The FOX TV series, House accurately portrays an opiate (Vicodin)-addicted physician, Gregory House, MD. Though a fictional character, Dr. House is a perfect depiction of the menace of opiate addiction which affects not only the general population, but also the modern-day medical practitioners.
Opiate use, misuse and addiction have been on the rise in recent years. Prescription opiate addiction is particularly rampant in the general population. Nonetheless, abuse of narcotic opioids such as heroin is still a great problem in many parts of the globe. In the US alone, opioid addiction has been ranked as the fastest rising form of addiction.
This class of drugs is a derivative of the opium poppy plant. It is inclusive of drugs such as codeine and morphine. Synthetic derivatives of these substances include Vicodin, Oxycodone, Heroin and Percodan. Heroin is an illegal drug, and its possession and use can lead to prosecution.
Medically useful opioids are used in pain management. Their strong analgesic properties make them ideal in treating severe pain. Nonetheless, recreational use of these drugs is common and is considered as abuse. The use of opiate substances is highly addictive. Often the recreational use and abuse of the medically prescribed opioids leads to use of hard opiates such as heroin.
Ingestion of opioid drugs can be oral, through nasal inhalation, injection into the blood stream or by smoking as a cigarette. Some medically used opioids are found in the form of skin patches.
The primary effect of long-term abuse of opiates is brain damage among other health problems.
The process of becoming addicted to opioids is often influenced by both the individual’s qualities and environmental factors. Essentially, the use and dependence of these drugs is primed upon the user feeling intense pleasure after using the drugs.
When an opiate drug gets into the body via whatever means, it is absorbed into the blood stream. The drug will ultimately reach the brain via blood. The surface of opioid-sensitive brain cells has specialized proteins called mu-receptors. The drug will attach to these mu-receptors resulting in bio-chemical changes in the brain that give the user pleasurable feelings. This pleasurable feeling is useful in masking pain as well as enhancing basic life functions through activities such as sex and eating.
If these opiate drugs are taken to induce pleasurable feelings in the absence of pain, the brain will see it as a reward process that motivates repeated use of the drug for pleasure. This rewards system is activated through the midbrain mesolimbic system. Its activation leads to release of dopamine which is responsible for the pleasurable feelings. Once this happens, the brain will create an association memory that links the feelings of pleasure to use of the opiates. The outcome is a craving of the drug under various circumstances.
With opioid abuse over time, dependence develops and overrides the simple thirst for pleasure such that the user simply can’t do without the drug. With the dependence, tolerance will also develop, and the user continually needs more of the substance to feel good. The combination of dependence and tolerance is a critical clinical situation that if left unchecked, can eventually lead to death.
There’s always a threat of addiction with opiate drugs, irrespective of the specific drugs used. A report by World Health Organization places approximately two million US citizens as being addicted to prescription opiates. This is also representative of what is happening in the rest of the world.
A CDC report also showed that about 46 people in the US died each day in 2012 from overdosing on prescription pain relievers. The report also showed that overdose deaths from heroin were almost as many. The rate of overdose death has been increasing by about 2% each year.
Besides the obvious health risks to the individual, opiate use and abuse have been linked to about 50% of all major crimes and violent crimes. Up to 10% of motorists who cause road traffic accidents are usually under the influence of opiates.
Studies show that up to 60% of minors, especially those in high school, have had past encounters with abuse or misuse of both prescription and non-medical opiates.
An interesting finding in a recent study shows that there is a strong correlation between opioid abuse and child abuse. Nearly 70% of individuals in opiate abuse treatment were sexually or physically abused as children.
Anyone can become dependent on opiates; however, the following people are more likely to eventually become addicts:
- Doctor shoppers i.e. people who will get prescriptions from wide-ranging sources simultaneously
- Consumers of high doses of opiates
- People who misuse multiple opiates that are prone to abuse
- People in low-living standards
- Mentally ill people
- People with previous substance abuse history
How to Tell That You Are Addicted
- A person who is addicted to opiates expresses the desire to keep using the drug in spite of the obvious adverse effects.
- The person will tend to spend a lot of cash and time in acquiring the drug.
- He or she may be willing to do anything including involvement in crime to get the opiates.
- Tolerance to the drug is a common feature of addiction.
- There is often an inability to stop using or reduce the use of the drug.
- An attempt to stop the drug results in withdrawal symptoms.
- An addiction problem will often have a drastic impact on the quality of life, work, education and relationships of the abuser.
Common Effects of Opioid Addiction
- Occupational and employment problems: work absenteeism, impaired productivity at work, poor relationship with colleagues, loss of employment
- Mental problems: confusion hallucinations, depression, impulsivity and risky behavior, hostility, irresponsibility, paranoia
- Social problems: social withdrawal, engagement in crime, neglect of family leading to divorce, abuse and general irresponsibility
- Personal problems: increased risk of infection with other diseases including HIV, impaired sexual function, respiratory depression, hypotension
Stopping the use of opiates makes the abuser experience the following:
- Autonomic symptoms: nausea, shivering, diarrhea, tearing, piloerection, diaphoresis, sweating
- Central nervous disorders: tremors, restlessness, insomnia, nervousness, confusion, depression, paranoia, memory deficits, irritability
- Pain: joint aches, diffuse muscle and bone aches, abdominal cramping
- Cravings for the drug
- Others: cardiac arrhythmias, seizures, dehydration
A doctor evaluates the patient and discusses the usage and history of interaction of the opioid. This determines the level of dependence and thus, the best treatment option.
Treating Opioid Addiction
There are physical, mental and social aspects that one has to address when managing and treating addiction. This, therefore, calls for professional intervention by addicts. There must also be willingness by the abuser to stop the addiction. In severe cases of opioid addiction, hospitalization is necessary.
Generally, for treatment to work three things must be done:
- There must be a commitment to quit.
- There must be help from a qualified and reliable medical practitioner.
- One must get support from certain organizations that help people addicted to opioids.
Your family, friends and colleagues should support you and help you break free of the drugs. The best treatment to addiction is through a residential treatment program. Here the patient receives support, vocational rehabilitation and counseling. Since opiate addiction calls for long-term care and support, the program may last for several weeks or months.
The first attempt at treatment is the supervised drug withdrawal. This is done in a controlled environment with close supervision and support. This process will normally be accompanied by withdrawal symptoms in various ranges of severity, but it is usually a short-lived experience when overseen by a team of professionals.
Addiction has been shown to be overcome through exercise, acupuncture, hypnosis and various forms of herbal remedies. However, the efficacy and safety of these alternative cures are not established.
After overcoming the initial steps of detoxification and medication, one is advised to join a reliable support group to prevent a relapse of the addiction. Relapses are common, therefore underlining the need for a quality support network.
Benefits of Seeking Proper Inpatient Treatment
Through a reliable program one is able to:
- Reduce and alleviate dependence on the drug.
- Reduce the negative effects that may have been caused by abuse of the drug.
- Reduce the morbidity and mortality resulting from opiate misuse and associated infection.
- Recover the health of the patient physically and psychologically.
- Facilitate the reintegration to the society, work, school or family.
- Improve the social functionality of the individual and help remove the person from the path of crime.
- Reduce the chances of relapse of the addiction problem.
As the above list indicates, the benefits of an inpatient treatment program can help a person safely and effectively overcome opiate addiction.