Opioids and Drug Abuse
Although it may seem to have only been discussed in the last couple years, the opioid epidemic started in the 1990s due to over-prescription of powerful, pain-relieving drugs based on the effects of much older drugs derived from opium plants. Pharmaceutical companies at the time reassured everyone that patients would not become addicted to these medications.
Since then, opioids (also called “opiates”) have become a national crisis due to widespread misuse and diversion. According to the Centers for Disease Control and Prevention, the United States spends an estimated $78.5 billion every year on health care, lost productivity, addiction treatment, and criminal justice involvement directly related to prescription opioid abuse.
How Do Opioids Affect the Brain and Body?
When used as prescribed, opioids provide pain relief for significant injuries. They’re often prescribed for broken bones, surgeries, toothaches, and other procedures.
When you consume an opioid, the opioid molecules attach to receptors on some brain cells. It then tricks the brain into producing excessive levels of dopamine, one of the chemicals responsible for happiness. Dopamine is released in much smaller amounts by eating great food, having sex, and other activities you enjoy, and the chemical’s job is to signal us to continue the activity.
In addition to relieving pain, the dopamine levels incited by opiates can lead to feelings of extreme euphoria, drowsiness, and poor coordination.
Examples of Opioids
- Heroin (heroin is the only opioid that is strictly illegal)
How addictive are opioids?
The level of dopamine released by opioid is unmatched by almost any other activity or experience, which is where addiction begins. The brain begins to associate the opioid with the good feelings that come immediately after taking the drug. As someone addicted to opioids continues to use the drug, the brain’s connection between the opioid and good feelings strengthens and it becomes harder to stop using.
If you drink a lot of coffee or soda to stay awake, you may have noticed you drink much more of that beverage now than you did before. Maybe you started drinking a small coffee every morning, but over time, you realized you were drinking more coffee to feel awake. Suddenly, you must drink two large coffees just to get going, and you’ve never felt that same caffeine buzz you did when you had your first coffee.
What we’ve just described is how tolerance develops. When someone who abuses opioids develops a tolerance for the drug, they’ll begin to take more and more of the drug to recreate that initial high. While the user might achieve it a few times, her tolerance will build up again, and she’ll have to continue upping her dose.
Eventually, this can lead to taking such a large dose that the person suffers an opioid overdose, a severe and life-threatening event.
Signs of an Opioid Overdose
The first step in treating an opioid overdose is to call 911. Without immediate treatment, a person can suffer permanent physical and mental damage and even die.
Once you’ve called 911, the operator may talk you through helping the person while you wait for medical assistance. This will likely include attempting to keep the overdosed person upright and awake or performing CPR if the person has stopped breathing.
Once the person is being cared for by medical professionals, their vital signs will be carefully monitored and treated. In severe cases, the drug naloxone may be administered to reverse the effects of the opioid.
In some states, doctors can prescribe an at-home version of naloxone for use in emergencies. These include an auto-injection device, Evzio, and a nasal spray, Narcan. If you believe you could be in a situation where you might need these, talk to your doctor.
What Are the Symptoms Associated with Opioid Withdrawal?
Opioid withdrawal can be an extremely uncomfortable process, but if the withdrawal is from opioids alone and not a combination of drugs, it is not life-threatening. Opioid withdrawal has two stages: acute withdrawal and post-acute withdrawal.
Acute withdrawal occurs around 12 hours after your last opioid use and can last anywhere between one week and one month. Days three through five are often the peak of the withdrawal, where symptoms are the worst. These symptoms are primarily physical and may include:
- Drastic mood swings
- Variable energy
- Low enthusiasm
- Variable concentration
- Disturbed sleep
Post-acute withdrawal usually lasts around two full years. These symptoms typically manifest for a few days before disappearing as suddenly as they appeared. The symptoms are typically psychological, including:
- Mood swings
- Trouble concentrating
- Trouble sleeping
When dealing with post-acute withdrawal episodes, it’s important to have a strong network of people around you who support your recovery, coping mechanisms to help you relax through the worst moments, and most importantly, patience.
What Are the Risks of Opioid Abuse?
Short-term effects include:
- Feelings of euphoria and pleasure
- Significant pain relief
- Severe drowsiness
- Impaired breathing
Long-term opioid abuse can lead to symptoms such as:
- A weakened immune system
- Mild to severe gastrointestinal problems, including constipation and bowel perforation
- Complications related to the use of needles, including scarring on the arms and bloodborne illnesses
- Significant depression of the respiratory system
- Brain damage due to hypoxia
- Abdominal bloating
- Liver damage
Opioids are highly addictive. Although someone can experience one without the other, people who abuse opioids are at a higher risk of developing dependence and addiction.
Opioid dependence is directly related to the physical withdrawal symptoms that appear when one doesn’t use that opioid.
Going back to our caffeine example, you might think about a time when you or someone you know forgot or was unable to get their coffee that day. Most commonly, you might develop a “caffeine headache,” but other symptoms include increased fatigue, irritability, and tremors. This happens because your body has created a dependence on caffeine. If you wait a day or two, however, you may find that those symptoms, and your dependence, disappear.
When a person has developed an opioid dependence, they will go through the physical symptoms associated with withdrawal when they stop using. These effects can take up to a month to fully go away.
Addiction is not normal, and it is officially classified as a disease. With addiction comes the psychological aspects of drug use, which include:
- Intense, uncontrollable cravings for the drug
- Uncontrollable thoughts revolving around the drug
- Inability to control drug use
- Compulsive drug use
- Drug use despite doing harm to oneself or others
- Destructive behavior in an attempt to acquire or use the drug
Cravings are created by altered brain chemistry and must be treated using therapy and by creating healthy, alternative behaviors.
What Are the Signs of Opioid Abuse?
There are several clues to look for when trying to identify an opioid abuse problem. Some of the signs include:
- Increased use of opioids over time
- Experiencing noticeable withdrawal symptoms when not using the drug
- Using more than you would like or more than is prescribed
- Experiencing negative consequences related to opioid use
- Putting off doing other things to instead use opioids
- Thinking obsessively about finding and using your opioid
- Having a history of unsuccessful attempts at cutting down your use of opioids
If you are trying to figure out if your loved one may be abusing an opioid, you should also look for:
- Intermittent loss of consciousness
- Attempts at “doctor shopping,” which involve getting multiple prescriptions from different doctors
- Dramatically shifting moods
- Extra pill bottles in the trash
- Social withdrawal and isolation
- Sudden financial problems
- Unexplained, decreased performance in school or work
Opioid Abuse Statistics
- Approximately one in four patients who are prescribed opioids for chronic pain misuse them.
- 5% of people who abuse opioids eventually transition to heroin.
- Between July 2016 and September 2017, opioid overdoses across the nation increased by 30%, with the Midwestern region seeing a 70% increase in overdoses.
- There are more deaths related to opioid abuse than all illicit drugs combined.
- 20,000 people died of prescription opioid overdose in the United States in 2016, and another 13,000 people died of heroin overdose.
How To Get Help for Opioid Abuse
Opioid abuse should always be treated by licensed professionals to ensure the safest and most effective treatment possible. By enrolling in a medication-assisted treatment (MAT), a person addicted to opioids gets access to medication that makes the effects of withdrawal more bearable, counseling for the mental illnesses that arise from or help lead to opioid addiction, and supportive resources for their loved ones. Therapy is especially important in treating an opioid addiction, as feelings of shame and guilt can lead to a relapse.
Contact Palm Partners Recovery Center today, and start conquering your opioid addiction.