- Hydrocodone (Vicodin, Norco, Lortab)
- Oxycodone (OxyContin, Endone, Percocet)
- Fentanyl (Fentora, Sublimaze, Actiq)
Opioids are any drugs that act on the opioid receptors in the brain, and these drugs are most often used to treat moderate to severe pain.
They can also be used to treat coughs and diarrhea, and to calm and sedate patients before major medical procedures. These drugs include opiates, which are directly derived from the opium plant, and synthetic and semisynthetic drugs that produce similar effects. This class of drugs may also be referred to as narcotics.
Prevalence of Abuse
Opioids depress the central nervous system, slowing heart rate and the respiratory and gastrointestinal systems. This can create a calming, sedative effect and, at high enough doses, a pleasurable or euphoric high. Because of this, they’re considered to have a high abuse potential and can be highly addictive. They also have a high potential for overdose, with opioid overdose cases outpacing those of any other drug class in recent years. According to the World Health Organization, 69,000 people die from opioid overdoses every year worldwide.
Many opioids are given out via prescription medication. Others are manufactured illegally, such as heroin. There’s also a significant black market around opioids, and many people have taken prescription drugs like Vicodin, that were originally prescribed to someone else, for recreational purposes.
All opioids tend to cause the individuals taking them to build up a tolerance.
This means that higher doses of the drug are needed over time to get the same effect. Even those who take prescription opioids exactly as directed will eventually develop a tolerance to them. However, that process will be more rapid when the drug is abused to get high.
The more an individual takes an opioid and the more a tolerance is developed, the higher the likelihood that an addiction will occur. At this point, users will feel as though they can’t get through the day or feel normal without a hit. They will likely experience withdrawal symptoms and intense cravings if they try to stop using opioids suddenly.
Once an addiction has developed, it’s very likely that the afflicted person will need treatment in order to get off the drug. Opioids, particularly heroin, are considered to be some of the most addictive drugs in the world. Getting off them can be so difficult that special programs have been devised to help addicted individuals deal with the withdrawal symptoms and cravings that so often lead to relapse. This includes using medications like methadone that are actually less intense opioids so people can gradually be weaned off these drugs.
Who Abuses Opioids?
In 2014, 4.3 million Americans age 12 and older were regular nonmedical users of prescription painkillers. This is the second most abused class of drug after marijuana, according to the National Survey on Drug Use and Health. Abuse of opioids among teens has been concerning, with 1.6 percent of the 12-17 age group having used a prescription opioid without a doctor’s permission in the month prior to the survey. The age group that uses opioids the most has consistently been the 18-25 set, followed by those ages 12-17.
There’s also more abuse of prescription opioids among the elderly than most other addictive drugs due to the high number of prescriptions given out to this age group in general. According to the American Academy of Addiction Psychiatry, 20 percent of people 65 and older take prescription analgesics (painkillers) several times per week, and the abuse/addiction rate among those with chronic pain is 18 percent.
Women are more vulnerable to opioid addiction than men due to the fact that they more often suffer from chronic pain, and they are more likely to be given prescription painkillers by doctors, according to the Centers for Disease Control and Prevention. About 18 women die in the US each day due to prescription painkiller overdose. This is a 400 percent increase from 1999, compared to a 265 percent increase for men. Non-Hispanic white, American Indian, and Alaskan Native women are the most likely to die of an opioid overdose.
When it comes to heroin, urban areas across the US have experienced epidemic abuse problems. This particular issue has seen more substantial growth among white individuals than minority races. Heroin use by white adults from 2004 to 2013 increased by 114 percent while the rates of use for this illicit substance have remained steady among other races. Experts believe this could be related to the increase in the rate at which doctors prescribe opioid painkillers. Recently, it’s been discovered that people of color, particularly black individuals, are systematically undertreated for chronic pain.
Signs of Addiction
The signs of opioid addiction tend to differ in some key ways depending on whether it involves prescription painkillers or illicit opiates like heroin. However, all opioids produce distinct symptoms that can help people to determine if an individual without a prescription is using this type of substance. These include:
- Small pupils
- Inability to feel pain
- Itchy or flushed skin
- Chronic constipation
- Shallow breathing
- Slurred speech
- Poor judgment
These are signs of opioid use. Even if a person is abusing opioids, it doesn’t necessarily mean they are addicted to them. Opioid addiction involves physical changes to the brain from the constant presence of the foreign substance that cause withdrawal symptoms and psychological dependence. When it comes to individuals who take prescription opioids for pain and other issues, it’s important to keep an eye out for addiction, especially if they’re taking them on a long-term basis.
Long-term use or abuse of an opioid combined with the above symptoms is a very concerning situation. If an addiction disorder is not addressed, it will only become worse and expose the afflicted individual to several serious health problems, such as liver, kidney, and heart issues. Sustained use has also been observed to have a significant negative effect on cognition.
In 2009, only 11.2 percent of the people who were considered to have an addiction problem received treatment, according to the Substance Abuse and Mental Health Services Administration. Much of the time, the reason people don’t get treatment is because they don’t seek it out. Real and perceived hardships from quitting and strong social stigma convince them that it’s better to hide the problem and keep using. It can be especially hard for people with chronic pain who don’t know how else they can find relief, elderly persons afraid of disapproval, and teens afraid that they’ll get in trouble.
For many, however, getting professional help is the only way that they can find long-term success in recovery. For opioid addiction, there are a couple medications that can be used to make the process of quitting much easier. Drugs like methadone and buprenorphine are opioids that produce the same effects as drugs like Percocet and heroin but don’t cause nearly the same high. For those who have developed a tolerance to opioids, they won’t experience euphoria on these drugs even if a lot is taken at once. This way, there’s little temptation to abuse the drug, and addicted persons can take it regularly to prevent withdrawal symptoms and lessen cravings. They can then, ideally, be weaned off the replacement drug over time and under medical supervision.
Alternatively, clients can opt for medically assisted detox. This involves staying in a hospital setting for a few days after ceasing use until the most severe withdrawal symptoms have subsided. During this process, medical staff can monitor vitals and treat or prevent withdrawal symptoms with various medications, including non-habit-forming medication for anxiety and depression, anti-nausea medicine, and non-opioid painkillers.
After detox, it’s recommended that addicted persons go into a rehabilitation program, most commonly known as rehab. People can general choose between inpatient or outpatient programs, with inpatient programs being located in a controlled facility and outpatient varieties allowing the freedom to go home or to work after therapy, support group meetings, and other treatment sessions. Rehab typically lasts for several months, after which the client is encouraged to continue seeing a therapist and/or attending support group meetings.
Addiction to opioids may be one of the most difficult illnesses anyone can face, especially without professional treatment. But no matter who you are – young or old, a chronic pain patient or a heroin user – everyone can get on the path to a better life with the proper support and care. With the negative health effects and potential for overdose that come with continued opioid abuse, it’s always worth the effort to reach out for help.