In the struggle against the national drug abuse epidemic, opiate abuse is one of the biggest challenges to overcome, as discussed by the National Institute on Drug Abuse. In the intervening years since that presentation was made, opiate use and abuse have increased, both for illicit drugs like heroin and for prescription medications used primarily as painkillers.
For those struggling with opiate addiction, the challenge to stop using the drug and stay sober in the long-term can be overwhelming. However, research into the causes, effects, and treatments for opiate abuse continues to make strides. Armed with knowledge and understanding of opiate addiction and treatment, this struggle can result in sustained recovery.
Opiate Medications and Drugs
Opiate drugs and medicines are made specifically from extracts of the opium poppy. As reported by Frontline, this flower has been cultivated for more than 5,000 years as a recreational drug and as a medicine to help a wide range of conditions and situations. Opiates have been used for the following purposes:
- To treat acute or chronic pain from illness or injury
- As surgical support for anesthesia
- For post-surgical pain management
- For cough suppression
- To treat diarrhea
The specific, well-known opiate drugs include morphine, codeine, heroin, and methadone – the latter of which is often used to manage opiate addiction with mixed results. These substances have also been used to create synthetic and semisynthetic versions of opiates called opioids, which are used for similar medical reasons. Because the synthetic opioid drugs can be much stronger than opiates, they can also cause addiction and other severe health issues as described below.
When Legitimate Use Becomes Abuse
In 2015, according to the National Survey on Drug Use and Health (NSDUH), 6.4 million people abused prescription psychotherapeutics. Of these, more than 59 percent, or 3.8 million people, were abusing prescription painkillers, including opiates. According to the study, this number continues to rise.
People who use prescription painkillers for a long time can develop tolerance and physical dependence on the drug. Sometimes, dependence on its own is not problematic; individuals with chronic pain conditions may depend on prescription painkillers to give them a normal quality of life. However, if the individual begins to misuse the drug – for example, if tolerance occurs and the person starts taking more of the medicine to counter what feels like diminished effectiveness – it is possible for the person to develop compulsive use of heroin that is a hallmark of addiction.
When a person becomes addicted to a prescription painkiller through this kind of abuse, the cost or the loss of ability to obtain the prescription can drive a person to use illicit opiates instead.
Illicit Opiate Use and Abuse Rates
Heroin started out as a drug used for medicinal purposes; however, it fell out of favor for this use after the high addiction potential of the drug was discovered. Now, it is considered an illicit drug.
Heroin is chiefly sought by individuals looking to get high or to continue a prescription painkiller addiction when the cost of obtaining drugs from the pharmacy is too high. As a result, heroin was abused at some point in 2015 by more than 825,000 people over the age of 12, according to the NSDUH. Of these, nearly 330,000 were current users.
Signs of Opiate Addiction
It is possible to recognize signs of opiate addiction, especially when the individual is abusing prescription painkillers. According to Family Doctor, overall symptoms of opiate abuse include:
- Drowsiness or lethargy
- Shallow breathing and slow pulse
- Loss of coordination
- Alternating between euphoria and depression
- Changes in sleeping patterns
- Slurred speech
When it comes to prescription medications, these symptoms might be coupled with other signs of abuse, such as:
- Missing or stolen pills
- Secrecy around medicine use
- Running out of pills sooner than expected
- Extreme focus on getting and using the medicine
- Multiple prescriptions from different pharmacies
It can be harder to be sure when illicit drug use is occurring instead of prescription abuse. However, the symptoms above coupled with the following overall signs of substance use disorders may indicate that illicit use is occurring:
- Inability to control or stop use of the drug
- Changes in social groups or activities, or difficulties in relationships
- Inability to keep up with, or abandonment of, responsibilities
- Unexpected risk-taking behaviors
- Cravings for the drug
- Withdrawal symptoms if use is stopped
Effects of Use and Abuse on Health and Safety
Development of opiate abuse or addiction can lead to risks to the individual’s health and safety over the long-term. A study review from the Primary Care Companion for CNS Disorders demonstrates that long-term opiate painkiller use can result in:
- Sleep apnea and other breathing issues
- Issues with the hypothalamus, pituitary, and adrenal glands
- Heart and circulatory issues
- Other problems with major organ systems
According to the National Institute on Drug Abuse, people who abuse heroin can have additional issues, including a lack of oxygen to the brain referred to as hypoxia, which can result in brain damage, and damage to blood vessels and circulation caused by injecting the drug, among other issues. In addition, overdose is a major risk to health and life that occurs with abuse of any opiate or opioid.
Opiate Overdose: Risks to Health and Life
Opiate overdose is a severe condition that can result in death. Data from the National Institute on Drug Abuse indicates that deaths by opiate overdose nearly tripled between 2002 and 2015. This includes deaths from prescription opiates alone, which doubled, and from heroin abuse, which increased nearly seven times in the same period.
Signs of opiate overdose include:
- Shallow or stopped breathing
- Extremely low pulse or heart rate
- Confusion and loss of coordination
Without immediate medical help, this can quickly lead to death. The risk of death is increased if the person has also been using benzodiazepines or alcohol.
Even if the individual survives an overdose, the lack of oxygen to the brain can result in permanent brain damage and memory loss. It can also cause organ damage that will affect the rest of the individual’s life. For this reason, preventing overdose by getting treatment for opiate addiction is vital as soon as the drug abuse problem is recognized.
Withdrawal Symptoms and Risks
Stopping opiate use is not always as simple as just giving up the drug. Opiate detox and withdrawal can be an extremely uncomfortable process, and this can make it challenging for the individual to avoid relapsing to drug use. While the detox process itself rarely results in life-threatening withdrawal symptoms, the high level of cravings and potential for relapse are health risks.
This is because people who have abused opiates for a long time often develop tolerance that causes them to increase to a very high drug dosage before getting help. During the withdrawal process, this tolerance decreases, so if the person then relapses at the higher dose, there is a much higher risk of overdose than there was while the person still maintained tolerance, as indicated by a study in the British Medical Journal. For this reason, getting professional medical support for opiate detox and withdrawal is a key step on the path to recovery from opiate addiction.
Professional Help with Opiate Addiction
Drug treatment therapies based on research are most likely to help a person get clean and stay that way. When seeking a treatment program, it helps to look for organizations that provide these types of treatments:
- Cognitive Behavioral Therapy
- Motivational therapies
- Family and interpersonal therapy
- Peer support or 12-Step program involvement
- Education about addiction
- Alternative therapies, nutrition support, and exercise programs
These combined treatments can be customized to suit the individual’s particular needs. It can also help to find a program that provides treatment for co-occurring disorders if they are present. With this kind of personalized, experienced treatment and follow-up care, an individual who is struggling with opiate abuse can develop the skills, knowledge, and motivation to stop using opiates for good and to embrace a healthier, more balanced life.