Opana Abuse, Addiction and the Available Treatment Options in Washington State

Opana addiction and abuse remain serious problems in Washington State, as well as in the U.S. as a whole. Once a person forms an addiction to this drug, detox and rehab is needed to get off it. It has become one of the most infamous opioids on the market, and in recent years it has drawn a lot of attention.

In 2015, Opana was linked to an outbreak of new HIV cases in Indiana, and it spread quickly. Further investigation revealed that it was because so many people were injecting this drug and sharing needles. Very few of these new cases were transmitted sexually according the National Institute on Drug Abuse.

But there are so many other problems that are related to the abuse of this drug. It can have a tremendous negative impact on the body and the mind when people misuse it. It can also lead to the use of harder opioid drugs, such as heroin.

We want people to be made aware of the risks of abusing Opana. Once a person starts using it, it is very easy to become addicted to it. Once they do, detox and rehab are the best solutions for recovery.

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A Quick Look at Opana: What Is It?

Opana is a brand name for the opiate analgesic oxymorphone and is used to treat moderate to severe around-the-clock pain. Opana itself comes in both an immediate release as well as an extended release tablet.

Other brands, however, such as Numorphan are administered via injection and are often used to treat labor pains or may be given before surgery along with a general anesthetic.

Opana belongs to a class of drugs called opioids. These powerful substances can be especially dangerous when used long term as they carry a high probability of addiction when used incorrectly as well as a significant risk of abuse.

A few other drugs that are opioids are heroin, Fentanyl, OxyContin, and opium.

Given the addictive potential of oxymorphone, it’s categorized as a Schedule II substance by the Drug Enforcement Agency and can only be legally obtained through a licensed and practicing physician.

Some of the most common street names for oxymorphone according to the DEA include:

  • The O Bomb
  • Stop Signs
  • Pink O
  • Pink Lady
  • Pink heaven
  • Pink
  • OM
  • IR
  • Orgasna
  • Oranges
  • Octagons
  • New Blues
  • Mr. O
  • Blues
  • Heavenly Blues

Like other opioids, Opana interacts directly with the mu-opioid receptors found in the brain. These specialized receptors help regulate certain bodily processes such as mood and pain relief.

The structure of these receptors aligns perfectly with the brain’s own opioids, enkephalins and endorphins, which are released naturally. Opioids like oxymorphone, however, mimic the physical and chemical structure of these chemicals but when they attach themselves to the opioid receptors, they stimulate them to a much greater degree.

When abused at especially high levels, these opioids can create intense feelings of euphoria and pain relief as well as tranquility and deep sedation. Part of the cause of this pleasure can be attributed to an intense rush of dopamine into the reward systems of the brain, according to the National Institute on Drug Abuse (NIDA).

What’s more, opioids have been proven to have an effect on another one of the brain’s primary neurotransmitters called serotonin. This chemical is instrumental in regulating mood, sleep, memory, and may play a significant role in addiction and withdrawal.

Opana has recently received a fair amount of media attention, particularly for its role in helping cause one of the largest HIV outbreaks in recent history.

In 2015, Scott County, Indiana saw an unprecedented outbreak of HIV cases. The New York Times reports that in a county which rarely saw a single case in an entire year, 2014 saw five positive cases in the last few months of the year.

By mid-January, eight more people tested positive for the immune disease. On March 24th, 2015, the number of new HIV cases had risen almost to 90. As of Dec. 9th, 2016, there had been 210 confirmed cases of HIV with 95% of those infected also testing positive for hepatitis C.

How did a problem like this develop so quickly? How does a single county’s rate of HIV infection jump to more than half a percent higher than the average of the rest of the country in just one year?

The culprit, it turns out, was Opana. While this drug used to be abused by crushing and snorting it, a new formulation of Opana replaced the old one in 2012 and made it harder to grind it into a powder.

Residents of the county soon learned, however, that this new formula could actually be dissolved and injected instead. Given the county’s rural nature, clean needles were hard to come by and, as a result, HIV began spreading like wildfire.

One of the more interesting aspects of the story is how the officials in charge actually put a stop to the spread of this life changing disease.

At-the-time governor and Vice President Mike Pence, a staunch republican with uncompromising ideals, was faced with a very serious question: how do we stop the spread of HIV in this community?

After reaching out to experts at agencies like the CDC, he was told that by far the best way to mitigate the damage of such an outbreak was to legalize a needle exchange program. At the time, such programs were outlawed entirely in the state.

However, Pence and a number of health officials with legislative sway were deeply opposed to the idea. After all, wasn’t a needle exchange just enabling further abuse?

After taking a look at the research though, Pence finally acquiesced and signed an executive order to begin a needle exchange program. This shift in legislation along with aggressive community outreach helped turn the tide of the outbreak permanently.

While the story is certainly a triumph for the harm-reduction approach to addiction, it’s also a great example of how being stuck in the past can and does ruin lives.

Pence waited a full two months before issuing the executive order to legalize needle exchanges – during which time a significant number of new cases had likely developed. Had there been no question that addiction was a disease rather than a moral failing, they could have put an end to the outbreak almost immediately.


How Long Does It Take to Get Addicted to Opana?

One of the main questions among opioid users (especially those that have a legal prescription for the substances) is how long does it take to get addicted to oxymorphone?

And it’s a fair question. After all, a whopping 75% of heroin users report that their first opioid experience was with a prescription drug.

It’s reasonable to wonder, then, if you’re at risk for developing a dependency to Opana which can eventually lead to addiction.

The simple answer to this question is: you can develop a dependency faster than you think. The hard data is sparse on this question as so many different individual factors go into developing an addiction but in general, many practitioners believe that dependency can develop within just two weeks.

It’s worth remembering, though, that the risk of dependency scales with the dosage and the level of abuse. An especially prolific Opana abuser may find themselves hooked on the drug after just a week while the more conservative patient may use it for months at a time without suffering withdrawals.

In the end, it depends upon the individual, their exposure to other substances, their habits, their history of abuse, and many other factors as well.

If you’re worried about becoming dependent on oxymorphone though, it’s important that you openly discuss your concerns with your doctor. You may help influence his or her treatment suggestion and could even open up non-opioid treatment options that you weren’t aware of.

While discussing your condition with your prescribing physician is often the best way to help you determine if you’ve actually developed an Opana addiction, you can also take matters into your own hands as well.

For instance, there are a number of self-assessment tools available today that can help you look at your own behaviors objectively and figure out if you need to seek further help from a qualified professional.

Taking online addiction assessments such as a short quiz is one of the quickest ways of determining your level of addiction and dependency. It’s simple, helpful, and ultimately a pain-free first step you can take on your road towards sobriety.

For the more detail-oriented among you, you can also use the official substance use disorder guidelines developed by the Diagnostic and Statistical Manual of Mental Disorders as well. This comprehensive questionnaire includes 11 criteria that practicing physicians and psychiatrists use to diagnose substance addiction.

In the end though, no matter which assessment tool you go with, you’re still showing that you’re willing to take the first steps in actually confronting your addiction. And that is often the hardest step of all.

Like many other opioids, oxymorphone has a particularly long list of short-term side effects in addition to the ones that are the reason for taking the drug in the first place. And unlike the euphoria and pain relief that some users experience when taking this drug, the other side effects aren’t quite as enjoyable.

According to Drugs.com they include:

  • Difficulty passing stool
  • Feelings of being constantly moving
  • Increase sweating
  • Nausea
  • Vomiting
  • Spinning sensations
  • Sleepiness
  • Acidic or sour stomach
  • Belching
  • Decreased appetite
  • Decreased weight
  • Diarrhea
  • Discouragement
  • Excess air or gas in stomach or intestines
  • Feeling of warmth
  • Feeling sad or empty
  • Full or bloated feeling
  • Heartburn
  • Indigestion
  • Lack of appetite
  • Loss of interest or pleasure
  • Passing gas
  • Pressure in the stomach
  • Redness of the face, neck, arms, and occasionally the upper chest
  • Stomach discomfort or upset
  • Swelling of the abdominal or stomach area
  • Tiredness
  • Trouble concentrating

These short-term effects are just some of the more common ones too. Plus, the severity of the symptoms often depends on the degree of abuse as well. As such, the symptoms of a hardcore oxymorphone addict will likely be much worse than those of someone who only abuses this drug occasionally.

Beyond that, one of the most notable short-term abuse side effects is the risk of overdose which can lead to permanent damage as well as potentially fatal outcomes.

As with any other opioid, whether it be heroin or even methadone, overdosing on oxymorphone can end up being fatal. Opioids are notorious for depressing respiration as well as other bodily functions and when taken at high doses they can slow your breathing to an absolute stop.

The threat of overdose and ultimately the overall danger of overdosing is compounded even further when opioids like Opana are combined with other central nervous system (CNS) depressants like benzodiazepines and sleeping medications.

This is particularly true when it comes to mixing opioids with alcohol. Studies have shown that there is a significant increase in risk of dangerous levels of respiratory depression when the two substances are used in combination. What’s more, this risk is particularly pronounced in the elderly.

The main point here is that opioids are already deadly enough on their own. When you add other substances like alcohol or benzodiazepines into the picture too, you’ve got one dangerous cocktail that may end up taking your life.

How Has Opana Impacted Washington State?

Most people are aware of how serious the opioid epidemic is in the United States. President Trump called it a national health emergency, and for good reason. The United States government was forced by court ruling to provide data that tracked the sales of opioids between 2006 and 2012. The information that was discovered within that data was staggering.

During that time, billions of painkillers were prescribed to people all over the United States. But the revelation also shed some light on something else – the pharmacy companies knew exactly what they were doing. They knew about the number of pills being prescribed each year and in each city and town in the country. In addition to that, lawsuits have alleged that these companies purposely ignored a number of red flags that related to violating federal laws. They were also well aware of the black market that was forming.

Endo Pharmaceuticals is the company that made Opana. In 2016, they stopped promoting opioids and have worked to eliminate the company’s painkilling products. This included withdrawing Opana ER from the market. In addition, no new research has been done to develop newer opioid medications.

The FDA stated that “the benefits of the drug may no longer outweigh its risks” when it pulled Opana from shelves entirely. The FDA Commissioner at the time was Scott Gottlieb and he stated, “We are facing an opioid epidemic – a public health crisis, and we must take all necessary steps to reduce the scope of opioid misuse and abuse.”

Prior to pulling the drug, research indicated that patients started to inject the drug more often after its reformulation. Injecting it became associated with severe outbreaks of HIV and hepatitis C. There were also concerns about people getting diagnosed with thrombotic microangiopathy, which is a serious blood disorder.

Long-Term Effects of Opana

Similar to other opioids like it, oxymorphone also has a wide variety of long-term effects, some of which can be quite devastating both physically and psychologically.

One study, for instance, found a number of correlations between long-term opioid abuse and health effects like:

  • Constipation
  • Respiratory depression
  • Gastrointestinal bleeding
  • Heart disease and failure
  • Sexual dysfunction
  • Fatigue
  • Anxiety disorders
  • Cramping

Another recent study outlined some additional long-term effects of abusing oxymorphone on a regular basis. Researchers found that using opioids like Opana for more than just 30 days could result in new-onset depression, possibly caused by “changes in neuroanatomy and low testosterone,” according to the study.

According to the National Institute on Drug Abuse (NIDA), researchers are also looking into connections between protracted use of opioids like oxymorphone and permanent brain damage.

The depressed respiration that’s so common in opioid abuse may actually be lead to less oxygen getting to the brain than what it requires. This condition is also known as hypoxia and it can have serious psychological and neurological effects.

Long-term opioid addiction in general may also decrease the amount of white matter in the brain, possibly affecting “decision-making abilities, the ability to regulate behavior, and responses to stressful situations” according to NIDA.

Withdrawals from oxymorphone can be incredibly uncomfortable. In fact, many substance abusers claim that detoxing from opioids like Opana is worse than trying to get off any other drug on the market today with the exception of benzodiazepines.

And with this especially long list of symptoms provided by Mental Health Daily, it’s easy to see why:

  • Yawning
  • Vomiting
  • Sweating
  • Watery eyes
  • Runny nose
  • Suicidal thoughts
  • Paranoia
  • Panic attacks
  • Muscle aches
  • Memory problems
  • Nausea
  • Itchiness
  • Irritability
  • Hot flashes
  • Insomnia
  • Heart palpitations
  • High blood pressure
  • Goose bumps
  • Headaches
  • Dizziness
  • Fatigue
  • Diarrhea
  • Dilated pupils
  • Crying spells
  • Depression
  • Concentration problems
  • Cravings
  • Agitation
  • Anxiety

To make matters even worse, the withdrawal timeline for oxymorphone and other opioids can end up being particularly long for the immediate and protracted phases, up to three weeks for some opioids. The combination of the especially uncomfortable side effects of Opana detoxification as well as the long timeline lead many opioid addicts to eventually relapse.

Some oxymorphone abusers also report feeling a number of especially long-lasting symptoms after detoxing from Opana.

While opioid withdrawals can be especially hard to bear and often end up lasting for at least several weeks, these other symptoms are different – they include mostly psychological effects including:

  • Irritability
  • Anxiety
  • Sleep difficulties
  • Mood swings
  • Fatigue
  • Lack of motivation
  • Impaired concentration
  • Impulsivity

What’s more, this collection of symptoms has been reported in users for multiple years, not just weeks or even months at a time.

Those in the addiction community have coined a term for this especially protracted and mostly psychological withdrawals – post-acute withdrawal syndrome or PAWS. While its existence is still up for debate among physicians, there are thousands of recovering addicts that adamantly agree that PAWS is a very real disorder.

Some physicians have found that treating PAWS with medications like naltrexone has brought about at least minor successes but in general, time is often the only antidote for this frustrating and lengthy aspect of addiction.

Treating Opana Addiction in Washington State

Even though Opana is no longer on the market in the United States, people still manage to get it. It can be bought on the streets and many people purchase it online. Because it is so potent, it does not often take long for people to get addicted to it. When they do, they need professional treatment to stop, in most cases.

When a person is addicted to Opana, they are both physically dependent on it and psychologically addicted to it. That means a two-step approach is necessary in order to address both aspects of their substance abuse problem.

The first step should always be for the individual to go through a professional medical detox. Medications may be ordered for the person to help with their withdrawal symptoms. Some people may be recommended for medication-assisted treatment. This means that they will be given medications that are specifically designed to help with opioid withdrawal.

After the detoxification period is over, the next step is to go through drug rehab. It is essential for people to learn and understand why they started using Opana. Some may have started it as a way to treat pain. But many use this drug for recreational reasons. In reality, they are usually trying to self-medicate the symptoms of a co-occurring disorder.

Recovering from an Opana addiction requires treating co-occurring disorders. Otherwise, recovery in the long-term is very unlikely.

Our Outpatient Rehab Program at Northpoint the Evergreen

At Northpoint the Evergreen, our outpatient drug treatment program is designed to provide personal support to people with addictions. We have worked with many people who are addicted to Opana. We know how serious this problem is and we are determined to provide the support people need to get off this drug successfully.

Our program is comprised of three levels of care. They are intensive outpatient treatment, partial hospitalization and traditional outpatient rehab. For people with Opana addictions, we will first refer them to a quality detox program that we trust. Afterwards, they can return to us for further treatment and help.

We have two locations for our clients’ convenience. Our facilities are in Seattle and in Bellevue.

Learn More About Opana Addiction, Abuse, Detox and Rehab in WA State

Opana addiction and abuse continue to plague Washington State. At Northpoint the Evergreen, we want our clients to know that we are committed to providing them with the very best treatment available. We know how challenging it can be to recover from this addiction. We will be there to provide support every step of the way.

Do you have questions about Opana abuse or addiction? Would you like more information about what your treatment options might be in Washington State? Please contact us today.

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