The current opioid epidemic in the United States started in the 1990s. However, it has grown stronger over the last 20 years. Millions of Americans have lost their lives due to opioid.
Overdoses as others struggle to live with addiction. As a result, on October 26, 2017, the president declared the opioid crisis a public health emergency.
Numerous actions have been initiated since the epidemic started claiming lives by tens of thousands each year. States, private organizations, and countless other stakeholders have been advancing the fight against opioid addiction. But what are opioids, and why are they so addictive? Is there hope for opiate addicts to reclaim their life? This article will help you answer such questions.
Opioids are drugs sourced from opium plants. They are naturally synthesized products like morphine and heroin, among other illicit drugs. The term also refers to drugs manufactured synthetically from the naturally-occurring opium products. They include:
Opioids work by way of binding to opioid receptors mainly found in the brain and spinal cord. They block pain feelings leading to their predominant use as painkillers. However, they can be addictive when a user relies on their pain-relief effects for long. They also induce feelings of happiness and pleasure at an enhanced rate. This makes users want to retake them, and soon enough, they get hooked.
The legal use of opioids in medicine includes the treatment of acute pain. It treats conditions like nerve injury, cancer, bone fractures, and even surgery all require strong painkillers. However,
due to their euphoria and pain-relief effects, doctors only prescribe opioids use for short periods.
Under medicinal use, opioids side effects include the following:
Opioids cause some severe problems such as respiratory failure accompanied by slowed breathing. Also, its use leads to chest pains, low blood pressure, choking, passing out, coma, or death. Long term users get intestinal problems, mood instability, low libido, and respiratory and menstrual problems.
Most legal opioids are manufactured as painkillers by pharmaceutical companies. Some, like morphine, are used for hospice care only. Doctors issue opioid prescriptions for people to
manage painful medical conditions with ease. In 2017 alone, healthcare providers in the US wrote 191 million opioid prescriptions. These prescription painkillers exist in pill form, making them easy to take even when on the go.
Illicit opioids like heroin and non-regulated fentanyl are produced and distributed by drug cartels. Most of the heroin trafficked in the United States is sourced from Mexican cartels.
Although the Mexican cartels also illegally synthesize fentanyl, most of it comes from China. This is due to the unregulated Chinese pharmaceutical industry.
Illegal opioids make their way into the US in many forms through the Canadian and Mexican borders. Cartels use different methods to sneak them into the country where they sell them to local gangs. This is why heroin and illegal fentanyl are primarily linked to violent gang activities. The gangs then distribute the drugs either in open markets or designated areas within the American states.
When one takes opioids, the drug enters the bloodstream and triggers an artificial influx of endorphins and dopamine. These neurotransmitters are responsible for the generation of ecstatic
feelings. One then gets a massive rush of euphoria in their body, which is dissimilar to the natural supply. To trigger similar euphoria again requires the user to retake them.
After continued opioids consumption, the brain stops releasing endorphins and dopamine naturally. By the time the endorphin release comes to a stop, a user will have formed a dependence on opioids for the ecstatic feeling. As such, the only way to feel great again is by continually taking the drugs they are used to. Over time, users get used to opioids to lessen feelings of dissatisfaction or pain. Opioid addiction generally develops in several stages.
Tolerance - When one has to increase the dose or amount of opioids gradually, they consume it to get high.
Physical dependence - One starts experiencing withdrawal symptoms when they stop using opioids, forcing them to go back to its use.
Psychological dependence - Opioid craving sets in, which mainly occurs at the peak of one’s addiction.
Opioid addiction can set in unintentionally, and this is what happens to numerous legal users. It starts when one has had a painful medical condition such as surgery or bone fracture. They then obtain a legitimate prescription to numb their pain as they recover. However, by the time they get better and no longer need the drugs, physical dependence has already set in.
During the initial stages of addiction, most people fake their pain to continue getting opioid prescriptions. Others visit multiple doctors to obtain several prescriptions or purchase painkillers from illegal online pharmacies.
The prescription painkiller addicts start using heroin due to its ease of access and low price. The National Institute on Drug Abuse estimates that about 80% of the current heroin users previously abused painkillers. These addicts are predisposed to fentanyl, whose potency is 50 times stronger than morphine.
The majority of individuals who take a fentanyl overdose do so unknowingly. They consume illegal synthetic fentanyl mixed with other illicit drugs like heroin. Fentanyl abuse rose after drug dealers laced their supplies with it. The earliest documented case of unlawful fentanyl overdose shows that the victims intended to buy heroin.
When people purchase painkillers from unregulated and illegal pharmacies, they also risk consuming fentanyl. Since its effects are similar to those elicited by the potent painkillers, most people buy it without knowing. Numerous illegal chemists lace their oxycodone and other legal prescription opioids with fentanyl. This was predominant in Canada in 2016 and could have been replicated in other US states.
Continued and intense use of opioids places users at the risk of overdose. Overdose also arises quickly when one mixes opioids with other drugs such as alcohol or cocaine. During an overdose, one stops breathing at a gradual rate. Opioids suppress neurological signals making one’s heart rate slow down too. The severe effects of an opioid overdose include permanent brain or nerve damage.
The most common signs of overdose are:
Opioid addiction is treatable regardless of its stage through a couple of supervised recovery programs. Before the administration of any treatment, it is essential to check for addiction signs.
The hallmark of such is when one admits the visible adverse effects but continues to consume the drugs.
Withdrawal symptoms make it very difficult for numerous opioid users to quit. The American Society of Addiction Medication (ASAM) even discourages the idea of individually quitting “cold turkey.” The professionals say that such attempts would only elicit stronger urges to use the drugs. Some of the most prevalent withdrawal symptoms include:
The opioid withdrawal symptoms can proceed for a period of one week up to a month. Acute withdrawal, or the first phase, kicks in 12 hours after the last opioid consumption. It intensifies from the third to the fifth day and can proceed for 4 to 5 weeks. The post-acute stage, also called the second phase, can last up to two years.
The acute stage mainly comprises physical withdrawal symptoms, while the second phase consists of emotional symptoms. Subsequent withdrawal symptoms include anxiety, mood swings, variable energy, and concentration, among others.
The American Society of Anesthesiologists recommends supervised detoxification & rehabilitation as the safest opioid addiction recovery methods.
Most rehab programs begin their treatment plans with medical detox. Detoxification allows you to overcome opioid dependency seamlessly. The detoxification process involves the use of drugs to treat nausea, pain, and other withdrawal symptoms. However, detoxification alone is not sufficient to rid someone of opioid addiction. A medically-assisted withdrawal program should follow after detoxing to prevent the chances of a relapse.
Medication-Assisted Withdrawal involves the use of methadone, buprenorphine, and naltrexone combined with behavioral therapy. The use of methadone and buprenorphine administration can be used for several years. They are both opioids with lower abuse potentials being the best opioid replacements. This opioid replacement therapy can proceed for as long as it’s needed. Next, doctors prescribe naltrexone a week after all withdrawal symptoms have dissipated. It blocks the opioid receptors causing fewer cravings for the drugs. It does not reduce the withdrawal symptoms but prevents relapse after or during recovery. One should never take naltrexone before the detoxification process. It can lead to intense withdrawal symptoms.
Medication-assisted withdrawal is one of the most critical components of opioid recovery. The Center on Addiction terms such treatments as “potentially lifesaving.” As such, individuals with severe opioid abuse problems should look for rehab centers that offer medication-assisted treatment. This is because severe opioid addiction requires multiple months or years for a full recovery.
At rehabilitation centers, counseling and therapy sessions begin soon after detoxification. Medications like methadone and buprenorphine assist in stabilizing patients for them to bear with the situation through the courses. Therapy assists patients in learning how to control the problematic behaviors brought about by addiction. This includes education on self-copying strategies, effects of opioids, and how to avoid relapses. There are numerous therapeutic techniques employed to help individuals to recover from opioids addiction. Some standard therapeutic measures include cognitive and dialectal behavioral therapies. Rehabilitation centers also offer contingency management, community reinforcement approach, and family-based therapies.
Treatment programs and individual rehabilitation approaches continue to diversify and evolve. Many recent changes cause this, but detoxification precedes almost all programs. However, detoxification never wards off the psychological, behavioral, and social problems associated with addiction.
This involves inpatient rehabilitation treatment for 24 hours each day in non-hospital settings. Therapeutic communities (TCs) are the most known forms of long term inpatient treatment, where individuals spend 6-12 months. Therapeutic communities mainly focus on “re-socialization” of an individual who has severe opioid abuse problems.
The treatment facilities use other residents, staff, and environment as critical components of treatment. This involves the view of addiction in the context of one’s social and psychological deficits. Treatment focuses on the development of personal accountability and responsibility. Besides, the sense of social productivity developed during the treatment lower the chances of relapse.
This form of treatment is highly structured and involves activities designed to challenge the residents to change. It includes the destruction of damaging concepts, beliefs, or destructive behaviors. Residents are then encouraged to adopt new, harmonious, and more constructive interactional means of interaction. By the time an individual is through with the treatment, he or she is ready to start a drug-free life.
Numerous therapeutic communities offer comprehensive services such as employment training and other support services. Research proves their effectiveness in the treatment of opioid abuse in conjunction with mental disorders or other substance addictions.
Short-term inpatient programs are relatively short but have more intensive treatment approaches. They are mostly based on the 12-step addiction treatment approach. The 12-step program was initially designed for alcoholism treatment, and its widespread use began in the 1980s. With time, it has proven its worth in treating opioid abusers.
It starts with a 3-6 week inpatient treatment phase followed by extended outpatient therapy. After that, participants have to take part in self-help groups such as AA. After the residential treatment, patients should remain actively engaged in outpatient treatment programs. The aftercare programs help to prevent relapsing after one has been released from inpatient treatment.
Numerous forms of outpatient treatment vary in the intensity and types of services supported. They are way cheaper than inpatient or residential programs and also practical for individuals with intense commitments. This can include people with jobs or extensive social supports that demand their frequent physical presence.
Low-intensity outpatient programs only offer drug education. This might make them impractical for individuals with severe opioid addiction. However, there are other intensive outpatient programs, such as focused day treatment models, which are better. Under intensive day treatment, patients get similar treatment as they would receive under residential treatment.
Group counseling is one of the main components of numerous outpatient treatment programs. Some also incorporate people with mental health problems or multiple drug addictions.
Individual patient characteristics and needs, amongst other factors, impact the success of most outpatient treatment programs.
Opioids act by way of blocking pain receptors and inducing euphoric feelings. This leads to a temptation to use more, and eventually, addiction kicks in. When one gets addicted to opioids, withdrawal symptoms discourage their path to recovery. This puts them in more constant danger of overdose and other long term opioid abuse effects.
Nevertheless, recovery is possible, and it should incorporate a series of supervised programs. Successful recovery begins with detoxification for one to get rid of their opioid dependency.
After that, one should get medication-assisted treatment to overcome the withdrawal symptoms effectively. Naltrexone helps to block opioid cravings effectively, and it is used in the last stage of medication-assisted treatment.
Rehabilitation also involves several therapy programs that can be offered under inpatient or outpatient conditions. Residential treatment is highly impactful for severe opioid addiction, while outpatient treatment favors those with numerous commitments. Criminals who get opioid treatment in jail have better chances of long term recovery.