What Are Opioids?
Opioids are a class of drugs that people naturally find in the opium poppy plant. Dozens of opiates and opioids, are taken from the seeds of the opium poppy or synthesized in labs. These drugs are either chemically similar to, or derived from opium poppies. They work in your brain to cause a variety of effects including pain relief.
Opiates and opioids are prescription medicines. People refer to them as painkillers. Sometimes opiates and opioids can also be street drugs such as heroin.
Opioids include:
Medications that doctors prescribe to relieve pain are prescription painkillers. Examples of such prescription painkillers include:
- OxyContin (oxycodone)
- Vicodin (hydrocodone)
- Morphine
- Codeine
- Heroin and illegally manufactured fentanyl
Effects
People use prescription opioids to block the pain signals between the brain and the body. Doctors prescribe opioids to treat moderate to severe pain. Along with controlling pain, opioids also:
- Cause relaxation
- Cause a feeling of being happy or “high”
- Slow your breathing
- May cause constipation, nausea, confusion, and/or drowsiness
Commonly Used Opioids
Sometimes people refer to opioids as narcotics. Although they do relieve pain, they don’t fit into the same category as over-the-counter pain relievers. The most commonly used opioids are:
- Prescription opioids like OxyContin and Vicodin
- Morphine
- Codeine
- Fentanyl, a synthetic opioid 50 to 100 times stronger than morphine
- Heroin
Risks of Using Opioids
Using opioid medications comes with certain risks. Regular use of these medications can increase your dependence and tolerance. Tolerance means that you need stronger and more frequent doses of opioids to experience the same pain relief.
Once individuals develop a tolerance for opioids, it usually isn’t much longer until they also develop opioid dependency and addiction. Once individuals develop opioid addictions, they must attend opioid or opiate detox followed by opioid rehab or opiate rehab.
Opioids can even harm your ability to breathe when a higher dose is taken. When people misuse opioids though, it can lead to a fatal overdose. This risk of respiratory depression (slowing or stopping your breathing) increases if you’ve never used opioids before or if you are taking other drugs that interact with the opioid.
What are Synthetic Opioids?
The term “synthetic opioid” means a class of substances that researchers know:
- are opiates or
- they agree that they have opiate-like effects
The same as the substances they imitate, such as codeine and morphine, synthetic opioids can provide sedation and pain relief.
This class includes drugs with approved medical uses, like fentanyl, and those without, like U-47700, also known as “pink,” carfentanil, and acetyl-fentanyl. The most researched and well-known drug is fentanyl. Fentanyl has been used for years to treat individuals suffering from chronic pain. However, recently fentanyl and other synthetic opioids have been turning up in heroin.
Heroin and Synthetic Opioids
Why do people use heroin to cut synthetic opioids? It’s due to a profit-driven motivation to provide cheap, strong drugs to meet the demand for street heroin. Fentanyl and other synthetic opioids have been shown to be attractive cutting substances for heroin because they are inexpensive to make and they have strong sedative properties.
It’s important to note that synthetic opioids aren’t cut into heroin by the street dealers, but by those higher up on the supply chain.
What are the Effects of Synthetic Opioids?
Synthetic opioids can cause:
- Constipation
- Nausea
- Respiratory depression (which can cause overdose)
Overdose From Synthetics
In addition, synthetic opioids tend to be highly potent. When taken without the individual’s knowledge, and with a less potent substance like heroin, the risk of overdose increases substantially.
There were 9,580 known deaths related to synthetic opioids in 2015. These occurred mainly in the eastern U.S. where heroin mixed with fentanyl is more common.
As of 2016, overdoses from synthetic opioids were rising. In general, drug overdose deaths have been rising for the past twenty years. Most overdoses are from either heroin use or the misuse of prescription opioids. As the use of heroin and other opioid use continues to escalate, the incentive will remain strong to combine these drugs with cheap and powerful imitators like fentanyl and other synthetic opioids.
OUD and the Cycle of Addiction
Opioid addiction, called opioid use disorder (OUD), can leave you feeling caught in a trap. That’s because opioids seem to hijack the brain and change how it normally functions and processes rewards. When a person takes opioids, it triggers a surge of dopamine which causes an increased sense of pleasure compared to “natural rewards.”
According to the National Institutes on Drug Abuse (NIDA), these large surges of dopamine “teach” the brain to seek the drug at the expense of other healthier sources. The wish to either feel the pleasure of opioids again or avoid the negative experience of opioid withdrawal when not using it becomes a powerful force to use opioids over and over.
Over a period of time, to people suffering from opioid addiction, things that were once enjoyable, can’t compete with the effects of opioids. This process impacts areas in the brain that manage:
- Reward
- Decision-making
- Self-control
- Learning
Cycle of Addiction
Altogether, these changes can make quitting feel like it is completely out of your control and creates the following cycle of addiction:
1. Initial Use
Taking opioids and feeling high, relaxed, or escaping pain, negative moods, or feelings. This positively reinforces repeated use.
2. Abuse
Using the substance on a recurring basis. This might mean increasing the amount and frequency of their doses.
3. Tolerance
After using opioids for a period of time, chemical changes in the brain occur. Upping the original dosage doesn’t bring about the same physical or mental effects as previously. This may help for a while but eventually, the brain adapts and a higher dose is needed to recapture the original high experience.
4. Dependence
At some point, the brain becomes dependent on having opioids to feel normal or function properly.
5. Addiction
After long-term use, the person finally reaches the addiction stage. Addiction is a chronic mental health disorder caused by compulsive substance abuse even though it results in harmful consequences. A person in this stage will have such an intense focus on using that it completely takes over their life.
6. Relapse
The intense desire for opioids to experience pleasure or just to feel “normal.” This can become compulsive and difficult to control.
What Are Some Signs of an Opioid Addiction?
Once a person becomes addicted to opioids, they’re not using opioids to feel good anymore – they’re using them to feel normal. Signs of opioid addiction include:
- Disorientation and drowsiness
- Slurred speech or slowed movements
- Being in and out of consciousness, even while sitting up or in a public situation. This is sometimes called being “on the nod” or nodding out.
How Can You Reduce Your Risks of Opioid Addiction?
- If a doctor prescribes you opioids, take them exactly as directed.
- Never combine opioids with benzodiazepines or alcohol. Mixing can increase your risk for a fatal overdose.
- Never use while alone.
- Always start with a low dose. This is important if you’re using opioids for the first time or using them after a period of not using them. A period of abstinence reduces your tolerance which puts you at a higher risk for overdose.
- Keep naloxone nearby and make sure someone else knows how to use it.
- You can prevent infections by using clean needles and kits.
How is Opioid Addiction Treated?
There are several very effective treatment options for treating opioid addiction. However, the gold standard is medications that greatly reduce cravings and the risk of a deadly overdose. In addition to medication, therapy, support groups, and other treatments combine to help individuals achieve lasting recovery.
Medications
Medication-assisted treatment (MAT)helps many people in opiate rehab and opioid rehab. The following medications are often used in MAT.
- Methadone – Methadone relieves withdrawal symptoms and helps during detox. It can also be used as a long-term maintenance medication and decreased slowly over a long time.
- Buprenorphine (Subutex)– Subutex can also be used for long-term maintenance. It can also be combined with naloxone to help prevent dependence and misuse.
- Naltrexone – Naltrexone can help prevent a relapse. However, it can cause a sudden and severe withdrawal if used while opioids are still in your system.
The use of medications like methadone for detox is legally restricted to inpatient or residential settings or specially licensed outpatient programs.
Detox
For people with OUD, the beginning of treatment is usually detoxification or detox. Detox is a medically supervised and controlled withdrawal process from the drug. On its own, detox is not the solution to opioid addiction. This is because most people with opioid addictions go back to using opioids unless they attend opiate rehab or opioid rehab after detox.
The severity of the opioid withdrawal symptoms depends on the dose and speed of withdrawal. No single method to detox is guaranteed to work for all people. Often, regular heroin users switch to the synthetic opioid, methadone, while in detox.
After the switch, such addicts slowly taper off their medication and/or drug use. Likewise, people may use the blood pressure medicine, clonidine, to shorten the withdrawal time and relieve physical symptoms.
Early Withdrawal Symptoms Include:
- Anxiety
- Muscle aches
- Insomnia
- Agitation
- Increased tearing
- Sweating
- Yawning
- Runny nose
Later Withdrawal Symptoms Include:
- Diarrhea
- Abdominal cramps
- Nausea
- Vomiting
- Dilated pupils
- Goosebumps
Opioid Rehab
Most people require long-term treatment after opioid detox. Long-term treatment options for opioid or opiate rehab include the following:
- Residential Treatment – You will live at the treatment facility full-time.
- Partial Hospitalization Treatment (PHP) –You will spend 5-7 days at the facility and go home in the evenings.
- Intensive Outpatient Program (IOP)
This type of program also allows you to live at home while attending treatment sessions at the facility 3-5 days per week.
An OP provides the same types of treatment as the more intense programs but with less time requirement. Outpatient program treatment is also used as a continuing treatment after completing a higher level of care.
Dual Diagnosis Treatment in Opioid Rehab
As mentioned, opioid use is usually begun as a solution to a problem. Sometimes the problem is pain. But many times, the problem is a mental health issue that seems to be relieved with the use of opioids. A person suffering from a mental health disorder and an OUD at the same time is said to have a dual diagnosis and the two disorders need to be treated at the same time.
Many facilities do not offer dual diagnosis treatment. Consequently, many people in dual diagnosis treatment bounce around from facility to facility treating first one disorder and then the other, while the primary problem gets worse again.
Treatment Therapies
During your treatment program, you will engage in addiction therapies. The most effective therapy for opioid addiction is behavioral therapy. The most commonly used therapies are:
- Cognitive-Behavioral Therapy – CBT has been found to be effective in helping to recognize how your faulty thinking has caused your negative behavior. CBT is also effective for preventing relapse.
- Dialectical Behavior Therapy – DBT is a form of CBT but focuses more on emotional responses and building relationships.
- Family Therapy – When one member of a family has an addiction, it affects the whole family. As a result, it’s important to address family relationships with family members.
- Holistic Therapy – Holistic therapy provides experiences that treat the whole person – mind, body, and spirit.
Opioid Addiction Treatment in Maine
If you or a loved one need help with opioid addiction, you can find opioid rehab or opiate rehab at Casco Bay Recovery. We are a state-of-the-art facility located in Portland, Maine, and can provide you with several levels of care including dual diagnosis treatment.
Our team of addiction treatment specialists is intensely driven about helping individuals break free from addiction. Contact us today. Let’s talk about how we can help.
References:
https://www.hopkinsmedicine.org/opioids/what-are-opioids.html