According to the Centers for Disease Control and Prevention (CDC), opiate abuse has reached epidemic proportions in the US – they report that 44 people die of opiate overdose every day. A major contributor to this epidemic is an increase in abuse of prescription painkillers, such as Vicodin and OxyContin, as well as continued availability and use of the illicit drug, heroin.
When taken as prescribed, opiate drugs are safe, effective medications that can help people manage pain. However, misuse of opiate drugs can quickly lead to abuse and addiction. Nevertheless, treatment for opiate abuse is available, and recovery is possible through comprehensive substance abuse treatment and rehab.
Overview of Opiate Drugs
All opiate drugs – including controlled prescription painkillers and the illicit drug heroin – originate from a substance in the seeds of the opium poppy. According to the National Institute on Drug Abuse (NIDA), these opiate compounds interact with certain receptors in the brain and body, creating a sensation that diminishes a person’s ability to feel pain, which is the main reason for the use of the substance as medicine.
Some newer opiate drugs are synthetic or semi-synthetic versions of opiate compounds, meaning that they are at least partly created in a lab rather than extracted from poppy seeds. Heroin is a semi-synthetic opiate created solely for abuse. Many of these drugs, however, were created as medicines that are helpful in managing different types of pain under various circumstances.
Some of the more well-known prescription or medically appropriate opiates include:
Fully synthetic opiates:
Intended Use of Opiates
The receptors that opiates act on are part of the body’s natural pain relief system. When opiates are introduced to this system, they bond powerfully with the receptors, helping to increase the dulling of pain to a higher level than the body can naturally achieve.
For this reason, accepted uses of legal opiates center mostly around controlling pain during surgery, after injury, and with illness or injury. Opium poppies were originally used for pain control thousands of years ago.
That being said, as described by the News Medical website, these drugs can also be prescribed for other purposes, including:
Because of their high abuse potential, opiates are defined by the U.S. Drug Enforcement Agency as narcotics, and they are tightly controlled even when prescribed legally. Nevertheless, people who misuse the drugs can become tolerant to the effects – meaning that as time goes on, they need to take more of the drug to get the same effects – and develop a substance use disorder.
- Prevalence of Abuse
There is some debate as to how likely a person is to abuse prescription opiates. An article from the journal Neuron discusses studies indicating that 2-6 percent of people who are treated for pain using opiates actually begin to abuse the drug. This indicates that the abuse potential is lower when the substance is used as directed. The article also indicates that the majority of people who abuse opiate drugs – about 70 percent – do not get them via prescription.
Nevertheless, about 20 percent people who are prescribed the drugs begin to abuse them. Also, according to the National Survey on Drug Use and Health, 4.3 million people 12 and older were using prescription pain relievers for nonmedical reasons in 2014. This figure includes 1.9 percent of adolescents abusing prescription painkillers.
According to the CDC, the following elements may contribute to a high risk of opiate abuse:
- Previous diagnosis of a substance use disorder
- Family history of substance abuse or mental illness
- Long-term or high-dose use of prescription opiates
- Inappropriate prescribing practices, including overlapping or multiple prescriptions
- Rural, low-income living situations
One of the major issues of the current opiate use epidemic is that those who start abusing prescription opiates are more likely to begin abusing heroin as well. Responsible prescribing practices by doctors can help to lower the risk of opiate abuse and addiction, thereby helping to prevent crossover into heroin abuse.
- Signs and Symptoms of Opiate Abuse
If opiate abuse is suspected, there are some physical symptoms that may be apparent, as described by WebMD:
- Mental confusion or forgetfulness
- Shallow or slow breathing
- Slurred speech
- Small pupils in the eye
- Nausea and vomiting
If the person is unconscious with extremely shallow breathing, an overdose may have occurred, and emergency help should be sought. Opiate overdose can result in death.
According to the Substance Abuse and Mental Health Services Administration, a person who is struggling with an opiate use disorder may exhibit various behaviors and signs, such as:
- Strong desire and cravings for opiate drugs
- Giving up other activities to focus on seeking or using opiate drugs
- Inability to keep up with school, work, or home responsibilities due to drug use
- Problems in relationships based on opiate use
- Inability to stop using the substance despite continued problems caused by use
A person who is abusing prescription painkillers may also be refilling a prescription more often than needed, stealing or buying pills from relatives, or hiding pills. If several of these symptoms and signs are observed, it may be time to seek treatment for a substance use disorder.
Treatment Options for Opiate Abuse
There are many options for treating opiate abuse or addiction. Outpatient and inpatient programs exist to help people stop use, learn how to manage the cravings and triggers that lead to continued abuse, and maintain recovery from opiate abuse.
An article from the journal Addiction indicates that consistent, long-term treatments for opiate dependence are more likely to result in positive outcomes. According to experts, this kind of treatment includes a full spectrum of care services that meet the individual’s particular needs, including:
- Medically supported detox and withdrawal from the opiate drug
- Medical maintenance of abstinence from the drug, if necessary
- Therapy to promote positive changes in thoughts and behaviors regarding opiate abuse
- Management of any underlying or co-occurring mental health disorders
- Group and family therapy to build a supportive network
- Education about opiate abuse and addiction
- Motivational support and aftercare services after treatment
This kind of treatment is most easily found in a comprehensive, research-based inpatient rehab program. Through this type of program, a person dealing with opiate addiction or abuse can receive an individualized treatment plan that provides the specific treatment types most likely to result in the person’s ability to recover from, manage, and avoid relapse to opiate drug abuse.
In addition, this type of treatment is more likely to result in the positive changes needed to prevent prescription opiate abuse from leading to complications, such as overdose or future heroin use and abuse. Getting in touch with a reputable treatment center can be the first step in stopping opiate use and getting control over the challenges and risks of abusing these drugs.