The United States is currently struggling with what is being referred to as an “epidemic” of addiction to opiate drugs. The result of this epidemic is an increase in deaths caused by accidental overdose. News headlines in the last several years have been full of reports on these deaths, including those of high-profile people like Phillip Seymour Hoffman and Prince.
Use of opiate drugs – both prescription and illicit – is continuing to rise all over the country. Spurred particularly by increased issues with prescription painkillers, the nonmedical use of opiates has become a major concern for government agencies, state health organizations, and communities, as individuals and their loved ones suffer the negative effects of opiate abuse and addiction.
The first step in understanding the insidious nature of the opiate abuse epidemic is understanding the drug itself. Opiates are natural, synthetic, and semisynthetic derivatives of opium, a substance found in the seeds of the opium poppy, which is indigenous to parts of Asia. For centuries, people have harvested this sticky, gel-like material to kill pain and – for some – to get high.
Opiates are highly useful, medically. These drugs work in the body by dulling the pain response, helping doctors treat pain that occurs with severe injury, surgery, and chronic conditions. Opiates can also be used to treat other conditions, such as severe coughs. WebMD explains some of the various kinds of opiate medicines, which include:
- Morphine: a natural opiate, chiefly used with anesthesia to manage pain during surgery and for post-surgical pain management
- Codeine: a natural opiate, used primarily as a cough suppressant and to treat diarrhea
- Hydrocodone (Vicodin): semisynthetic, for moderate to severe pain and coughs
- Oxycodone (OxyContin): semisynthetic, for round-the-clock treatment of moderate to severe pain
- Fentanyl: a synthetic opiate, potent, used for moderate to severe pain, anesthesia supplementation, and breakthrough pain treatment
Some opiate drugs, like methadone and Suboxone, are even used to treat addiction to other opiates. However, all opiates, including these two drugs, have a high risk of abuse and addiction.
Opiate Abuse and Addiction
Along with their pain management uses, opiate drugs are commonly abused for their psychoactive qualities. Like many similar drugs, opiates work on the dopamine system of the brain, as described by the National Institute on Drug Abuse, resulting in a feeling of well being and euphoria. These feelings contribute to the high that makes opiates highly popular for nonmedical, recreational use.
People who use prescription opiates to treat pain for a long time can become quickly tolerant of these drugs because of their effects on the brain. Tolerance results when the brain becomes accustomed to the drug, resulting in the person needing to increase the dose or take the drug more often to get the same physical and psychological effects. Increasing dosage or frequency of use without the advice of a doctor can increase tolerance and lead to addiction to the opiate drug.
In addition to prescription medications, one of the most prevalent illicit drugs is heroin, a commonly used recreational drug that can have the same addictive effect as any other kind of opiate. A number of prescription opiates, such as fentanyl and oxycodone, have found a different life on the club scene and in the illicit market.
Because of the highly addictive nature of opiate drugs, they are considered to be Schedule II and III narcotics according to the Drug Enforcement Agency. As a result, they are restricted and regulated by US law, even when legitimately prescribed.
People Who Abuse Opiates
A lot of people may have an image in their head of the “typical” opiate user. This image often comes from stereotypes about heroin abuse and the illicit drug world. However, because of the increasing prevalence of prescription opiate abuse, this stereotype is highly inaccurate. Truly, a person who struggles with opiate abuse can come from any walk of life.
A number of those who struggle with opiate abuse are adolescents and young adults, according to the Substance Abuse and Mental Health Services Administration, and the drug can often be found in urban areas among those who engage in other illicit drug use. However, opiate abuse is also prevalent among middle-aged women, the elderly, people who live in rural areas, and veterans, based on the same article. Users range from famous people and executives to those who are struggling financially or who are socially ostracized.
In other words, the opiate abuse epidemic is not just about the typical drug user. It’s happening all over the country, in families of all kinds.
Signs of Opiate Addiction
People who abuse opiates can have some common symptoms, based on the body’s response to the drug. During drug abuse periods, these symptoms can include:
- Drowsiness or sleeping a lot
- Slowed heart rate and breathing
- Lack of concentration or focus
- Decreased cognitive ability
- Decreased care about appearance
Healthline, on the other hand, demonstrates that, for a person who isn’t using opiates constantly, withdrawal in between uses can result in:
- Insomnia or restlessness
- Nausea and digestive upset
- Runny nose and eyes, goosebumps, and dilated pupils
- Cravings for the drug
These symptoms can often be quite severe and lead the person to return to using the drugs.
In addition, opiate abuse or addiction can be recognized through signs that are common across substance abuse types. These signs, based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), include:
- Using the drug more often or in larger amounts than intended, or being unable to stop using
- Experiencing severe cravings and spending large amounts of time seeking or using the drug
- Experiencing damage to relationships or an inability to keep up with responsibilities due to drug use
- Participating in dangerous activities while using the drug, such as driving or risky sex
- Continuing to take the drug even when faced with negative consequences
If multiple signs above are present, the individual struggling with opiate use may need professional help to quit using opiates.
Treatment for Opiate Use Disorders
Many people who become addicted to opiates attempt to quit on their own. While this is possible, and there is generally no risk of death for people who stop opiate use, the severe withdrawal symptoms and cravings can make it very difficult to maintain abstinence and recovery from opiate abuse. In fact, The Clean Slate indicates that more than 95 percent of people who try to quit using without help end up relapsing within as much as 20 years, while for those who get at least some help quitting, at least 13.6 percent are able to remain sober.
On the other hand, professional treatment can help people manage withdrawal and learn to handle cravings so they can more reliably avoid relapse to opiate use. In fact, reputable treatment centers rely on research-based treatments that are demonstrated to have a higher chance of resulting in long-term recovery.
These treatments combine certain medical, psychological, and social therapies and supports to help people learn to manage the challenges of opiate addiction and sustain abstinence in the months and years following rehab.
Types of Therapies Used in Treatment
Drug addiction treatment centers use a combination of therapies to help people learn to overcome cravings and the triggers that cause them. These therapies may include:
- Medically supported detox: helps control symptoms and cravings throughout this sensitive time in order to prevent relapse that would interfere with recovery
- Cognitive Behavioral Therapy: helps the individual learn to recognize and manage triggers and cravings, making it possible to substitute drug abuse with healthy behaviors
- Family therapy: teaches all family members ways to deal with a drug abuse problem, helping to provide needed support for the struggling loved one and emotional management for the family
- Peer support programs: provides peer support, often in the 12-Step model, through others struggling with the same issues, creating a sense of solidarity, a source of experience and advice, and the accountability that supports abstinence
- Motivational support: offers tips, tricks, and resources for the motivation that is essential to helping a person maintain long-term abstinence and recovery
- Aftercare: ongoing support after treatment that may include living situations, therapy, and feedback that can maintain the lessons learned in rehab beyond treatment
By combining these types of treatment, individuals can create the circumstances that have been shown to make it possible to overcome addiction, leading to long-term recovery.
Co-occurring Disorders and Opiate Abuse
Sometimes, opiate abuse occurs with other mental health conditions. In fact, there is strong evidence that many opiate abuse or addiction problems arise as a result of self-medication, or using drugs to help manage the symptoms of co-occurring mental health disorders. These disorders may include:
- Mood disorders like depression or bipolar disorder
- Anxiety disorders
- Post-traumatic stress disorder
- Other psychological issues, like eating disorders or schizophrenia
A challenge arises when a co-occurring disorder complicates opiate abuse. Often, the drug abuse and the other disorder become connected, even if they weren’t to begin with, and feed into each other. This means that it is difficult to recover from the substance use disorder if the co-occurring disorder is not treated at the same time.
Some treatment centers specialize in treating co-occurring disorders, using some of the therapies above, as well as others, to treat these disorders alongside the substance abuse. This can ensure recovery on all fronts.
The First Step to Wellness
Opiate abuse is a difficult challenge for the people who struggle with it and for their loved ones. However, once opiate addiction is recognized, it is possible for these individuals to get help in recovering from drug abuse and returning to a life free from drugs.
Finding a certified, research-based treatment program is the first step to getting the help needed to get in control of an opiate addiction or abuse problem. With proper care, people can discover ways to maintain abstinence on a long-term basis and embrace a healthier life.