Opioates Abuse & Addiction: One of the Greatest National Threats Today
Few other substances have made such a lasting impact on the country than opioids. Whether it’s the scorching health concerns of heroin use or the far-reaching toxicity of misusing prescription painkillers, opioid abuse is rampant, dangerous, and all-encompassing.
Below, we take a look at just what opioids and opiates really are: how they affect the brain, what some of their short- and long-term effects are, as well as some issues surrounding their abuse like the growing opioid epidemic, how to spot signs of overdose, and the best ways to detox from these substances.
What Are Opiates?
Opiates are a class of chemicals that are used primarily to treat moderate to severe chronic or acute pain in patients. They come in two varieties: synthetic and natural. Natural opioids come from the opium poppy plant known technically as the Papaver somniferum, a plant native to the Mediterranean region.
Opioids also come in synthetic forms as well. These drugs are chemically manufactured to produce effects similar to the natural opioids found in the opium poppy, but are able to be much more easily manipulated in order to create the particular desired effects.
Both natural and synthetic opioids can be highly addictive. Patients can and have built up a physical dependency on such medications in as little as just two weeks of use. As such, physicians are encouraged to prescribe many of them only for short-term conditions.
Given the addictive nature of these medications, they’re currently classified as Schedule II substances by the Drug Enforcement Agency (DEA).
Opiates vs. Opioids
It’s more than likely that you’ll see both of these terms applied to a number of different drugs. And while some people may simply use the two interchangeably, there is actually a bit of a difference when it comes to how the term should be used.
The definition of an “opiate” according to Dictionary.com is “a drug containing opium or its derivatives, used in medicine for inducing sleep and relieving pain.” When used in its proper form, then, “opiates” is meant to refer only to drugs that use chemicals derived from the actual poppy plant – natural opioids.
The term “opioids” on the other hand has grown to include all chemicals that interact directly with the brain’s opioid receptors. This encompasses both medications derived naturally from the poppy plant as well as those that are created synthetically.
So, remember, there is a difference between opioids and opiates, even though some people don’t know it.
There are an enormous number of both natural and synthetic opioids on the market today as prescription opioids are some of the most widely prescribed drugs. What’s more, researchers are constantly in motion trying to synthesize new opioids to add to the market.
As such, new products are coming out each and every year.
A few examples of the chemicals derived from natural opiates include:
- Morphine (brands like Arymo ER, Kadian, MorphaBond ER, MS Contin and illicit substances like heroin)
- Codeine (brands like Fioricet, Phrenilin, and certain lines of Tylenol)
- Opium (brands like Paregoric, Opium Deodorized, and B&O Supprettes)
Some of the most popular synthetic opioid base chemicals are:
- Meperidine (brands like Demerol HCl, Meperitab, Mepergan and Meprozine)
- Oxycodone (brands like Oxaydo, OxyCONTIN, Oxyfast, and Roxicodone)
- Fentanyl (brands like Abstral, Actiq, Duragesic, Fentora, and Ionsys)
- Methadone (brands like Dolophine, Methadose, and Diskets)
Hydrocodone (brands like Vicodin, Lortab, Lorcet, Ibudone, and Repraxain)
As opioids in general are highly abused substances, used illicitly in order to create a sense of euphoria and tranquility, these drugs have a number of street names to watch out for.
Some of the most common ones according to the DEA are:
- Big H
- Black Tar
- Brown Sugar
- Dover’s Powder
- Hillbilly Heroin
- Purple Drank
- Sippin Syrup
Opioids & Opiates Effects on The Brain
Opiates and opioids interact directly with a certain type of receptor found in the brain known as the mu-opioid receptor. These specialized structures help regulate mood and pain relief and, when activated by the brain’s natural opioids (enkephalins and endorphins) can be instrumental in normal functioning.
Opioids mimic the structure of these natural neurotransmitters but tend stimulate the receptors even more than their natural counterparts. The result (depending on the type of opioid and the level of abuse) is an overwhelming sense of euphoria and pain relief.
There are three types of opioids (chemicals that interact with the body’s opioid receptors): agonists, partial agonists, and antagonists.
The agonists lock into these receptors and stimulate them to varying degrees. Drugs like fentanyl, for instance, may end up stimulating the receptors more intensely than, say, methadone.
A partial agonist activates these same receptors but to a much lesser degree than agonists. As such, they tend not to produce the euphoric effects that make opioids such a common substance of abuse.
And finally, opioid antagonists block these receptors entirely and do not activate them.
Opioid agonists and partial agonists are the drugs you imagine when you think of opioids in general. They’re the ones that produce typical symptoms of opioid intoxication like euphoria and pain relief by actually activating the opioid receptors in the brain.
Some of the most common opioid agonists are:
Partial opioid agonists on the other hand only activate the opioid receptors partially as the name suggests. The most common partial opioid agonist is buprenorphine and it’s sold under the brands:
Contrary to agonists, opioid antagonists bind to the receptor but do not actually stimulate it. This prevents other opioids from attaching and activating it, thereby preventing the drug’s effects.
Two of the most popular opioid antagonists are naloxone and naltrexone, both of which are commonly used in treating opioid dependency and addiction.
Naltrexone comes into play by blocking the opioid receptor’s entirely, making any subsequent opioid abuse completely fruitless. Substance abusers may use this medication as part of a comprehensive treatment program to help prevent relapse since even if they did use again, they still wouldn’t be able to feel the same euphoric high.
Naloxone on the other hand is an extremely competitive antagonist that can actually remove opioids that are already attached to receptors. As such, naloxone is an invaluable chemical compound in the case of opioid overdose as it can entirely reverse the drug’s effects in the body and stop a potentially fatal interaction.
We truly are in the middle of an unprecedented epidemic when it comes to drug use and abuse. There are more drug overdoses today than there ever have been in the history of our country. In fact, the number of lives drug overdoses have claimed in 2016 outnumbered all of the American casualties of the Vietnam war.
And this war is still being fought today.
Opioids, both prescription like OxyContin or illicit like heroin, have played an enormous part in the growing epidemic. Prescription opioid abuse in particular has spiked dramatically in the past several decades. Overdoses from such medications has actually quadrupled since 1999.
Part of the reason for this substantial uptick is the fact that these medications are being prescribed so haphazardly. In the past, doctors in the U.S. used to only prescribe opioids for short-term pain such as that after a surgery or for end of life care. But in the 1980s, a few studies in particular came out championing the low addiction risk for such drugs.
Physicians now had the published resources to reference for their decision to prescribe a high-risk medication for the long-term.
What’s more, pharmaceutical companies also began aggressive marketing campaigns for such products around the same time, pushing physicians to prescribe these medications even more for conditions that should have warranted further review.
This combination of factors compounded into the situation we’re in today. And while many federal agencies have come out and stated that we truly are in the middle of an opioid epidemic, there’s still a lot more work that needs to be done.
A Few Statistics on The Scope of the Opioid Problem
Below are a few statistics to help put the opiate problem into perspective.
- 91 Americans die from an opioid overdose every single day. This number has quadrupled since 1999 and is only growing.
- Prescription opioid abuse is rampant. In just 2015, 5 million people abused such prescriptions. As a result, over 2 million people suffered from a prescription opiate or opioid use disorder and 33 thousand people died from overdosing on these medications in the same year.
- Drug addiction now claims more lives per year than both guns and car crashes.
- Drug overdoses from substances like opioids are now the leading cause of death for Americans under 50 years old.
- Current estimates show that 5 million people use and abuse opioids around the world today.
Am I Addicted to Opioids?
While it might be pretty easy to identify opiate abuse in others, one of the biggest hurdles on the road to recovery is learning how to identify an opioid use disorder in yourself.
For many substance abusers, denial is the last defense of a brain already hardwired to reward drug-seeking behaviors. It isn’t necessarily a choice to deny the truth, but rather is what the brain has adapted to perceive as the truth.
This trend is in no way unusual either. In fact, SAMHSA’s 2013 National Survey on Drug Use and Health (NSDUH) found that an astounding 95.5% of the 20.2 million substance abusers including opioid abusers who actually needed treatment did not seek it because they felt they didn’t need it.
That is 19.3 million people who are unable to identify the signs of an addiction or were able to live with the idea that they were actually addicted to an illicit substance.
That’s why it’s important that you know how to look at your behaviors and patterns of abuse objectively and accurately. Otherwise, you’ll never be able to get the help you need to overcome your opioid use disorder and move on to a healthy and sober life.
Self-Assessment Options for an Addiction to Opioids
There are a number of very effective self-assessment tools available to help you recognize the signs of an opiate addiction or patterns of opiate abuse. These assessments come in a variety of different formats and levels of comprehensiveness.
We’ll take a brief look at some of the best self-assessment tools available to you right now. So, don’t wait any longer – there’s bound to be a tool to meet your specific needs and help you determine once and for all if you may have an opioid abuse problem.
- Quick Online Addiction Quiz – A brief 20 question addiction quiz that just may give you all the answers you need to determine if further research into your substance abuse problem is warranted.
- The NIDA Drug Use Screening Tool – A comprehensive assessment tool with a streamlined design makes this screening test easy to use and incredibly detailed. Sponsored by the National Institute on Drug Abuse.
- The CRAFFT Screening Tool – Primarily for use in interviewing adolescents to determine if their behaviors are putting them at risk for further abuse, the CRAFFT tool is simple but is a great way to really start thinking about your behaviors from an objective perspective.
- The Opioid Risk Tool – The only tool designed specifically for assessing opioid risks, this tool can be both administered and scored in less than 1 minute, making it perfect for anyone with especially limited time.
- CAGE-AID – One of the briefest assessment tools, the CAGE-AID was originally developed specifically for alcohol addiction but was later expanded to include drug use as well.
- Drug Abuse Screening Test (DAST-10) – A brief but effective screening tool, this test contains only 10 items and typically takes less than 8 minutes to complete. And with simple yes or no questions, the DAST-10 is easy to use as well.
Using the DSM-V for Opioid Addiction Screening
The criteria used by the DSM-V are another useful set of guidelines you can use to compare to your own behaviors as well. Also known as the Diagnostic and Statistical Manual of Mental Disorders, the DSM-V outlines 11 different criteria for a substance use disorder.
Amobarbital detox is available to assist you as you stop this
One of the most notable benefits of using these criteria to assess your opiate dependency is the fact that many physicians and mental health practitioners use the same criteria to diagnose a substance use disorder in their own patients.
If an individual confirms that they’ve experienced at least two of the following scenarios in a 12-month period, they are likely to have a problematic pattern of opioid use.
Short-Term Effects of Opiates
Opioids are notorious for having an especially long list of short-term side effects that can come about during their use. What’s more, actually abusing opiates can lead to even more severe versions of these symptoms as well.
According to Drugs.com, some of the most common side effects among most opioids are:
- Drowsiness and impaired judgement
- Severe itching
- Opioid-induced constipation
- Nausea or vomiting
- Withdrawal symptoms upon discontinuation
- Tolerance to the pain relief effect over time
While these are the most common side effects, each opioid and opiate will typically have their own individual long list of short-term side effects as well. These individual short-term side effects of opiate abuse may include:
- Relaxed and calm feeling
- Weight loss
- Difficulty having a bowel movement
- False or unusual sense of well-being
- Sleepiness or unusual drowsiness
- Absent, missed, or irregular menstrual periods
- Bad, unusual, or unpleasant (after) taste
- Face is warm or hot to the touch
- Halos around lights
- Loss in sexual ability, desire, drive, or performance
- Night blindness
- Problems with muscle control
- Skin rash
- Uncontrolled eye movements
- Stomach discomfort or upset
- Redness of the skin
- Over-bright appearance of lights
- Muscle stiffness or tightness
- Heartburn or indigestion
- Floating feeling
As you can see, the short-term side effects of opioid abuse can be quite extensive. And when these substances are combined and taken with other substances like alcohol as well, the list of adverse health effects grows even further.
Obviously one of the most dangerous short-term side effects of opioid use and abuse is the risk of overdosing on these harmful substances.
When it comes to an overdose, every second really does count. That means there is no time for worrying about the legality of the substance an individual overdosed on. There is also no time to lie to medical professionals about what they consumed or how much they took.
Withholding key information from medical professionals is not only immoral, it may end up costing you or your friend’s life.
As such, if you do notice the signs of an opioid overdose, call 911 or the national poison helpline at 1-800-222-1222 immediately.
There are a few details about the situation that you can have ready to make the situation even more successful in terms of helping the overdosing party. They are:
- The person’s age, weight, and their level of consciousness at the time.
- The name of the product that was overdosed on as well as the specific strength of the dosage (e.g. 30mg immediate release Arymo ER morphine pills).
- The time the pills were swallowed.
- The number of pills that were swallowed.
And while this information can greatly help medical professionals determine the proper course of action, the main thing to remember here is once again, time is of the essence. Therefore, if you don’t have this information on hand, do not delay calling anyway.
The better able you are to actually identify the telltale signs of an opioid overdose, the quicker you can get the help you or another individual really needs. Ultimately then, spotting the signs of opioid overdose early on can save lives and reduce the overall damage of an overdose.
The quickest way to spot an overdose is by looking for what’s called the “opioid overdose triad”:
- Respiratory depression
- Pinpoint pupils
But there are other signs to be on the lookout for as well. MedlinePlus points out that an overdose can also be characterized by:
- The person’s face going extremely pale and/or feeling clammy to the touch
- Their body goes limp
- Their fingernails or lips have a bluish or purplish color to them
- They start vomiting or making gurgling noises
- They cannot be awakened or are entirely unable to speak
- Their breathing or heartbeat slows or stops completely
If you notice any of these signs, call emergency medical services or poison control immediately.
Long-Term Effects of Opiates
There are a number of physical long-term effects of opioids to be aware of as well.
- Opioid-Induced Hyperalgesia (OIH) – Seemingly in direct contrast to one of the primary reasons for taking opiate and opioid pain relievers in the first place, long-term opioid use and abuse has been shown to develop a condition whereby a patient will actually feel more pain rather than less.
- Opioid-Induced Bowel Dysfunction (OIBD) – This umbrella term for a number of gastrointestinal symptoms has been the cause of one third of opioid patients dropping from treatment entirely. Symptoms include constipation, vomiting, abdominal pain, bloating, and incomplete evacuation.
- Increased Risk of Cardiovascular Issues – Some studies have shown that long-term opioid use and abuse is correlated with increased cardiovascular mortality events. These risks to heart health may be caused by the decreased respiration common in many long-term opioid users.
- Sleep-Related Breathing Problems – Once again related to the changes that long-term opioid and opiate use can have on respiration, one study found that almost half of chronic opioid users had severe sleep apnea while 71% had moderate sleep apnea.
Undiagnosed sleep apnea has been associated with such health complications as hypertension, depression, heart disease and diabetes. What’s more, the economic burden of this disorder in the U.S. is nearly $150 billion.
The long-term use and abuse of opiates has also been associated with a number of psychological effects as well.
- Hormonal Problems – Long-term opioid use and abuse has been shown to have a significant effect on the body’s ability to produce sex hormones such as testosterone. This condition, called hypogonadism, can result in a number of complications in men and women including decreased sex drive, irregular menstruation, as well as psychological effects.
- Brain Damage – NIDA reports that long-term opiate use is being investigated as the cause of loss in the brain’s white matter. Heroin in particular is suspected of having a significant role here.
- The lack of oxygen in the brain caused by decreased respiration is also the subject of study today. This condition, called hypoxia, can have significant psychological and neurological impacts that may result in permanent brain damage.
- Depression – A recent study found that opioid use over a significant period of time may actually contribute to new-onset depression in as little as 30 days of use. Low testosterone and changes in neuroanatomy are cited by the study as two of the most probable causes of the mental disorder.