Opioid Addiction

Orange County Treatment

Opioid Addiction

Orange County Treatment

What Makes a Drug an Opioid?

Opioids are a general group of drugs that aim to relieve pain and work with cell receptors found in the body. Opioids can be manufactured using the poppy plant to create morphine, or engineered in a research facility to produce fentanyl.​​​1 When opioid medication travels across the blood and attaches to the receptor cells in the brain, signals are released that suppress pain and increase feelings of pleasure.

Opioids are frequently utilized as medication because they are a synthetic substances that cause relaxation. Remedial opioids are utilized for the most part as a treatment for moderate to severe levels of pain; however, some opioids can be utilized for the treatment of diarrhea and coughing. Opioids can likewise make individuals feel euphoric, which is the reason they are abused. This can prove fatal considering that opioids are exceptionally addictive, and there is a high risk of overdosing and death. This is why medical detox is frequently recommended as a first step for the treatment of opioid use disorder. Heroin is one of the world’s most hazardous opioids and is never utilized as a medicinal drug in the USA.

Opioid Drugs

Drugs that come under the category of opioids include:

Prescription Opioids

Codeine

Hydrocodone

Hydromorphone

Meperidine

Methadone

Morphine

Oxycodone

Opium

Heroin

History of Opioids

Prescribing Addiction

The opioid crisis has occurred in 3 waves. The main wave started in the early 1990s when deaths related to the use of opioids began climbing after a steep increase in the number of prescriptions for opioids or a combination of opioid for pain management. The increase in opioid prescriptions was influenced by assurances provided to medical communities by pharmaceutical companies who guaranteed that the dependency risk of medicinal opioids was exceptionally low. Towards the end of the 20th century, 86 percent of patients that were taking opioids were using them for pain not related to cancer.​​​2 Communities with increasingly accessible opioids were among the main areas that started to experience increasing addictions. Opioid availability also increased diversions, or the exchange of opioids from someone who was prescribed the medication and selling it to someone else, which is unlawful.

Wave of Heroin

The second wave began somewhere close to 2010 with a quick increase in deaths due to abuse of heroin, which is a form of opioid. With early attempts at reducing opioid prescriptions starting to showcase results and medicinal opioids becoming more difficult to access, the epidemic shifted towards heroin. Heroin was a widely accessible and cheaper alternative, albeit a more fatal and illegal form of opioid. Heroin abuse expanded across both sexes, every age, and every socioeconomic group. Deaths occurring as a result of overdosing on heroin expanded by 286 percent between 2002 to 2013, and close to 80 percent of people who abused the drug had confessed to misusing medicinal opioids prior to shifting to heroin. Heroin is normally injected, which subjects the person to increased danger diseases like heart or blood infections, skin infections, hepatitis B and C, and HIV/AIDS.

Fentanyl Fatalities

The third epidemic wave came in 2013 with increased deaths linked with engineered opiates such as fentanyl. The steepest ascent in drug-associated deaths took place in 2016 with well over twenty thousand deaths as a result of fentanyl and related medications (Stannard, 2016). The expansion in deaths due to fentanyl intake has been connected to mixing fentanyl within different abusive drugs.

Opioid Abuse by the Numbers

As of late 2017, the United States government proclaimed the opioid endemic a general wellbeing crisis. The therapeutic industry, especially doctors prescribing pain medications, have been active members in addressing the current problem.

Doctor-recommended medication management programs have helped to decrease opioid prescriptions by 8 percent and death rates associated with overdosing on medicinal opioid by 12 percent.4

Regardless of these decreases in prescriptions in the United States, opioid-related deaths due to overdose keep on increasing at disturbing rates.

In 2016, 64,000 individuals died from overdose. More than 42,000 of these deaths were a result of opioid intake, which is a twenty percent increase from the 52,000 deaths as a result of drug overdoses that occurred in 2015.

Overdoses with fentanyl are the biggest factor, accounting for 20,000 deaths altogether; with heroin representing 15,000 deaths; and physician-recommended drugs under 15,000.

Health Risks of Opioids

Temporarily, opioids can help with pain relief and induce relaxation. Regardless, they can also bring about significant damage, which includes slowed breathing, euphoric feeling, constipation, nausea, confusion, and drowsiness. Opioid abuse can result in hindered breathing, which may result in hypoxia, a condition where very little oxygen is reaching the brain. Hypoxia can have short and long-term neurological and mental effects such as permanent brain damage, coma, or even death.1 Research analysts are also researching the long-term impacts of addiction to opioids on the brain, and if the harm is reversible or not.

Older adults are at higher danger of accidental abuse since they regularly have more than one medication to take due to constant ailments. Multiple medications increase the danger of interactions between drugs or between illnesses and drugs that influences the breakdown of medications in the body.

How Opioids Work

Medicinal opioids prescribed for relief from pain are considered safe when taken for a brief period and supervised by a medical professional; however, abuse may still occur. Taking prescription opioids in a manner or amount other than advised is a sign of abuse. Other signs of opioid misuse include taking another person’s prescribed drugs, or repeated use of the prescription to experience a high. When abusing a medicinal opioid, it may be taken in its typical method via swallowing the drug.3 Sometimes, pills are pulverized or capsules are opened, so that the powder can be mixed in water and injected.

Opioids tie to and initiate opioid receptors on cells situated in numerous regions of the spinal cord and brain as well as other organs, particularly feelings associated with pleasure and pain. When opioids connect to these receptors, they block the signals of pain that the brain is sending to the body and increase levels of dopamine that are released throughout the body. This release reinforces the drug abuse, resulting in an increased likelihood the substance abuse will continue.

Misconceptions About Opiates

Addiction to opioids is due to weak morals and poor decisions

Opioids may bring about physical dependence and tolerance when utilized precisely as recommended for the treatment of pain.8 Consequently, opioids are not normally viewed as perfect in treating chronic pain over the long-term. Opioid abuse can start with a real and necessary prescription. Therefore, a healthcare providers must closely monitor opioid medication use in patients.

Individuals abusing heroin are from big cities, are poor, and without insurance

Heroin use has expanded across most socioeconomic groups in the United States. An increase in opiate abuse has been shown among the female population, those with higher incomes, and ones with private insurance. Prescription opioid addiction increases the chances of dependency on heroin as well.

Overdosing on an opioid can be reversed

Naloxone or Narcan is an opioid antagonist medication that attempts to reverse the impacts of opioid drugs in the focal sensory system. Narcan can effectively save lives when administered early enough in the overdose.

Close to a hundred deaths occur as a result of overdosing on opioids on a daily basis in the USA. A single dose of Narcan may not be enough to reverse some overdoses due to very high doses, response times of medical supports or due to the combination of drugs taken. Overdosing on opioids and death are genuine risks of abusing opioids.

Every form of opioid carries equal risk

Opioid medications shift in their strength, onset rate, and length of activity. Opioids like oxycodone, for instance, produce results rapidly yet wear off quickly, while opioids such as methadone are considered long-acting. Fentanyl is a highly potent opioid, more than fifty to a hundred times more powerful than morphine.​​​5 Higher strength implies that the medication is more dominant, raising the hazard for overdose and dependency at lower portions than with different opioids. While overdose and dependency could occur from the abuse of any opioid, those that are fast acting and potent can be progressively risky when abused.

Taking Opioids as prescribed will not result in addiction

Ultimately, any use of opioid medications can prompt dependence and tolerance regardless of whether these medications are taken for alleviation of chronic pain. When the medications wear off, withdrawal can be troublesome both physically and emotionally. This may result in people taking opioids in between a dosage, or increasing dosage in an effort to avoid withdrawal. Opioids can likewise lead to a euphoric high when abused, which can result in ongoing misuse of opioids. Any nonmedical use of opioid medication can result in dependency quickly.

Not everyone can become addicted

There are a few risk factors that could result in increased vulnerability to addictions, like the presence of other comorbid disorders, environmental conditions, trauma and stress exposure, family history, etc. However, any individual who routinely abuses opioids can experience the ill effects of addiction. One out of four individuals who take medicinal opioids on a long-term period in primary care will struggle with addiction.

Detoxification without professional aid is safe

Due to the changes opioid medications bring about in the brain, withdrawal becomes more significant and troublesome to handle, which is why detoxification is usually recommended with professional help. Therapeutic detox can use medications to handle withdrawal symptoms. During medicinal detox, emotional wellness and health hazards can be closely monitored by medical professionals to guarantee the wellbeing and security of the patient. After medical detox, an individual should proceed to an extensive treatment program for addiction that could prevent relapse and supports healthier recovery.

Opiate Detox Symptoms

Withdrawal symptoms throughout detox can be difficult to battle without expert intervention.

Withdrawal side effects can include:

  • Dizziness
  • Goosebumps
  • Muscle Cramps
  • Tremors
  • Anxiety and Depression
  • Excessive Tearing and Yawning
  • Cravings
  • Dry Mouth
  • Chills and Sweats
  • Shortness of Breath
  • High Blood Pressure
  • Chest Pains
  • Restlessness and Irritability
  • Confusion
  • Nausea
  • Insomnia

When opioids have been misused over a long period of time, withdrawal symptoms will occur when medication use is reduced or stopped.

Opiates are physician-recommended in some cases. They can mitigate pain while causing a feeling of elation. When an individual briefly uses them as recommended by a specialist, sedatives can be helpful to recuperate from damage or an ailment. When utilized wrongfully or too much, they are addictive and dangerous. While drug withdrawal is typically not threatening to one’s life, they are not easy to navigate and are safer and more manageable with professional assistance.

Treatments for Opioid Use Disorders

Detoxification

Detoxification is the first phase in treatment. This includes clearing the substance from the body and restricting withdrawal responses. In eighty percent of cases, a treatment center will use medication to decrease withdrawal side effects. If an individual is dependent on more than one substance, frequently, prescriptions will be required to decrease withdrawal side effects for every drug individually.

Behavioral Therapy and Counseling

This is the most well-known type of treatment following detoxification. Treatment may happen on an individual, group or family basis depending upon the needs of the person. It is generally full-time at the start of treatment with the number of sessions slowly as side effects are reduced over time.

Cognitive Behavioral Therapy (CBT)

This is the most common type of treatment following detoxification. CBT enables individuals to perceive and change perspectives regarding substance abuse.

Family Therapy

This is intended to help families heal from the effects of substance abuse. Frequently used in families with teenagers with substance abuse issues, however, all families effected from substance use disorders benefit from family therapy.

Motivational Interviewing

Motivational interviewing helps expand upon a person’s readiness to make a change and adjust behavior that is negatively impacting their lives.

Rehabilitation Programs

Long-term treatments for substance abuse can be highly viable and regularly focus on staying medication-free and continuing in family, professional and social obligations. Completely authorized private offices are accessible to structure a 24-hour care program, give sheltered lodging, and provide urgent medical interventions. Some facilities may provide therapeutic services, such as:

Short-term private treatment

This is concentrated on detoxifying and setting up a person for a more drawn-out period inside a remedial community via intense and concentrated counseling.

Housing for Recovery

This serves as a provision for managed, transient lodging to help individuals become engaged with obligations and adjust without substance use. Recuperation lodging incorporates counseling to deal with finding work and managing finances, along with linking an individual during the last phases of recuperation to community support.

Self-Help Groups

These meetings assist  in introducing others with equivalent addictive issue for support via regularly providing inspiration and decreasing confinement. They can likewise fill in as a valuable source of information, community, and education. Narcotics Anonymous and Alcoholics Anonymous are examples of such groups. 

Medications

An individual may take prescriptions for a continued period of time when recuperating from a substance-related addiction and related complications. Individuals most generally use medicinal drugs during detoxification to manage withdrawal side effects. The medicine will shift depending on the substance that the individual is reliant on. Long-term utilization of medication lessens desires and discourages relapsing or going back to using the drug after addiction recovery. Prescriptions do not serve as an independent treatment for addictions and must accompany other methods for managing the addiction, such as psychotherapy.

Finding Help

Research has shown the treatment of opioid addiction works most effectively when different mediational strategies are used in combination, both pharmacologically and psychosocially. In such a manner, medication to handle withdrawal symptoms, support groups for recovery, community prevention strategies, peer and family support, and working on reducing the stigmas associated with drugs and addiction are all essential in achieving progress with regard to the opioid epidemic.

There is also a requirement for governments to take adequate measures that focus more on rehabilitation and discouragement of drug use, because simply making a drug illegal will not prevent its use. Treatment alternatives and policies should be focused on, along with educational strategies and awareness campaigns about the stigma associated with it across states.

The opioid epidemic has come about largely due to a varied series of attempts that were genuinely meant for rehabilitation purposes but with unintended, disastrous consequences. The assumption that opiates are devoid of significant side effects for chronic pain management are misled and have become apparent in the three epidemic waves that have caused a significant number of deaths. However, instead of shifting blame, the focus needs to shift towards health, focusing on the well-being of the people who are prone to becoming addicted to such drugs.

Resources

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  2. Dunn, K. E., Barrett, F. S., Fingerhood, M., & Bigelow, G. E. (2016). Opioid overdose history,
    risk behaviors, and knowledge in patients taking prescribed opioids for chronic pain. Pain Medicine, 18(8), 1505-1515.
  3. Harle, C. A., Bauer, S. E., Hoang, H. Q., Cook, R. L., Hurley, R. W., & Fillingim, R. B. (2015).
    Decision support for chronic pain care: how do primary care physicians decide when to prescribe opioids? a qualitative study. BMC Family Practice, 16(1), 48.
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