Opiate Abuse

Opiates are made from opium, which by itself is derived from the poppy plant. Opiates have medicinal uses: they are powerful painkillers, they are used to control diarrhea, and are used in cough suppressants. Opiates, when used excessively either for recreational purposes or with a prescription, can be highly addictive and dangerous. The term opiates refers to the narcotic alkaloids and their derivatives that are found in opium.

Common opiates include prescription medicines (used to combat chronic pain and other medical conditions) such as morphine, vicodin, oxycodone, etc., among many others. Opiate abuse is all about developing a dependence on the opiates.

Opiates have different binding sites or receptors in the brain. Most opiates bind to the mu receptors in the brain. Opiates have different actions on different parts of the brain and the nervous system. When opiates act on the limbic system, they produce feelings of relaxation, content, and pleasure. When opiates act on the brainstem, they work on involuntary actions such as breathing, etc. They act on both the spinal cord and the brainstem to decrease feelings of pain in the body.

Opiates may be ingested by swallowing, smoking, injecting, chewing, snorting, or inserting as suppositories. The formulation and method of ingestion decide the speed with which the effects of the drug follow. Opiates reach the brain faster when they are injected than when they are swallowed. The effect of opiates after ingestion is that they produce a quick and intense feeling of pleasure called euphoria followed by a sense of well-being. They also induce a numbness and calm drowsiness. Respiration slows down and reflexes are impaired. Judgment and decision-making are also altered.

The human brain produces its own version of opiates called endogenous opiates. These help the body to control pain. Pleasant relaxation which is felt after a bout of exercising can be attributed to the release of these chemicals.

Opiate Abuse and Addiction

Long-term use of opiates changes the manner in which the nerve cells in the brain work. When nerve cells are deprived of opiates that they are otherwise used to, the body experiences many different and strange symptoms called the withdrawal symptoms. They are similar to symptoms of flu and can be far worse. Opiates used for medicinal purposes are therefore carefully administered and monitored by doctors.

However, to keep away the withdrawal symptoms and the cravings that they may bring, users keep taking more quantities of the opiates and eventually become addicted to the drug.

Opiate abuse can affect the life of individuals starting in utero. Use of heroin during pregnancy is associated with children born with low birth-weight, fetal death, preterm labor, and other developmental deficits.

Abuse of opiates along with other drugs or alcohol can slow down respiration and cause death. The number of unintentional overdose deaths is on the rise. Ingestion of opiates by injections heightens the risk of contracting HIV/AIDS and other infectious diseases.

For an individual to be defined as dependent, three of the following six criteria need to be either exhibited or experienced:Feel a definite compulsion to take the drug.Finding it difficult to control the amount of drug ingested.Experience withdrawal symptoms when use of drug is stopped.Increased amounts of drug are required to produce the same effects as previously experienced.Develop disinterest in regular activities/work/hobbies, etc.Continue to take the opiate drug in spite of knowing that it causes harm.

Withdrawal Symptoms

The physical symptoms of withdrawal include tremors, cramps, sweating, fever, chills, diarrhea, runny nose, and other flu-like symptoms. Psychological symptoms include anxiety and panic, depression, insomnia, paranoia, cravings, malaise, etc. The more serious but rare symptoms include seizures, dehydration, suicide attempts, strokes, etc. Withdrawal symptoms are known to last for 48 to 72 hours in case of low doses and short acting opioids such as hydromorphone and oxycodone. The duration of these symptoms depend on the quantity and frequency of opiate abuse. Extended high-dose use of opioids such as methadone and buprenorphine withdrawal symptoms can last for as many as thirty days. As the exact mechanism of dependence and withdrawal are still not fully understood, it is difficult to exactly predict the nature of withdrawal symptoms and the duration for which they last in different individuals.

Treatment

Opiate abuse and subsequent dependence is a complex health condition that needs a long-term treatment. The overall treatment regimen is aimed at getting rid of the physical problems that accompany the addiction and also help the well-being and improve the social functioning of the affected individuals. There is no direct and single treatment method and what is often required is a combination of diverse treatment options suited to the individual patient's needs. The treatment spectrum consists of detoxification or removal of the drug resident in the system, pharmacological approach to treat the co-occurring physical and mental disorders and cognitive behavioral therapy that aims to improve the self-esteem and improve the assertiveness to resist temptation and make healthier choices.

Enrolling into an opiate addiction/abuse treatment facility is the best way to get professional assistance that may help the addict to regain his/her former life by breaking the addiction cycle.

Relapse

Relapse after the phase of detoxification is very common. Thus, attempting detoxification alone as a method of treatment is not recommended. However, detoxification is always seen as the first step that an addict can take towards abstinence. Substitution maintenance method of treatment is also used to wean off addicts from the heavy use of opiates. Methadone maintenance therapy helps addicts replace use of illegal opiates. It also helps the addicts to improve their social behavior and physical health. This therapy is known to lessen the cravings, block the euphoria, is non-sedating and medically safe. It can also be used on pregnant women who are addicts. Buprenorphine is another medication used for maintenance therapy and is considered safer than methadone.

Increased prevalence of addiction to prescription medication is because of misconceptions about the safety of their use, increased availability, and various other motivations for their abuse. Finally, whatever be the motivation, opiate abuse is associated with serious health risks.