What is narcotics abuse?

Causes

Narcotics produce their effect by binding to opioid receptors in the central nervous system. The human body contains opioid receptors to respond to naturally occurring opioids in the body known as endorphins. Endorphins serve to block or suppress the feeling of pain, having an analgesic and sedative effect. Narcotics lead to euphoria and sedation, produced by stimulation of the opioid receptors.

Risk Factors

The type of narcotic abused can be a factor in addiction potential. Heroin can cause addiction after one use; second in potency is morphine. Other risk factors for narcotics abuse include psychological mind-sets such as antisocial attitudes and sensation-seeking during adolescence. Environmental risk factors include dysfunction family relationships, poverty, gang membership, urban living, disposable income, family history of substance abuse, and low self-esteem.

Symptoms

Narcotics intoxication may include sensations such as euphoria, a rush of pleasure, relaxation, and drowsiness, followed by sedation or sleep. Users report feeling free from cares and worries, a lessening of anxiety and tension, and a sense of escapism from life. The feeling is so pleasurable that the user often develops an irresistible urge to use again, an urge that may eventually develop into an addiction.

Some of the negative effects of narcotics abuse are sleep disturbances, sexual dysfunctions, anxiety, drowsiness, inability to concentrate, apathy, lethargy, flushing of the face and neck, constipation, nausea, and vomiting. A person prescribed a narcotic may develop some withdrawal symptoms over time if use is suddenly interrupted. Generally, if narcotics are prescribed for a longer time for pain relief, the dosage is progressively lowered through the weeks to prevent withdrawal symptoms.

Withdrawal symptoms for narcotics are some of the worst exhibited for any abused substance. Early symptoms of withdrawal may appear within a few hours, but typically appear within six to thirty-six hours of the last dose. Symptoms of withdrawal are typically the reverse of the pleasurable effects produced by the narcotic and include anxiety, irritability, loss of appetite, tremors, salivation, yawning, flu-like symptoms, and sweating. More serious withdrawal symptoms include abdominal cramping, fever, gooseflesh, gastrointestinal upset, confusion, and convulsions. Less acute withdrawal symptoms, which may persist for months after the last dose, include anhedonia, insomnia, and drug craving. The severity of symptoms is proportionate to dosage and duration of abuse.

Screening and Diagnosis

Persons suspected of narcotics overdose require immediate emergency medical attention. With an unconscious person suspected of narcotics overdose, doctors will look for physical signs of overdose, such as shallow breathing and small pupils. Patients are then administered naloxone, an opioid antagonist, to reverse the possibility of coma (which can occur in as quickly as one minute).

To diagnose abuse, a doctor will question a person about his or her history of drug use, including use under dangerous conditions, and will ask about failures to meet obligations, legal problems, and impairments of social or occupational functioning caused by narcotics use.

Treatment and Therapy

Treating people who are addicted to narcotics is difficult, mainly because of denial and the severity of withdrawal symptoms. Detoxification is the first step, and the most common long-term treatment is to substitute methadone (a synthetic narcotic with less addictive potential) for the abused drug, followed by weaning the abuser off the methadone. Buprenorphine is another medicine that can be used in the same manner for detoxification. The drug clonidine is also sometimes used to help alleviate some of the symptoms of withdrawal, particularly salivation, runny nose, sweating, abdominal cramping, and muscle aches. Also, recovery groups such as Narcotics Anonymous provide an important source of community support for persons who are overcoming narcotics addiction.

Prevention

To prevent possible addiction and dependence, it is important to use opioid medications only at the prescribed dosages, or to avoid narcotics altogether. A recovering addict must deal with the intense, long-term psychological dependence on narcotics. Counseling, self-help groups, halfway houses, and group therapy may help recovering addicts maintain abstinence.

Bibliography

Glass, George. Narcotics: Dangerous Painkillers. New York: Rosen, 2000. Print.

Health Day. “Prescription Painkiller Abuse Rate Down, but Many Are Addicted: Study.” MedlinePlus. US Natl. Lib. of Medicine, 13 Oct. 2015. Web. 30 Oct. 2015.

Narcotics Anonymous World Services. Narcotics Anonymous: White Booklet. New York: BN, 2007. Print.

Sanburg, Paul R., Michael D. Bunsey, and Solomon H. Snyder. Prescription Narcotics: The Addictive Painkillers. New York: Chelsea House, 1991. Print.

United States. Natl. Inst. on Drug Abuse. “Commonly Abused Drugs Charts.” Natl. Inst. on Drug Abuse. NIH, Oct. 2015. Web. 30 Oct. 2015.