Opioids, also known as nature’s painkillers, are incredibly addictive and are responsible for the opioid crisis, which has taken thousands of lives over two decades. Opioids are derived from the opium poppy plants, but many are now synthesized in a laboratory. Prescription opioids such as Percocet®, Vicodin® and Lortab® are strong pain relievers that are used for acute severe pain but are often overprescribed for minor and chronic pain.
Opioid Use Disorder
Stronger opioids such as fentanyl and morphine are commonly used in a hospitalized setting and for cancer-related pain. Opioids are incredibly addictive and not only suppress physical pain but also create a sense of euphoria. Opioids work on the reward center of the brain, and therefore the cravings become stronger after each use. Opioid addiction can interfere with your personal and professional life, and result in financial hardship and even trouble with the law.
Opioid Addiction Statistics
- Between 21-29% of patients with chronic pain who are prescribed opioid medication end up misusing it.
- In 2018, opioids were responsible for 46,802 deaths in the U.S.
- Roughly around 80% of people who use heroin began by misusing opioid medicine.
- On average, 128 people in the U.S. die every day from an opioid overdose.
Opioid Use in the U.S. Compared to the World
Americans make up approximately 5% of the world’s population but are responsible for 80% of the consumption of the world’s opioid supply.
- United States (80%)
- World (20%)
Risk Factors for Opioid Addiction
- Chronic pain that is improperly treated
- Poor social support
Commonly Abused Opioids
- Hydrocodone (Vicodin and Lortab)
- Oxycodone (OxyContin® and Percocet)
Signs and Symptoms of Opioid Intoxication
Opioids can be life-threatening and can result in overdose even during your first time using. Prescription opioids that are not taken as prescribed or opioids that are purchased on the street can cost you your life. Opioids purchased on the street can be laced with other dangerous substances. The following are signs and symptoms associated with opioid intoxication:
- Emotional numbness
- Slurred speech
- Slow, shallow breathing
- Poor coordination and balance
- Pinpoint pupils
Naloxone: Opioid Reversing Drug
Depending on the opioid, the dose and what it is mixed with, overdose can occur within minutes. Naloxone, an opioid reversal drug, can be given to stop opioid withdrawal effects. This drug will elicit immediate opioid withdrawal effects and, if administered in time, can also prevent respiratory depression. This life-saving medication can be purchased over the counter and is strongly recommended for any individual who has struggled with opioid addiction. It is also recommended for loved ones to carry naloxone.
Opioid withdrawal is not life-threatening but can be uncomfortable and even painful. Opioid withdrawal symptoms can leave you feeling as though you want to use again to mask these unpleasant withdrawal side effects. Depending on the specific opioid and the dose, opioid withdrawal symptoms can occur 8-12 hours after the most recent opioid dose and peak 24-48 hours after the last use. These withdrawal symptoms can last up to two weeks, and therefore detoxification, which is the first step in the treatment process, usually is a one- to three-week process.
Signs and Symptoms of Opioid Withdrawal
- Rhinorrhea (runny nose)
- Lacrimation (tearing)
- Abdominal pain
- Bone pain
- Muscle aches
Seeking Help for Opioid Use Disorder
Opioid use disorder, whether prescription painkillers or heroin, can be life-threatening. It can ruin your relationships, wreak havoc on your professional life and finances, can negatively affect your physical health, trigger mental health and eating disorders, and can increase your risk for incarceration. Opioid use disorder can occur in as little as a few weeks. If you are susceptible to opioid use disorder, it is important to talk to your doctor about taking pain relievers that do not contain opioids. The following are signs that you should seek professional treatment for your opioid use disorder:
- Withdrawal symptoms in the absence of opioids
- Tolerance (needing a higher dose to induce the same effect)
- Engaging in illegal activity while high
- Engaging in criminal activity to obtain opioids
- Doctor shopping to seek more opioid prescriptions
- Purchasing opioids off the street
- Mixing opioids with other substances
- Cravings for opioids
- Drastic changes in mood
- A decline in work performance
- Social isolation
- Covering up your opioid use disorder by hiding pills and lying
- Driving under the influence of opioids
Treatment Options for Opioid Use Disorder
Detoxification is the first step in opioid treatment. Detoxification consists of administering medications in a supervised setting to lessen the withdrawal side effects. Medication-assisted treatment (MAT) for opioid use disorder successfully prevents withdrawal side effects, helps avoid future cravings, decreases overdose deaths and lessens criminal activity associated with opioid use disorder. Buprenorphine (suboxone), methadone and naltrexone are the three medications that can be given during detoxification and are often still needed in long-term treatment management. Methadone and buprenorphine (suboxone) are opioid-like medications that help treat pain without eliciting euphoria or triggering the brain’s reward system. As a result, these opioid-like medications are not as addictive compared to pure opioids. Naltrexone works by blocking opioids and will cause withdrawal effects if opioids are still an individual’s system. Naltrexone helps prevent future cravings and is often used for long-term opioid use disorder treatment.
Psychotherapy approaches are also necessary for opioid use disorder treatment. Cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), interpersonal therapy and family therapy are psychotherapy approaches that can help uncover and treat your underlying triggers and any co-occurring mental health disorders. Depending on the seriousness of your disorder, residential treatment or intensive outpatient is usually required, and after a certain amount of time, you can step down into a lower level of care, such as outpatient therapy. Outpatient therapy, in conjunction with support groups, is recommended for the best outcome in your long-term recovery.