Opioid addiction is a disease marked by uncontrollable cravings, dependence, withdrawal and a loss of control over drug use. Opioid use disorders place a person at a grave risk of adverse physical and mental health effects, including deadly overdose.
A staggering 2.1 million Americans aged 12 and older were past-year opioid drug misusers in 2016. The greatest number of these individuals misused prescription opioid pain relievers. This abuse isn’t without danger. Almost 18 percent of these individuals struggled with an opioid use disorder, either from heroin or opioid pain relievers.
For these individuals and their families, access to a comprehensive opioid treatment program could be the difference between life and death. Inpatient drug rehabilitation is built on the premise that healing takes time and access to evidenced-based treatment methods.
What Is An Opioid?
Opioid drugs are sometimes referred to as opiates or narcotics. The opioid drug class includes illicit street drugs, like heroin, and prescription opioid painkillers, such as Vicodin or OxyContin.
Prescription opioid medications are chemically similar to heroin. Though occasionally prescribed for cough and severe diarrhea, these medications are most commonly prescribed for acute or chronic pain.
Opioid drugs inhibit the body’s ability to transmit pain. They achieve this pain-relieving effect by targeting opioid receptors in the brain and spinal cord.
In addition to these effects, opioid drugs stimulate the brain’s reward and pleasure centers. This action creates a sense of well-being and pleasure (referred to as a “high) which is enticing to drug abusers.
The euphoric feelings associated with opioids become more extreme when a medication is used in higher-than-prescribed doses. These feelings also intensify when the drug is administered in a way other than intended, for instance by crushing and snorting a pill. Opioid drugs may also be smoked or injected. These actions increase the odds of dependence, addiction and overdose.
Most recreational abusers use opioids to create this feel-good effect, however, a significant portion of abusers began by misusing opioid painkillers to self-treat pain. Misusing a drug by self-medication is considered drug abuse and may result in addiction or overdose.
Frequently Abused Opioids
In 2016, approximately 626,000 people had a heroin use disorder and 1.8 million people had a pain reliever use disorder, according to the Substance Abuse and Mental Health Services Administration.
In addition to heroin, the following opioid medications are frequently abused:
- fentanyl (Actiq, Duragesic, Sublimaze)
- hydrocodone (Vicodin, Norco, Zohydro)
- hydromorphone (Dilaudid)
- meperidine (Demerol)
- methadone (Dolophine, Methadose)
- oxycodone (Percocet, Percodan, OxyContin)
- oxymorphone (Opana)
Designer synthetic opioids, or fentanyl analogs, are becoming more widely abused on the streets. These drugs are often a combination of substances, including substances such as fentanyl, heroin, and cocaine. Examples include carfentanil, “grey death” and U-47700 (“Pink”). These drugs are so potent that even touching them may cause overdose and death.
Signs And Symptoms Of Opioid Abuse
Opioid abuse creates many visible physical and mental signs. Learning the signs of abuse can help friends and family intervene sooner on their loved one’s behalf, so treatment can be sought.
The signs and symptoms of opioid abuse may include:
- decreased sense of pain
- dry mouth
- heavy limbs
- impaired coordination
- pain suppression
- mood swings
- nausea and vomiting
- pinpoint pupils
- slowed breathing
- slurred speech
- warm, flushed skin
After the prolonged abuse, many individuals become tolerant to the drug’s effects, requiring them to take more of the drug to produce the sought-after high. Additionally, the body will begin to expect frequent doses of the drug to function in a normal manner. This is called a physical dependency.
As a person develops the compulsive nature and uncontrollable cravings associated with addiction, their behaviors begin to change to accommodate frequent acts of drug-seeking and using.
At this stage, an individual will increasingly begin to ignore important responsibilities pertaining to their family, career or education.
Additionally, an addicted individual may:
- be unable to quit opioids, despite multiple efforts to do so.
- steal pills from family or friends.
- go to multiple doctors to obtain large amounts of an opioid drug (“doctor shopping”).
- stop participating in social events or hobbies.
- push loved ones away.
Further, an addicted person will continue to use opioids even after realizing that the drug is causing them physical or mental harm.
Dangers Of Opioid Abuse
The gravest dangers of opioid abuse are addiction and overdose. As abuse becomes chronic, many individuals develop serious health problems.
Injection drug users face a high risk of infection, including abscesses, cellulitis and the infection of various organs. Certain forms of organ damage may be permanent. Transmissible diseases, such as HIV/AIDS and hepatitis B and C, run high in injection drug abusers. Opioid drug abuse in any form increases the risk of these infections.
Individuals who snort opioids may develop holes in their septum (the tissue dividing the nostrils). Smoking the drug causes intense irritation to the lungs, leading some to develop various lung complications and even permanent lung damage.
The number of women abusing opioids during pregnancy is on the rise. This behavior can have devastating effects on the unborn child, causing neonatal abstinence syndrome (NAS). Maternal opioid abuse may also cause birth defects, miscarriage and premature birth.
Additional risks and dangers of opioid abuse include:
- brain damage
- cognitive problems
- higher suicide risk in veterans
- liver damage
- mental illness
- problems walking
Prescription opioid painkiller abuse is a risk factor for heroin abuse. The National Institute on Drug Abuse reports that “About 80 percent of people who use heroin first misused prescription opioids.” This presents additional dangers, as heroin is frequently cut with other substances, including deadly fentanyl analogues.
From 1999 to 2016, opioid overdose death rates tripled. In 2016, the number of these deaths were greater than those caused by guns and car accidents.
Opioids are central nervous system (CNS) depressants. When a person takes more of an opioid than their body can process, the central nervous system begins to slow to dangerous rates. Opioid overdose can be life-threatening if not treated promptly with the appropriate medical interventions.
Signs of opioid overdose include:
- the body goes limp
- cool, clammy skin
- fingernails or lips take on a blue or purple hue
- gurgling noises
- a person cannot be awakened
- a person cannot speak
- slowed or stopped breathing
- slowed or stopped heartbeat
If overdose is suspected, contact emergency medical services immediately.
Withdrawal from opioids is painful and uncomfortable. The severity of withdrawal varies and is determined by the person’s physiology, the drug of abuse and the level of abuse. Withdrawal symptoms appear after a physically-dependent person discontinues or significantly reduces their use of an opioid.
Early withdrawal symptoms include:
- achy muscles
- bone pain
- runny nose
- teary eyes
- uncontrollable leg movements
As withdrawal progresses, symptoms may become more intolerable, and include:
- abdominal cramps
- cold flashes and shivering
- dilated pupils
The onset of withdrawal varies per drug, but typically heroin withdrawal begins 12 hours after the last dose, while methadone withdrawal begins at 30 hours.
Opioid withdrawal symptoms are not in themselves life-threatening, but certain complications which arise from them may be. For this reason, a person should never attempt to withdrawal from opioids on their own without medical support.
Medically-Supervised Opioid Detoxification
The chemical toll of opioid abuse on a person’s body is great. To counter this, the body needs ample support while it cleanses the drug out of its system. It is very difficult to detoxify in a safe and successful way at home.
To reduce and alleviate intolerable withdrawal symptoms, our clinical staff will slowly taper the client off opioids. To do this, and to ease any accompanying cravings, we use Suboxone as needed. To further stabilize the body and initiate healing, we may also administer fluids and nutritional support. At this time, a person’s vitals will also be closely monitored.
Treatment For An Opioid Addiction
The best treatments for opioid addiction draw upon an integrated, multidisciplinary approach. Here at The Bluffs, we recognize this and assess each client accordingly to ensure we deliver the most compassionate, individualized care.
Addiction impacts a person physically, mentally, emotionally, socially and behaviorally. Treating all of these concerns takes time and an intensive level of care. This is the primary reason inpatient drug rehabilitation programs are such a vital part of recovery from opioid drugs.
Our residential treatment programs are designed to provide ample time for healing and the development of important recovery principles. Through a combination of medications, counseling, behavioral therapies, and other transformative treatment options, we’re committed to the success of each person’s recovery journey.
Contact The Bluffs to learn more about opioid addiction and treatment options.
MedLinePlus — Opioid Intoxication
Substance Abuse and Mental Health Services Administration — Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health