Opioid Addiction

Pushed aside by the Covid pandemic, in recent years, is an epidemic that claims the lives of more than 100,000 people annually, and is the leading cause of death for Americans under fifty years of age.

The past few decades have seen a significant rise in the number of Americans with opioid use disorders, a problem that has been exacerbated by Covid restrictions.

A recent survey of high school students found that nearly three percent of students had tried heroin and/or a fentanyl compound in the past year, and twenty percent had take prescription drugs, including opioids, without a prescription.

The surge in opioid-related overdoses has competed with the Covid pandemic for headlines in recent years, but opioids are implicated in more than ninety percent of unintentional fatal overdoses
in the United States.

Opioid pain relievers are generally safe when used for a short time as prescribed by a physician. However, some people misuse these drugs for their euphoric effects, and this can lead to addiction, overdose, and death.

Because of their high addiction potential, opioids are unlikely to be a safe and effective long-term treatment for pain, as many people have become addicted to opioids after taking prescribed opioids for long periods of time.

Whatever the reason for taking these drugs, addiction is a common result of long-term use.

Opioids bind to and activate opioid receptors in the brain and throughout the body. Not all opioids are the same, particularly as pertaining to how long they remain in the body, as well as to their potencies.

Agonist/Pure Agonist: When taken in higher quantities, these substances have no ceiling effect. When a pure agonist opioid substance is taken in a great enough dose, respiratory arrest will result. Examples of these include heroin, methadone, fentanyl, and morphine.

Antagonist: Also known as blockers, antagonists bind to the opioid receptors, blocking them from being used by other substances. These include naltrexone and naloxone. These are not opioids.

Partial Agonist: These will provide some of the typical opioid effect, including pain relief and prevention of withdrawal symptoms, but, when taken in high doses, they have a ceiling effect and will not lead to respiratory arrest unless combined with other central nervous system depressants. Examples of partial agonists include buprenorphine (Probuphine, Sublocade, Suboxone, Subutex, Zubsolv).

Opiates are naturally occurring substances found in the sap of opium poppies, and include morphine and codeine. Initially, the term opioids was used to refer to the synthetics, but, in common usage today, the term is used to refer to all substances that act as agonists on opioid receptors, natural or synthetic.

Opioid withdrawal includes intense physical and psychological symptoms that strongly encourage the continuation of the cycle of drug-seeking. For long-term opioid users, the addiction is no longer about seeking euphoric highs, but about doing whatever it takes to avoid withdrawal. People in withdrawal from opioids often relapse, not because they want to go back to drug use, but because they are unable to cope with the symptoms of withdrawal.

Depending on the substance, opioid withdrawal symptoms can start within a few hours of taking the last dose, and the symptoms may be physically distressing, psychologically distressing, or both. Acute withdrawal symptoms can last up to two weeks.

Psychological symptoms are likely to include anxiety, irritability, restlessness, depression, loss of appetite, and intense cravings to use. Physical symptoms may include aches in bones and muscles, cramping of the stomach and muscles, muscle twitching, diarrhea, elevated heart rate, pupil dilation, a runny nose, tearing, nausea and vomiting, hot and cold flashes, sweating, yawning, and gooseflesh.

The earliest symptoms are cravings, anxiety, a runny nose, and watery eyes. Nausea, vomiting, and diarrhea may occur at some point during the first twenty-four hours, and the risk of dehydration can cause a range of dangerous complications during the first three days.

After a few days, it is likely that the symptoms will begin to lessen. However, post-acute withdrawal syndrome may result in symptoms arising months or even years after sobriety has been reached.

These symptoms are not generally life-threatening, but every case of addiction is different, withdrawal symptoms can be life-threatening for some long-term users.

Your risks for withdrawal may depend on such factors as how long you've been using opioids, how frequently you use, the types of opioids you use, the method of use, and whether you have detoxed before, as well as your age, individual health, and any co-occurring conditions.

Each time you withdraw from an opioid and then go back to using, you are at an increased risk for opioid overdose. After quitting, your body quickly loses the tolerance that it had built up to the drug, so if you go back to using your former high dose, the result could be a deadly withdrawal.

Withdrawal from long-term opioid may carry some serious risks, so it's fair to say that just saying no will not be viable option at this point.

Serious complications that may occur during the withdrawal and detoxification process include lung infections, asphyxiation, aspiration of vomit, dehydration, and suicidal thoughts and tendencies. Of course relapse is another possible complication.

Since these symptoms, although potentially life-threatening, are treatable in a facility where around-the-clock care is provided, a specialized opioid withdrawal program is recommended for those with long-term opioid use or other significant danger factors.

In a treatment program, various medications may be used during the detoxification process in order to reduce the severity of withdrawal symptoms, and to make the process bearable.

People with long-term addiction to opioids are not continuing to use in order to have a good time. They continue using because they fear that they will be unable to tolerate the effects of withdrawal.

Online informational resources

Note: The above third-party links are for informational purposes only.