Opioid Abuse

Opioids are a synthetic or semi-synthetic class of drugs that are made from opium. Opioid abuse is a growing concern in the United States with thousands of people falling into the strongholds of addiction each year. According to the National Institute on Drug Abuse, “increases in abuse of opioids appear to reflect, in part, changes in medication prescribing practices, changes in drug formulations as well as relatively easy access via the internet.”

Most prescription painkillers are opioids.

While we now have information as to why opioids are being abused, this doesn’t prevent them from being misused. Opioid analgesic drugs are some of the most widely abused medications in the country. According to the CDC, 100 people die every single day as a result of drug overdoses and opioids are high upon the list of the causes of those deaths. In one year, more than 12 million people reported abusing prescription painkillers, mostly opioids, for non-medical purposes—and these numbers are on the rise.

What are Opioids?

Opioids are pain relieving medications that are often prescribed to patients following surgery, injury, illness or disease. They can be administered via a tablet, pill, capsule or liquid. Some are injected, others are crushed and snorted to produce euphoria and analgesic, pain relieving effects. The most common opioids include:

• Codeine
• Morphine
• Psuedomorphine
• Hydrocodone
• Hydromorphone
• Oxycodone
• Oxycontin
• Demerol
• Dilaudid
• Meperidine

Who’s at Risk?

According to NIDA, opioid abuse rates are high amongst an array of age groups, backgrounds, socioeconomic statuses and genders. It seems that nobody is safe from the potential dangers of opiate abuse unless they avoid the use of these medications indefinitely. Teens, young adults, the elderly and everyone in between is at risk.

There are some factors that increase the risk of opioid abuse including:

• A history of heroin use
• A history of drug abuse
• A history of trauma or injury
• A history of chronic pain
• A history of abuse either physical, sexual or emotional
• Mental illness

What Causes Opioid Addiction?

Opioids cause a quick release of endorphins which results in the pleasure and sense of euphoria that the user feels. Unfortunately, the euphoria is followed by an almost immediate calmness and sense of feeling tired or drowsy. When these drugs are repeatedly abused, according to NYU Langone Medical Center, the brain becomes dependent on the arousal felt from the drug.

Researchers further believe that people who have certain genetic risk factors may be more susceptible to opiate addiction. Regardless though, of risk factors, genetics, or other elements, using opiates places you at risk for physical dependence because opiates are highly addictive in nature.

Signs of Opioid Abuse

Various signs will appear when a user begins to abuse opioids. If the individual is prescribed the medication, you may notice that he or she runs out of medication before the due date or that the individual is seemingly taking the medication more often than before. If the medication is not prescribed, you may hear the individual talk about the drug or make subtle comments about using.

Some of the common signs of opioid abuse include:

• Taking medication when there is no reason to take it
• Using medication for any reason other than prescribed
• Making excuses to go to the doctor to get medication
• Faking pain in order to receive prescription drugs
• Seeking more than one doctor in order to be prescribed more than one prescription
• Getting caught with medication that is not the individual’s
• Being arrested for disorderly conduct, DUI or another crime related to using
• Taking opioids while driving, while at work or in a risky situation
• Failing to take care of children, household chores, homework, school work or other responsibilities
• Spending more and more time focused on opioids
• Using opioids with alcohol or other drugs
• Running out of a medication before the refill date
• Stealing medication from a loved one or family member
• Purchasing opioids from someone

Fortunately, opioid abuse is not necessarily an addiction—at least not yet! If you suspect that someone you know is suffering from opioid abuse, consider seeking prompt help right away.

Signs of Opioid Addiction

As the abuse of opiates and other drugs continues on, users are more likely to become physically and/or psychologically dependent on the drug. Opioid addiction is characterized by a strong physical dependence that results in withdrawal symptoms when the user makes any attempt to cut back or quit using. Often times, the symptoms of withdrawal are so strong, the only way a user knows how to cope is to take more of the drug—this begins the downward spiral of opiate addiction that is both difficult to treat and equally difficult to cope with.

According to UCLA, some of the most common signs of opioid addiction include:

• Taking opiates more frequently than they are prescribed
• Taking larger doses of an opioid than is prescribed
• Making attempts to cut back or quit using opioids and failing
• Making sacrifices to family time, responsibilities or otherwise in order to obtain opioids
• Developing a physical tolerance to the medication or drug which requires increased or more frequent dosing to produce similar effects
• Developing symptoms of withdrawal when the drug is not used
• Being confused or otherwise unkempt
• Slowed breathing or respiratory depression
• Sedation, heavy limbs and general tiredness
• Needle or track marks from injecting opioids
• Impaired sensation or inability to feel or sense pain
• Agitation or irritability when opioid use is not possible
• Making promises to quit or cut back and failing to follow through on the promise
• Getting into legal or other forms of trouble as a result of the drug use and continuing to use
• Going through great lengths in order to obtain opioids such as lying or stealing from loved ones
• Doing “whatever it takes” in order to get the drug
• Continued opioid use despite health problems, relationship problems or other consequences
• A general desire to quit that is always overcome by the cravings to use

Tolerance

Opiate abuse can quickly lead to increased tolerance to the drug. Opioid tolerance is described by the University of Vermont as:

• A diminished sensitivity to the substance
• A need to take more of the substance in order to produce the same effects

With tolerance to the opioid, users will often show fewer signs or symptoms of use. For instance, users can develop a significantly high tolerance to the respiratory depression and sedation that is felt from opioids as well as to the analgesic effects and the euphoria. Subsequently, very little tolerance is developed toward the constipation that comes from using opioids or to the constriction of the pupils. Most users will continue to show these signs or feel these effects regardless of how long or how often they have used opioids in the past.

Opioid Withdrawal

Physical dependence is a significant factor in opiate addiction and it’s the leading cause of continued drug use. Opiate withdrawal can be difficult to cope with, may even be painful at times, and usually causes the user to fall back into old habits of drug use despite good intentions. According to the Medical College of Wisconsin, signs and symptoms of opioid withdrawal include:

• Sweating and yawning
• Tearing or watery eyes
• Flu-like symptoms including nausea and vomiting
• Anxiety and restlessness
• Dilated pupils
• Tachycardia or hypertension
• Cramping and abdominal pain
• Muscle aches and pains as well as bone or joint pain
• Diarrhea
• Insomnia or changes in sleep patterns

These symptoms generally begin about 6-12 hours following the last opioid dose and will peak around 72-96 hours later. Withdrawal duration will depend on a variety of factors but generally doesn’t last more than 10 days for most users.

Treating Opioid Abuse and Addiction

Once opiate addiction has been formerly diagnosed, treatment can begin to help counteract the effects of the drug and stabilize the user. Physical tolerance and withdrawal will be the primary focus of the first few weeks of treatment. Once the patient has detoxed and there are no longer physical addiction signs, counseling and behavioral therapy can commence to help change the reactions and responses that the user has to triggers that may otherwise cause them to relapse.

Methadone or other medications such as Buprenorphine or Naloxone are often given to the patient to help speed the process of withdrawal, reduce or eliminate cravings and treat symptoms. Some patients cannot manage abrupt reduction or discontinued use of opioids and must take a medication to stabilize—it’s important to work closely with a treatment professional in order to ensure you are taking a safe medication and that your vitals are remaining stable during detox.

Counseling, such as individual or group counseling, will provide you with a safe and controlled atmosphere to work through some of the problems that you’ve been having and to get things in order. If you’re not sure about talking with a counselor, keep in mind that everything you say will be protected by your doctor/patient rights. Be open and honest with the counselor and you will gain the most out of your treatment.