Opioids are a class of drugs that include the illicit drug heroin as well as the legal prescription painkillers, oxycodone, hydrocodone, codeine, morphine, fentanyl and others. Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system to produce pleasurable effects and relieve pain. Opioid addiction is at epidemic proportions in the United States today.
Prescription opioid addiction is one of the biggest (if not the biggest) drug problems today. Opiate medications are surprisingly easy to obtain. Frighteningly, prescription opiate abusers are far more likely to eventually develop a heroin addiction than a non-opiate abuser, as heroin will offer a similar high at a lower price.
Opioid Addiction and Overdoses
Any long-term use puts you at risk of opioid addiction, even if the substance is used as prescribed. Many people who use opioids will develop a tolerance to them–a phenomenon that can trigger the cycle of addiction. Tolerance means that the same amount of the drug no longer has the same effect as it once did. When this occurs, people routinely take more and more of the substance to elicit the desired response. This ever-increasing dosing places one at high risk for overdose.
Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.
Prescription Drug Abuse
Some medications have psychoactive properties and, because of that, are sometimes abused. Misuse of prescription drugs means taking medicines in a manner or dose other than prescribed, taking someone else’s prescription or taking a pill to feel better. The three most commonly abused types of prescriptions medications are opioids, central nervous system depressants, and stimulants.
Prescription drug misuse can have serious medical consequences. Increases in prescription drug misuse are reflected in increased emergency room visits, overdose deaths associated with prescription drugs and treatment admissions for prescription drug use disorders. Among those who reported the past-year non-medical use of a prescription drug, nearly 12 percent met criteria for prescription drug use disorder. Unintentional overdose deaths involving opioid pain relievers have more than quadrupled since 1999 and have outnumbered those involving heroin and cocaine since 2002.
If prescription drugs are taken for emotional problems without the supervision of a medical professional, the only result of the drugs will be to mask or numb the upset feelings. Although a person may not experience their depression for a period or may be temporarily able to stop obsessing about a particular problem, in most cases, the problem is just made worse as the person is not learning how to cope with the specific feelings and issues at hand efficiently.
Prescription drug abuse is increasing. Doctors are prescribing more drugs for more health problems. The growing numbers of online pharmacies can make it easier to get prescription drugs without a prescription. The abuse of prescription drugs often results in negative effects on personal relationships, employment difficulties and job loss, financial difficulties, legal issues, and psychological problems.
Many prescription drugs have the potential to become physically or psychologically addictive. To abruptly discontinue prescription medications could result in serious medical complications, like seizures or convulsions. Withdrawal from prescription drugs should be attempted only under medical supervision. Withdrawal from sedative medications, in particular, can be life-threatening without appropriate medical monitoring.
Risk factors for prescription drug abuse include:
- Past or present addictions to other substances, including alcohol and tobacco
- Family history of substance abuse problems
- Younger age, especially the teens or early 20s
- Certain pre-existing psychiatric conditions
- Exposure to peer pressure or a social environment where there’s drug use
- Easier access to prescription drugs, such as having prescription medications in the home medicine cabinet
- Lack of knowledge about prescription drugs and their potential harm
Signs of Opioid Use
There are many physical and behavioral symptoms indicating someone may be abusing an opiate including:
- Continued use despite knowing it is leading to or worsening a psychological problem
- Poor Judgment
- Inability to make decisions
- Inability to Plan
- Poor concentration or attention
- Memory problems
- Taking prescription drugs for longer than prescribed or in higher doses
- Spending an increasing amount of time using or trying to get more opioids
- Inability to meet other responsibilities in life
- Avoidance of previously important activities
Effects of Opioid Addiction
There are some short-term and long-term effects of opioid use including:
- Feeling tired, fatigued, and sedated
- Constricted pupils leading to decreased sight in dim or darkened conditions
- Nausea and vomiting
- Chest pain
- Reduced respiration and trouble breathing
- Weakened immune system functioning
- Gastric problems ranging from constipation to bowel perforation
- Many medical issues related to intravenous administration including localized abscesses, embolic events, systemic infection or contraction of bloodborne illnesses
- Significant respiratory depression or cumulative hypoxic end-organ injury
Withdrawal symptoms resulting from the decrease or cessation of the opioid can vary depending on the specific type of opiate taken, the dose and the length of time the individual has been dependent on the drug.
Common withdrawal symptoms include:
- Negative Mood
- Muscle and joint pain
- A runny nose
- Drug cravings seem intolerable
- Rapid breathing
- Yawning due to decreased oxygen intake
- Increased Salivation
- Goosebumps or chills
- Nasal stuffiness
- Abdominal cramps
- Confusion or disorientation
- Enlarged pupils
- Loss of appetite
Prevention of Abuse
Prescription drug abuse may occur in people who need painkillers, sedatives or stimulants to treat a medical condition. If you’re taking a commonly abused drug, there are ways to decrease your risks.
- Make sure you’re getting the right medication. Make sure your doctor understands your condition and the signs and symptoms. Tell your doctor about all your prescriptions, as well as over-the-counter medications, herbs and supplements, and alcohol and drug use. Ask your doctor whether there’s an alternative medication with ingredients that have less potential for addiction.
- Check in with your doctor. Talk with your doctor on a regular basis to make sure that the medication you’re taking is working and you’re taking the right dose.
- Follow directions carefully. Use your medication the way it was prescribed. Don’t stop or change the dose of a drug on your own if it doesn’t seem to be working without talking to your doctor. For example, if you’re taking a pain medication that isn’t adequately controlling your pain, don’t use more.
- Know what your medication does. Ask your doctor or pharmacist about the effects of your medication, so you know what to expect. Also check if other drugs, over-the-counter products or alcohol should be avoided when taking this medication.
- Never use another person’s prescription. Everyone is different. Even if you have a similar medical condition, it may not be the right medication or dose for you.
- Don’t order prescriptions online unless they’re a reliable pharmacy. Some websites sell counterfeit prescription and nonprescription drugs that could be dangerous.
Opioid Addiction Treatment
Three significant options for prescription drug abuse treatment include detoxification, inpatient rehabilitation, and outpatient therapy.
Detox involves withdrawing from the drug, often slowly with the use of stabilizing and maintenance medication under the supervision of a medical treatment team. If you’re detoxing from powerful opiates, you might be prescribed methadone or buprenorphine to make the transition more manageable. Detoxification is completed on an inpatient basis to maintain safety.
Following the transition from detox, most will be referred for continued treatment via residential rehab or outpatient therapy depending on many factors. Influencing the decision for treatment type is the individual’s level of opiate use, the presence of any home or family supports, amounts of insurance coverage/resources to cover care, as well as taking into account any previous attempts at recovery. Rehab typically lasts anywhere from 30 to 90 days with much of the time being devoted to individual therapy, group therapy, and other activities that help promote recovery from opiates and other substances.
During therapy, you will attend sessions with a therapist or counselor. These meetings will help you to uncover the triggers of your addiction. It helps to impart practical coping skills to resist the temptation of drugs while seeking out helpful supports. It can also help you reconnect with your family and friends.
In conjunction with outpatient treatment, some in recovery may require more support. For someone in recovery from opioid addiction, this might take the form of a halfway house or sober living facility, which gives former users the chance to get sober and rebuild their lives in a safe and supportive environment.