitation, muscle aches, sweating, runny nose, and cramping. Other medications can treat vomiting and diarrhea.
Buprenorphine (Subutex) has been shown to work better than other medications for treating withdrawal from opiates, and it can shorten the length of detoxification (detox). It may also be used for long-term maintenance, like methadone.
Persons withdrawing from methadone may be placed on long-term maintenance. This involves slowly decreasing the dosage of methadone over time. This helps reduce the intensity of withdrawal symptoms.
Some drug treatment programs have widely advertised treatments for opiate withdrawal called detox under anesthesia or rapid opiate detox. Such programs involve placing you under anesthesia and injecting large doses of opiate-blocking drugs, with hopes that this will speed up the return the body to normal opioid system function.
There is no evidence that these programs actually reduce the time spent in withdrawal. In some cases, they may reduce the intensity of symptoms. However, there have been several deaths associated with the procedures, particularly when it is done outside a hospital.
Because opiate withdrawal produces vomiting, and vomiting during anesthesia significantly increases death risk, many specialists think the risks of this procedure significantly outweigh the potential (and unproven) benefits.
Opiate detox
If you or someone you know is suspected to be suffering from opioid dependency, GenPsych can help. Call 1-855-436-7792 or click to schedule an appointment.
Sources:
http://www.nlm.nih.gov/medlineplus/ency/article/000949.htm
http://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids
http://www.addictionsandrecovery.org/opiates-narcotics-recovery.htm
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