Opioids are the driving force behind the drug crisis currently happening in the United States. With over 63,600 overdose deaths on the U.S. in 2016, over half (42,249) involved opioids. Opioid addiction is a chronic disease with physical and psychological effects. Opioids can cause dependence, withdrawal, and overdose as direct adverse effects. Plus, injecting opioids like heroin increase a person’s risk for contracting infectious diseases like HIV and hepatitis.
Opioid addiction is treatable through detoxification and various kinds of evidence-based therapies. If you are concerned about opioid addiction, the following article will shed light on opioids, the addiction epidemic, and how it can be treated.
Opioids refer to naturally occurring and synthetic psychoactive substances originally derived from the poppy plant. Morphine was the first opioid used as a medicinal drug to treat pain symptoms in surgeries and in military combat settings. Since then, scientists have synthesized more potent compounds and there are currently several opioid pain relievers prescribed today.
Opioids are used to treat pain and they are very effective. Our bodies produce endogenous opioids called endorphins (as “endogenous morphine”). Opioid receptors are all over the body, particularly in muscle, skin, organ tissue, and bones. When you experience pain, opioids can curb or stop the signal at each part of the pain trail to your brain including at the pain origin, in the spine (the dorsal root ganglion), and in the brain. However, opioids from the poppy plant and synthetic opioids are much more powerful than the body’s natural endorphins.
Opioids attach to opioid receptors and slow the sending and receiving of pain signals across the synapse (the space between nerve cells that allows the passage of information). Opioids are so powerful that users don’t just feel pain relief, instead they feel euphoria, drowsiness, and sedation.
Drug addiction is a complex and progressive disease of the brain caused by a period of regular use of opioids. In most cases, addiction is caused by abuse of prescriptions drugs or illicit opioids. Because opioids have profound psychoactive effects on systems that are vital to moderating pain and cause a feeling of euphoria, the brain can become dependent on the drug relatively quickly with frequent or heavy use.
When opioids create a feeling of euphoria, it sends signals to your brain that tell it that opioid use is good and should be repeated. Your brain is designed to identify things that make you feel good. Whether having satisfying meal, laying down in a comfortable bed, or hugging a loved one, your brain tells you, “This is good. Do this again!” Without this response, we may not have survived as a species. It teaches you to keep doing things that help you survive like eating, resting, and forming social bonds. The limbic system (also called the reward center) is responsible for identifying these “feel good” activities. Of course, there is a flaw in the system.
Your limbic system is built to identify good things you would normally find in nature and encourage you to keep seeking them out. However, cheese, candy bars, and heroin aren’t found in nature and they are way more potent than your limbic system is used to. Sugary and fatty foods are rare in nature so your brain is designed to crave as much as you can get, but in today’s society, we have fat and sugar in abundance. In the same way, endorphins are released in small amounts naturally but heroin and opioids completely flood the brain in opioids.
Your limbic system reacts to this by learning that opioid use produces an intensely good feeling and teaches your brain to use it again, almost impulsively. It typically takes opioids several uses for you to develop a dependency.
The United States is in the middle of a drug addiction and overdose crisis called the opioid epidemic. The phrase refers to the exponential growth of opioid addiction and the tens of thousands of overdoses that have occurred every year since the early 2000s. Overdose deaths as a whole have surpassed other causes of injury related deaths like motor-vehicle accidents, firearms, and homicide.
Overdose has become the leading cause of death of people under 50 years of age, and opioids in particular killed 42,000 people in 2016. The problem seems to be growing with very little signs of stopping. Today more than 115 people die every day from an opioid overdose.
Opioid addiction is a serious disease and one that is very difficult to recover from, especially without help. Because the disease is progressive and chronic, people who fall into a pattern of addiction often don’t seek or receive the help they need. Those who do receive treatment may relapse back into addiction, particularly when they stop pursuing continued recovery (i.e. relapse prevention strategies, attending support group meetings).
Opioids in controlled settings are powerful painkillers and it’s possible that they can lead to addiction even when used as directed (in some cases). However, they typically don’t kill you out right. If the average person takes appropriate doses of opioids, it can cause some gastrointestinal distress. Other drugs like meth, alcohol, and even cigarettes are associated with significant, inherent health risks. Most negative effects come from dependence, overdose, and withdrawal. However, overdose symptoms are often deadly.
During an opioid overdose, opioids relax your body to the point where your breathing slows to dangerous levels in a process called respiratory depression. This symptom can slow and even stop a person’s breathing to the point of hypoxia, brain damage, coma, and death. Other symptoms include unconsciousness, pupil dilation, seizures, and muscle spasms. The exact mechanism of opioid-induced respiratory depression is unknown. However, some believe that the brain’s ability to detect carbon dioxide in the body, which triggers breathing, is diminished by opioids.
Overdose can happen in three different ways:
As you continue to use opioids, you start to build a tolerance and it takes more and more to achieve the same effects. Someone who goes through detox and spends time in sobriety will lose most of that tolerance. This can happen when someone goes through a treatment program, has to have medical procedures that require sobriety, or spends time in prison. After a period of sobriety, people who relapse are at a greater risk of overdose. If you relapse by taking a dosage that you were once used to, it may be an extremely high dose for you after losing tolerance.
Similarly, people who use extremely high doses can experience overdose. This can happen accidentally if you become used to a diluted opioid. Some dealers will “cut” heroin to stretch profits. This involves adding inert substances to the drug to increase volume. Experienced drug users can typically tell the difference when a dose produces a smaller effect. However, new heroin users don’t know the difference. If you become used to a diluted dose and then take the same dose of a purer hit of heroin, you may overdose.
To sell cut heroin to people who are experienced opioid users, some dealers will mix in cheaper, more powerful opioids like fentanyl and its analogs. These opioids can be 50 times more powerful than heroin and are potent in small doses. Users that take heroin even with small amounts of fentanyl mixed in can overdose.
Currently, fentanyl is causing a spike in overdose deaths and driving the opioid epidemic to record heights. The average person can experience a fatal overdose if they take a two to three milligram dose of fentanyl, which is lighter than a single grain of sand. Fentanyl is used in medical settings for its fast-acting, pain-relieving effects. However, it’s carefully diluted and measured for medical uses. On the street, most dealers don’t have the resources to measure out small amounts safely.
The rampant increase of opioid addiction and overdose started around the early 2000s but it may be traced back to the 90s. Pharmaceutical companies encouraged the use of opioids, assuring that they would not cause significant amounts of addiction when used properly. Doctors and healthcare providers started to increase the amounts they prescribed opioids. To their credit, only between 8 and 12 percent of people who use opioids become addicted and many of those abuse the drug or get it from friends and family members rather than from their doctor.
However, with health care providers writing around 66 opioid prescriptions for every 100 people in the U.S. in 2016, eight percent is a significant number. Plus, the increase of opioid over prescription flooded illegal markets with prescription opioids.
However, opioids don’t just come from misuse of official sources. Significant amounts of heroin and now fentanyl are imported and smuggled into the U.S. from Mexico and China. Mexican transnational criminal organizations are chief among the U.S. suppliers of opioids according to the Drug Enforcement Administration’s 2019 National Drug Threat Assessment.
Fentanyl is contributing to the current surge of overdose deaths as it finds its way into illicit heroin products without the user’s knowledge.
Opioid addiction, like other psychoactive substances and addictions, have a set of signs and symptoms that reveal that there is a problem to the opioid user and their loved ones. Some of the telltale signs of addiction that tell the user that they are developing a dependency on opioids involve withdrawal and tolerance. If you feel diminishing effects after taking the same dose, it means that you are developing a tolerance and your brain is starting to get used to the drug. If you skip a dose or take a smaller dose and experience nausea, muscle cramps, depression, agitation, or anxiety, it may be a sign of withdrawal. Finally, the most common sign of opioid addiction is drug cravings. If you feel strong compulsions to take opioids after cutting back or if you fail to stop using because of cravings, it’s a sign of opioid dependence.
Addiction in general has some common signs that can be identified by a user’s loved ones, which include:
A person doesn’t have to exhibit all of these signs for and addiction to be present. If you or someone you know has shown some of the above signs and symptoms, seek treatment at a rehabilitation facility to find out more about treatment options.
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Opioid addiction is a disease, but it is treatable and is very possible to live a life of long-lasting recovery. Through, personalized addiction rehab and recovery, you can achieve and safeguard sobriety. Drug addiction treatment involves a mixture of cognitive and psychological therapies as well as medication when needed. Clients who enter addiction treatment progress through levels of care starting with detoxification and ending with relapse prevention programs. Through the process, you will become independent of the physical effects of drugs and then address psychological factors.
Opioids don’t typically cause deadly side effects in withdrawal. Instead, withdrawal symptoms often mimic flu-like effects with sweating, nausea, vomiting, diarrhea, and body aches being fairly common. However, in some cases, opioid withdrawal can lead to medical complications that can prove deadly. For instance, significant sweating, vomiting, and diarrhea can lead to dehydration, which can be deadly without medical treatment. If you also have other medical conditions like heart disease, withdrawal may exasperate them.
Medical detox is a safe option for people who need medical help going through the withdrawal phases of recovery. Medical detox can ease painful or uncomfortable symptoms and help you avoid relapse.
Reynolds, Dean. (2017, June 6). Overdoses now leading cause of death of Americans under 50. Retrieved from https://www.cbsnews.com/news/overdoses-are-leading-cause-of-death-americans-under-50/
U.S. Department of Health and Human Services. (2018, March 6). About the U.S. Opioid Epidemic. Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/
United States Drug Enforcement Administration. Fentanyl. Retrieved from https://www.dea.gov/factsheets/fentanyl
National Institute on Drug Abuse. (2018, March). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#nine
CDC. (2017). Annual Surveillance Report of Drug-Related Risks and Outcomes. Retrieved from https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf
United States Drug Enforcement Administration. (2019) 2019 National Drug Threat Assessment. Retrieved from https://www.dea.gov/sites/default/files/2020-01/2019-NDTA-final-01-14-2020_Low_Web-DIR-007-20_2019.pdf