What is opioid abuse?

Causes

Opioids produce a quick, intense feeling of pleasure (euphoria) followed by a sense of well-being and calm drowsiness. Opioid drugs produce their effects by binding to the opioid receptors of the central nervous system, which respond to the body’s intrinsic opioids known as endorphins to naturally block or suppress the sensation of pain. When opioid drugs are used repeatedly, the level of natural endorphins in the body is diminished and the brain is likely to become dependent on the drug. Opioids are highly addictive.

Risk Factors

Risk factors that increase the chances of developing opioid addiction include a history of abuse of other types of drugs and the presence of a mood or anxiety disorders. Men between the ages of twenty and twenty-nine are also at a greater risk of developing opioid abuse.

Symptoms

There are several symptoms of opioid abuse. One symptom is tolerance, or the need to increase the dose in order to achieve the same effect. Another symptom is increased amounts of time spent drug-seeking. Other symptoms include the interference of drug or drug-seeking behavior with social, occupational, or school functioning; the continued use of drugs despite social, legal, occupational, or interpersonal consequences stemming from drug use; desire or efforts made to decrease or stop drug use without success; and withdrawal, the adverse symptoms that occur when the drug is not taken.

Symptoms of withdrawal are many, such as aching, fever, leg tremors, sweating, chills, and craving the drug. Some other symptoms of withdrawal are diarrhea, nausea, and vomiting; sleeplessness; abdominal pain and muscle aches; restlessness; tearing eyes and runny nose; yawning; panic; and irritability.

Screening and Diagnosis

A diagnosis by a medical expert will include questions about the symptoms of opioid abuse as well as questions pertaining to a patient’s medical history. A physical examination is also performed. Urine and blood tests may also be conducted.

Treatment and Therapy

The treatment options for opioid abuse consist of detoxification, rehabilitation programs, support groups, behavioral therapy, inpatient and outpatient programs, and medications. In rehab programs, people with opioid abuse stay in a controlled environment for anywhere from a few days to several months. The length of stay is determined not by medical necessity or patient desire but by insurance companies. Many programs require that an individual detoxes from the drug before attending or being admitted. Some programs have detox units and areas incorporated in the facility so that individuals can easily transition from one phase of rehab to the next. One support group, Narcotics Anonymous, is a twelve-step program that many find helpful in maintain sobriety. Substance use disorder, especially in relation to opioid addiction, does not have a "one size fits all" cure. Recovery is a long and arduous road to travel and a multi-faceted and multi-pronged approach is the most effective.

Behavioral therapy is another valuable treatment option. Behavioral therapy is designed to modify people’s attitudes and behaviors related to opioid abuse. In therapy, a person will learn how to avoid and cope with situations in which he or she is most likely to use drugs.

Medicines that have been shown to be effective in reducing withdrawal symptoms are methadone, buprenorphine (Subutex), and buprenorphine and naloxone (Suboxone). When combined with therapy, these medicines can help an individual adjust to not using drugs. They may also help an individual go through withdrawal at home, rather than at an inpatient facility.

Prevention

The best way to prevent this condition is to never use opioids. For persons taking prescription opioid medications for pain management, it is important to use the drug only at the prescribed dosages in order to prevent the development of drug dependence.

Bibliography

Edlund, M., et al. “Risk Factors for Clinically Recognized Opioid Abuse and Dependence Among Veterans Using Opioids for Chronic Non-Cancer Pain.” Pain 129.3 (2007): 355–62. Print.

Hall, Wayne, Chris Doran, Louisa Degenhardt, and Donald Shepard. “Illicit Opiate Abuse.” Disease Control Priorities in Developing Countries. 2nd ed. Ed. D. T. Jamison, et al. Washington: World Bank, 2006. Print.

“Mind Over Matter: Opiates.” National Institute on Drug Abuse: NIDA for Teens. National Institutes of Health. 2012. Web. 30 Mar. 2012.

Smith, Janna Malamud. "A Multipronged Approach to the Addiction Epidemic Has to Include Empathy." Cognoscenti. WBUR/National Public Radio, 29 Oct. 2015. Web. 30 Oct. 2015.