Making Sense of the Scary Opioid Epidemic in America

There’s so much talk currently on the opioid epidemic in the United States. As a consequence, opioids have become so demonized that you may even think they are practically useless. They do have their usefulness. But at what cost? These substances – more precisely, their abuse – have brought sorrow to not a few families.

What are opioids? Why do you need to exercise caution when using them, if you have to? We will be discussing these and other things you need to know about abuse and addiction as well as treatment.

What Are Opioids?

Opioids are described as compounds that produce similar effects as morphine on opioid receptors. These receptors mediate the substances’ somatic and psychoactive effects. They are mostly present in the central and peripheral nervous system as well as the gastrointestinal tract.

You tend to hear more about opioids when talking about painkillers. They are arguably more popular for management of pain, particularly the chronic type. You are more likely to get them for pain sensations that other painkillers can’t handle effectively well.

Other medical uses of opioids include control of diarrhea and opioid induced constipation. This type of drugs is also somewhat strangely used for treating opioid overdose and opioid use disorder. Doctors may also use them to prevent withdrawal symptoms.

It is common for the terms “opioid” and “opiate” to be used interchangeably. But they are somewhat different, technically. Opiates are drugs that are naturally derived from the opium poppy. On the other hand, opioids include synthetic and semi-synthetic substances. You may consider opiates, including morphine, a subgroup of opioids, according to Encyclopedia of Molecular Pharmacology.

Examples of opioid drugs available include:

Oxycodone (OxyContin, Percocet)
Hydrocodone (Vicodin, Lortab)
Codeine
Fentanyl

Opioid Epidemic in America

Opioids are among the group of painkillers that carries the highest risk of addiction. This explains why there is so much talk about abuse in the United States, where the degree of the problem has reached epidemic level. These substances constitute one of the biggest drug challenges in the country today.

The opioid epidemic or crisis refers to the rapid rise in the use of both prescription and non-prescription opioid-based medications in America and Canada. It is thought that the crisis actually started in the 1990s. About a third of the people in the U.S. reportedly had chronic pain issues at the time. This led to greater push for more liberal use of opioids for dealing with these problems.

While rising opioid abuse is a global phenomenon, America is where it is excessively common. Some estimate has it that the U.S. consumes roughly 80 percent of global supply of opioids by pharmaceutical companies. That’s huge! This is undoubtedly because the country is the largest market for many of the pharmaceuticals.

As one would expect, opioid abuse has led to other problems. The most troubling of these, perhaps, is the loss of loved ones. Deaths from drug overdose have risen drastically, with some 64,000 losing their life as a result in 2016. It killed more Americans in a single year than both the Vietnam and Iraq wars combined. Almost half of these deaths were due to prescription opioids.

How Addiction Develops

Narcotic or opioid painkillers somehow find their way to many people despite the fact that they are available strictly on prescription. Their potency for dealing with pain makes them highly preferred. Some also assume that because these drugs come from a doctor they can be used safely to the extent of even ignoring instructions.

Now, the risk of addiction is not entirely out of the question when you use opioids according to your doctor’s advice, let alone when you don’t. You may find that you require greater amount to achieve the effects you had in the past. Tolerance develops and transitions to dependence, in which case you don’t feel your best without taking these drugs. And when addiction sets in, you may never be able to break free unassisted.

People do not always use opioids strictly for medical purposes; they also use them as recreational drugs. They are much like other substances of abuse that produce euphoric effects. Opioids impede the release of the brain chemical known as GABA by binding to receptors. This causes dopamine levels to surge and give the “high” feeling. There is hardly a faster way to addiction than these.

Also, people who are on prescription opioids are thought more likely to become addicted to heroin. Annual prescriptions jumped from 76 million in 1991 to 219 million in 2011. But a dramatic rise in the use of heroin was also observed despite this increase. The latter drug offers a cheaper, more powerful alternative to prescription opioids for many.

Some experts say there is still no change in reported pain cases despite the surge in availability and usage of opioids for this purpose.

How Opioid Abuse Impacts on Families

The abuse of these substances affects families terribly. Opioid abuse can make you lose your loved ones, even when they may not necessarily be dead. It puts significant strain on relationships between spouses, siblings and friends.

If someone was trustworthy before starting to abuse opioids, do not expect them to remain so once they have started. They tend to not pay attention to important matters and could lose their jobs as a result of the side effects.

You may be shocked at what an abuser can do. Such a person may start to do things you do won’t ordinarily expect them to. They start to tell lie and there is possibility of them starting to steal to get opioids for use.

It is clear to see why there is usually friction between an opioid abuser and their loved ones. Family members will not be pleased to see the person bringing shame on them. But the scariest of all is the higher risk of mortality.

According to the Wall Street Journal, the opioid epidemic has left thousands of children in sudden need of foster care after losing their parents. The newer synthetic opioid Fentanyl is particularly more deadly. It’s up to 50 times more powerful than heroin. You can overdose merely by touching or inhaling it.

Short-Term Effects of Opioid Abuse

The high you feel from excessive use of opioids is among their short-term effects. Degree of this feeling depends on method administration, whether injected, snorted or swallowed. It only lasts for a while before going away.

Constipation – This is a common short-term side effect of opioid use or abuse. Research suggests that it affects as much as 90 percent of patients. Possible complications from constipation include hemorrhoids and bowel construction.

More pain – You may find this rather unbelievable, but opioids may actually intensify pain sensation in some persons. It is not clear why this happens, but it does.

Other short-term effects include:

Nausea
Vomiting
Diarrhea
Slowed breathing
Delayed reaction
Drowsiness
Loss of consciousness
Confusion
Isolation

Long-term Side Effects of Opioid Abuse

Some doctors are more likely to place more emphasis on the above short-term side effects. But as disturbing as these may be, the long-term side effects are scarier. They include:

Weakened immune system – It is not exactly an easy thing to boost your immune system functioning. You therefore do not want anything to weaken it. But that is what opioids can do. Experts say your body’s ability to get rid of infections drops immediately after using the substances.

Infections – People who use opioids, especially those who inject them, are more likely to contract certain infections. This can happen if they got carried away and started sharing needles or injecting under poor conditions. The startling surge in the cases of HIV witnessed in some parts of Indiana in 2015 was an example.

Hormonal imbalance – Researchers have observed that opioid drugs throw your hormone levels out of balance. They commonly affect levels of sex hormones such as testosterone and estrogen. Testosterone levels especially feel the impact more. In a study, it was found that the use of opioid painkillers for just 30 days caused T levels to drop. Hormonal imbalance leads to other issues such as:

Erectile dysfunction
Menstrual irregularities
Reduced libido
Joint deterioration
Infertility

Depression – Research shows that depression is a possible long-term side effect from the use of opioids. Around 1 of every 10 patients is thought to have this problem.

Furthermore, opioid injections can cause long-term damage to the cardiovascular system. They increase the likelihood of suffering a heart attack.

One can understand from the foregoing why a high number of deaths are linked to these addictive substances.

Treatment for Opioid Abuse and Addiction

You have to move very fast and get help if you are having opioid abuse issues. Treatment for abuse typically starts with some questions, including on duration of abuse. These will help to set the tone for the treatment.

There are two main approaches to getting over opioid dependence, namely: medical and behavioral. The medical options include:

Methadone – Doctors often use this to make the process of weaning off abusers from opioid use easier. They have been employing this drug since the 1960s, so it’s quite popular. Interestingly, methadone is also an opioid drug, a synthetic one. It binds to opioid receptors in the brain and spinal cord and activates them to reduce withdrawal symptoms.

Methadone is strictly regulated and requires daily visit to the clinic to get your dose. It is commonly used as part of rehabilitation programs.

Buprenorphine – This drug serves similar purpose as methadone. Its level of regulation is not as strict as that of methadone. Some also claim that it is safer. It is possible to get buprenorphine prescribed or dispensed to you by your doctor. It helps to control opioid withdrawal symptoms and cravings.

Naloxone – Sometimes used alongside buprenorphine or another drug, naloxone is an opioid antagonist for dealing with cases of overdose. It displaces the substance of abuse in the receptors, making it less likely to produce unpleasant effects.

Behavioral therapy is also employed along with these medications. This improves efficacy of both. Options include individual or group therapy, 12-step programs and residential treatment centers. Counseling is an integral part of the rehabilitation process.

Opioids are too dangerous to handle without due consideration. It is not advisable to see them in the same light as regular painkillers. Medical professionals advise that they should be considered as option of last resort when other alternatives, including non-steroidal anti-inflammatory drugs (NSAIDs), have failed.

You put yourself at great risk of addiction, along with medical complications, when you misuse these opioids. So, watch it and don’t be another victim.

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REFERENCES

Opioid epidemic - Wikipedia (https://en.wikipedia.org/wiki/Opioid_epidemic)

Painkiller Effects | Short Term, Long Term & Side Effects (https://drugabuse.com/library/the-effects-of-painkiller-use)

The Down Side and Side Effects of Painkillers – Health Essentials from Cleveland Clinic (https://health.clevelandclinic.org/2013/07/the-down-side-and-side-effects-of-painkillers/)

Opiate Abuse Symptoms, Signs and Addiction Treatment (https://drugabuse.com/library/opiate-abuse/)

Opioid - Wikipedia (https://en.wikipedia.org/wiki/Opioid)

Painkillers and hormones | Dr. Marc Darrow is a Stem Cell, PRP, Prolotherapy Expert in Los Angeles. (http://www.stemcellinstitute.com/painkillers-and-hormones/)

Drug Use Hurts Families | Easy to Read Drug Facts (https://easyread.drugabuse.gov/content/drug-use-hurts-families)