Opioids are a class of drugs that are used both for medicinal and recreational purposes. They date back several centuries and were first synthesized in Germany in 1937, as morphine was derived from the sap of opium poppy pods. The potent effects of this drug were realized to have analgesic properties and have since garnered great attention in the medical community. Opioids are used as anesthetic during surgery, for pain relief during childbirth, and for post-operative and chronic pain.
While these drugs have an important place in medicine, they are widely abused recreationally. In 2012, the National Institute on Drug Abuse noted that 2.1 million people in America were abusing prescription opioid pain relievers. The most commonly prescribed painkillers are:
- Oxycodone
- Hydrocodone
- Codeine
- Fentanyl
- Hydromorphone
Oxycodone is one of the most widely abused prescription drugs. The American Journal of Psychiatry reported on a screening of 27,816 clients entering treatment for opioid addictions, noting that 5 percent had cited use of oxycodone.
Other opioids are also commonly abused. Almost all of the world’s hydrocodone supply is consumed solely by the United States, NIDA states. Codeine is found in many prescription cough suppressants that individuals drink in copious amounts to get high.
Fentanyl is a highly dangerous and potent opiate that is typically reserved for chronic pain and used as a surgical anesthetic. Despite that, its abuse is growing. Cited as being 50 times stronger than heroin by AOL News, lives are lost to fentanyl on a daily basis.
Heroin
Still, these prescription medications aren’t the only opioids on the market. NIDA accounts for 10,574 people losing their lives to heroin overdoses in 2014. The risks involved with heroin abuse are not solely with death, however. Many of the side effects linked to its abuse can cause lasting, permanent injury. A lot of individuals who overdose on this drug fall into a coma where any number of injuries can occur to the brain. The same goes for the seizures and convulsions that are known to occur as a result of heroin abuse. Some people will end up with chronic clinical depression or anxiety disorders they battle for years and sometimes for the rest of their lives.
Injection drug use is far more common with heroin than opioid pain relievers, though it is possible to inject many forms of prescription opioids as well. A lot of people who abuse heroin share their supply, and the tools used to prepare doses. They might even share needles. When these supplies, needles, and syringes are shared, the risk of transmitting disease is prevalent. AVERT reports that around 18 percent of Americans living with HIV are people who inject drugs. Hepatitis B and C are also serious concerns among people who inject heroin and other drugs.
Unfortunately, prescription opioids often act as a gateway to heroin too. Some individuals do enter treatment needing help with addictions to both substances. NIDA reports that one in 15 people who use prescription opioid painkillers without a medical need for them will end up using heroin within a decade.
When Help Is Necessary
Common warning signs of abuse of opioids include:
- Being overly alert or displaying unusually heightened awareness
- Loss of appetite
- Trouble falling or staying asleep
- Energy levels that ebb and flow to extremes
- Loss of ambition to take care of typical life responsibilities
- Poor control over one’s own behavior, thoughts, and feelings
- Depression
- Anxiety
- Loss of important relationships or careers
- Irritable mood
The physical symptoms occur mostly as a result of abuse, but some may arise when someone who abuses these drugs hasn’t used in a few hours and is experiencing symptoms of withdrawal. The emotional and mental symptoms are caused by withdrawal, as well as the way opioids affect the brain. Over periods of long-term abuse, dopamine receptors fail to function without the drugs driving them to do so. As a result, mood disturbances become a part of the individual’s new reality.
People who suffer from co-occurring mental health disorders may exhibit even more prominent signs of opioid addiction. Their typically liable mood swings may become even more erratic. They might become violent or start engaging in reckless behavior.
Treatment for Opioid Abuse
The National Association of State Alcohol and Drug Abuse Directors notes that 9.7 percent of admissions to treatment in 2012 were for cases involving prescription pain relievers as the primary substance of abuse. Many of the individuals who abuse these drugs are doing so with their own prescriptions.
The Centers for Disease Control and Prevention reports that 259 million prescriptions were written for these drugs in 2012. Countermeasures have been taken to try to scale back abuse, such as encouraging tighter reigns on the prescribing of oxycodone in recent years, but people who abuse these drugs often move on to an alternative when so many are available.
Oftentimes, opioid addiction treatment involves both medication and therapy. Methadone maintenance programs are the most widely prescribed across the nation. With success rates ranging from 60 to 90 percent, per the California Society for Addiction Medicine, they are considered to be among the safest and most effective programs for opiate addiction currently in practice. Buprenorphine is another option that has also shown efficacy. However, there may be more room for abuse of the Subutex variant of this drug since a full month’s supply can be prescribed. That being said, there is a version of buprenorphine that is combined with naloxone (known by the brand name Suboxone) that is less susceptible to abuse.
While medication can be an important component of treatment, therapy makes up the backbone of a solid recovery program. Therapy will address the initial reasons that led to substance abuse as well as triggers that may prompt individuals to return to opioid use. Most addiction treatment programs incorporate both individual and group therapy into their offerings, as well as support group participation and aftercare planning.