Opioids are highly addictive, very strong painkilling medications such as Oxycodone or Morphine that are usually prescribed by doctors. Some opiates are illegal and not prescribed by doctors though, such as Heroin. This class of drugs works by imitating chemicals naturally made in the brain. They affect multiple systems in the body when ingested, resulting in different responses from the body parts involved.
Opiates affect the limbic system which controls emotions. When the drug acts on the limbic system, feelings of happiness or relaxation are common, and sometimes if enough of the drug is taken, euphoric states can ensue. Opioids also influence the brain stem, which may cause breathing and heart rate to slow and coughing to subside.
This is why opiates such as Codeine are ingredients in some cough medications. The most common part of the body that opiates act on is the spinal cord. When the drug works here, pain is reduced, as signals from the spinal cord to the brain are inhibited. This is usually the desired effect of the drugs when prescribed by a doctor.
There are many reasons that people take opiates, some have already been mentioned. Pain relief is a very common use for these drugs. Some people take opioids in order to control their anxiety. For some people, anti-anxiety medication is not enough and they must turn to other drugs. While this class of drugs does work for this purpose, it also can play a large role in the development of an addiction. Most often when opiates are being abused, they are being used to achieve an intense high.
Since these drugs react with the brain, large doses taken either orally, intravenously, smoked in a cigarette, or inhaled through the nose can easily induce a euphoric state that is highly desirable for people abusing these drugs and most likely others. This seems like it would be the most obvious abuse of this class of drugs, but there are so many different people abusing the drugs that it’s hard to tell.
It’s very easy for users of opiates to become dependent upon them, and it’s also very difficult to successfully treat an addiction to these drugs. The reason it’s so difficult is because the human body forms a mental and physical dependence on opiates. It’s just like any other common addiction to cigarettes or alcohol; it takes a lot of willpower to stop taking the drugs. In many cases, people are hospitalized in order to be more comfortable during the withdrawal.
It is possible to go through the withdrawal without being hospitalized, but the symptoms are so uncomfortable and even painful that the chances of making it through the withdrawal are minimal. There have been instances of rapid detoxification taking place while the patient was under anesthesia in order to save the patient the pain of going through the withdrawal symptoms. However, this method is not very popular, as vomiting is common with opiate withdrawals and vomiting while under anesthesia caused many patients to aspirate and develop pneumonia.
Everyone who uses opiates, whether with a prescription or not, is at risk of developing an addiction. Users don’t even have to misuse the drugs. This class of drug is highly addictive because it produces changes in the brain, most noticeably in the pain centers. When the drug is taken away, the brain sends out signals telling the body that it must have more.
People with family histories of drug abuse or dependence can potentially have a greater risk of developing a dependency on opioids. Also, anyone with a history of alcohol abuse or misusing other drugs may be more likely to develop an addiction to painkillers. Mental illnesses such as bipolar disorder, depression and anxiety can increase the likelihood of opiate abuse as well, due to the euphoric state the drug can induce if enough is taken.
Every year, 5 million Americans develop addictions to opioids, and 17,000 people die due to overdoses. There are different severities of opioid overdoses, ranging from symptoms like drowsiness and slurred speech to coma and possibly death. It’s relatively easy to overdose on opioids because after prolonged use of the drugs, the body becomes desensitized to them. The dosage will have to be raised in order to still feel the effects, increasing the risk of overdose.
This is problematic for people using the drugs for pain, as their pain will not be controlled without a higher dose. For people abusing opiates, they will not feel the desirable effects and will require more, increasing their risk for an overdose. Because they’re not being prescribed these drugs by a doctor, someone abusing opiates does not know what doses are appropriate, and therefore are very prone to taking too much.
Long term use of opioids can potentially cause irreversible health issues. Brain damage can occur, as well as impairing the brain’s ability to produce natural pain reducing hormones such as dopamine. This will lead to a lifelong dependency on some sort of pain management in people with chronic pain. The only way to minimalize the risk of dependency and damage to the brain is to take opioids only as directed by a healthcare professional.
When someone that is addicted to opioids stops taking them (either willingly or not,) withdrawal symptoms usually are experienced. Symptoms of withdrawal include but are not limited to shivering, nausea and vomiting, sleeplessness, abdominal pain, and cravings for the medication. These symptoms are not pleasant, but also usually are not harmful and subside after about 72 hours after the drug has fully left the body. The withdrawal symptoms are usually what force people to keep taking the drugs. The symptoms are so undesirable that users of opiates would rather take the chance of ruining their health than experience the withdrawal symptoms.
There are many different symptoms of opiate dependency. They can include an increased tolerance for the drug, meaning more is needed to feel the effects that less used to produce, excessive sleeping or fatigue, or large fluctuations in weight. Other more obvious symptoms are withdrawal symptoms when attempting to stop taking opioids, continuing to take the drug even when health is at stake, and the inability to continue day to day routines due to the effects of the drug.
Symptoms of opiate dependency should immediately be shared with a doctor or other healthcare professional in order to prevent the dependency from getting out of hand. The choice to stop taking opioids should also be shared with a healthcare provider, as medical attention may help make the process of detox easier and increase chances of success.
People that are addicted to opiates are not necessarily “bad” people. Many people that suffer from chronic pain are addicted to opioids merely because they are the only thing that helps with the pain. In fact, some recent studies show that about 9% of Americans have addictions to these kinds of drugs.
In many cases, the addiction has stemmed from prolonged, heavy use of the opiates for whatever reason. A few weeks on opioids can cause an addiction. This is because the brain and body get used to having the opiates present and when they are taken away, the body and the brain do not like it. All of the withdrawal symptoms begin and do not end until more of the drug is taken or the full process of the withdrawal has taken place.
Over the last two decades, the amount of people taking opioids for non-medical reasons has multiplied. The reasons for this abuse are unclear, and little scientific research has been done to attempt to find any answers until now. Dr. Sandra Comer is a Professor of Clinical Neurobiology in the Department of Psychiatry at the College of Physicians and Surgeons of Columbia University, and a Research Scientist at the New York State Psychiatric Institute.
She has spent a majority of her career researching and experimenting with the effects of opioids on the human body. She has done studies regarding the difference in opiate effects on men, women having normal menstrual cycles, and women on oral contraceptives, along with many other related studies. Recently, Dr. Comer has been awarded a grant to continue her research on opiates and how and why they are used.
This research is going to take place at the New York State Psychiatric Institute in the near future. The study is going to compare the effects of opiates in drug abusers as well as non drug abusers. The reason for this is to find out who is abusing opioids. To further understand why drug abusers and non drug abusers misuse opiates, each group will consist of subjects without any pain and also subjects with experimentally induced pain. Through this study, Dr. Comer hopes to gain a better understanding of who is abusing prescriptions opioids and why.
The research is going to be inpatient at the aforementioned institution, and is planned to last about 3.5-4 weeks. If you are interested in being a part of the study or learning more about it, you can call Dr. Comer’s screening hotline at 646-774-6243.
References:
http://www.substanceabuse.columbia.edu/comer.htm
http://www.emergingsolutionsinpain.com/about-us/contributing-faculty/43-sandra-comer
http://clinicaltrials.gov/ct2/results?term=Sandra+Comer&Search=Search
