Opioid Addiction

Opioids are a naturally occurring brain chemical, a common prescription medication, and a popular class of recreational drugs. Opioids also represent one of the most significant substance-related public health issues in American history. The epidemic of opioid addiction and overdose of the past decade has affected hundreds of thousands of people. 

But what causes opioid addiction, how does it work, and how can it be treated? Learn more about opioid addiction and how it can affect you. 

What Is an Opioid?

Opioid is a term that refers to both naturally occurring opiates like morphine and codeine and synthetic and semi-synthetic substances made in labs. Opioid drugs occur in your brain naturally with chemicals called endorphins, a word that combines the term “endogenous morphine.” 

Endorphins are designed to block pain receptors throughout your body. They can bind to opioid receptors to block pain signals that are being sent or received. 

Endorphins can help you rest and recover from physically demanding tasks and minor injuries. However, serious injuries and diseases may cause severe pain that your endorphins can’t mask. In these cases, medical professionals turn to prescription opioids like morphine or oxycodone. Prescription opioids are more powerful in your body than natural endorphins, and they’re capable of blocking even severe pain. 

Opioids can have several positive effects on the body of someone who’s experiencing pain. Opioids block pain signals, which can alleviate stress in recovery. They can also have a sedative effect, which can encourage more restful sleep in recovery. However, they can also have some negative effects like drowsiness, confusion, and constipation. They can also slow breathing, especially in higher doses. 

Opioids are also used recreationally. Opioids like heroin are commonly used in the United States to achieve a euphoric high. However, that can increase your risk of addiction and overdose.

Why Is Opioid Misuse Dangerous?

Opioids are potent medications that can be extremely useful for people who need them. However, using them for too long or using them without a prescription can be dangerous. Opioids can be extremely addictive, causing substance use disorders after a period of misuse. 

Opioid addiction is highly challenging to get over on one’s own, and it can start to affect your life in many ways. Opioid use disorders are associated with financial and legal problems, mental health issues, relationship problems, infectious diseases, and homelessness. 

Opioids can also be acutely dangerous during an overdose. High doses of an opioid can cause a person to experience respiratory depression and a loss of consciousness. Respiratory depression can lead to oxygen deprivation, coma, and death. Opioids may lead to overdose more quickly when they’re combined with other drugs like alcohol or prescription depressants. 

An opioid overdose can be reversed with an opioid receptor antagonist medication called naloxone, which is often sold in pharmacies and carried by first responders.

Why Do Opioids Cause Addiction?

Addiction is a disease that’s characterized by the compulsive use of a drug, even when it’s causing significant consequences in your life. Addiction is officially diagnosed as a substance use disorder, and it’s both a chronic and progressive disease. Addiction affects the brain in a way that creates powerful compulsions to use, especially as a way to cope with stress. 

Opioids can cause a feeling of euphoria, which releases a chemical called dopamine. Dopamine is associated with reward and motivation, and it works with the reward center of the brain. This part of the brain is designed to pick up on activities that release rewarding chemicals like dopamine. Activities can include eating a particular food, physical intimacy, and even a good conversation with someone you care about. The reward center helps you repeat tasks that can help sustain or enrich your life. 

However, opioids and other drugs can also cause an intense release of these feel-good chemicals. Your reward center can’t tell the difference between drugs like opioids and healthy, reward-chemical-producing activities. High doses or frequent drug use can cause your brain to get used to the chemical and come to rely on it. 

Frequent opioid use can also cause chemical dependence, which is related to addiction. Dependence is your body’s adaptation to the presence of opioids and the uncomfortable withdrawal symptoms that are caused when you try to quit. 

Opioid addiction often starts with misuse or using for too long. Then your body becomes used to the drug and adapts to it by adjusting your brain chemistry. You continue using opioids to feel normal. As you become addicted, you may have impulses to use through subconscious triggers, stressful situations, or as a force of habit. 

Opioid addiction is difficult to overcome, and it usually requires professional addiction treatment.

What Is the Scope of Opioid Addiction?

Opioid addiction is one of the most widespread substance use problems in the country’s history. Prescription opioid misuse often leads to the use of illicit drugs like heroin and fentanyl. According to the U.S. Centers for Disease Control and Prevention, opioids were involved in almost 450,000 deaths between 1999 and 2018. 

There has been a steady increase in overdose deaths during the past decade. In 2013, overdose death rates spiked with the introduction of the powerful opioid, fentanyl, into the illicit drug rates. 

Fentanyl is 50 to 100 times stronger than morphine. It can cause a deadly overdose in doses as small as 2 mg (milligrams), which is the approximate weight of a snowflake. In 2018, there were more than 31,000 overdose deaths related to synthetic opioids like fentanyl in the United States. Fentanyl may be mixed into other drugs like heroin and cocaine without the user knowing, leading to a deadly overdose. 

In 2018, there were more than  20.3 million people over age 12 with substance use disorders related to alcohol and illicit drugs. Around 2 million people had substance use issues related to opioids. Only a fraction of the people struggling with substance use problems get the help they need.

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How Can Opioid Addiction Be Treated?

Opioid addiction is a chronic disease, but it can be treated. Addiction treatment is a multidimensional process that’s intended to treat biological, psychological, and social needs. Addiction treatment also has several levels of care that range from intensive medical treatment to clinical outpatient programs. 

Before an addiction treatment program begins, you’ll go through an assessment process to determine the right level of care for your needs.

Treatment often begins with medical detox, the highest level of care in addiction treatment. Detox involves medically managed treatment with the intent to get you through the withdrawal phase of your recovery. Opioids aren’t usually life-threatening during withdrawal, but they can cause uncomfortable flu-like symptoms. 

In some cases, opioid withdrawal can cause dehydration, which can be dangerous. Many people with opioid use disorder go through detox to alleviate symptoms and to make it through withdrawal without relapse. 

After detox, you may go through the next level of care that’s appropriate for your needs. If you have high-level physical or psychological needs, you may go through an inpatient (residential) program. If it is determined that you can live independently, you could move on to intensive outpatient or outpatient treatment. Through these levels of care, you will likely have several therapy options, including individual and group therapy.

Sources

American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction

CDC. (2020, March 19). Opioid Data Analysis and Resources. Retrieved from https://www.cdc.gov/drugoverdose/data/analysis.html

CDC. (2020, March 19). Synthetic Opioid Overdose Data. Retrieved from https://www.cdc.gov/drugoverdose/data/fentanyl.html

National Institute on Drug Abuse. (n.d.). Opioids. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids

SAMHSA. (2018). Key Substance Use and Mental Health Indicators in the United States. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

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