Of all the substances that are used and taken in the United States every year, opiates are amongst the most addictive, with millions of prescriptions being written and filled every year.
The strength and nature of the substance mean that many people will become addicted or develop a reliance on opiates simply by taking a dose that has been prescribed and approved by a doctor.
Prescription opioid misuse is a growing problem and one that shows no signs of slowing down. Battling opiate addiction and breaking the cycle of abuse can be tough, and having all the facts at hand can help individuals to understand the journey that they are facing.
What Are Opiates?
The term opiates refer to a controlled prescription substance that is derived from a chemical known as opium, and this is naturally occurring in poppy plants and, in particular, the seeds.
Opiates have a number of legitimate medical uses and are often used clinically by professionals to treat pain in patients that range from mild to severe. Opiates have a naturally calming effect, and this can make them more prone to abuse and, in many cases, addiction.
According to experts at the National Institute on Drug Abuse, almost 50,000 people across the United States died from the effects of opioid-involved overdoses in 2019 alone – and this is a problem that appears to be escalating in scale.
For many individuals, an addiction to opioids will begin following a prescription from a medical professional for pain, usually following some type of injury or accident.
To help alleviate pain, painkillers are given in a specific, controlled dose, and the majority of patients will start taking the medication in good faith, with zero intention of developing an addiction down the line.
Over time, however, a person will typically build up an increased tolerance to the medication that they have been prescribed – this is extremely common with prescription opioid pain relievers. This means that the substance in question has started to build up within the body, and the patient will start to feel that the drug is less effective.
As a result, they will increase their dosage, often way past the recommended amount, simply to attempt to achieve the effects and benefits that were initially offered – in many cases, pain relief.
Continually increasing the dose consumed will eventually result in a physical dependence on the drug – the patient will need to continue to take opiates in an attempt to feel “normal”, or return to daily life.
This, in turn, will lead to cravings, and a desire to continue to use and take the drug at any cost – and despite any negative effects or consequences that may be becoming apparent.
Left unchecked, the drug-taking behavior will spiral completely out of control, causing serious damage to psychological and physical health, and having a devastating impact on daily life.
By this point, the patient is in the throes of addiction, and this is more than a strong desire to take and use the drugs in question – addiction is a serious neurological condition that can leave the victim feeling totally hopeless and out of control.
What Are The Two Categories Of Opiates?
It is important to note that not all opiates are the same; they will be prescribed for a very wide range of medical needs, and so come in a range of types. Broadly speaking, opiates will be classified into one of two categories: antagonists and agonists.
Antagonists are generally considered to be less addictive in nature than agonists, though it is important to state that there is still a potential for abuse and addiction.
In many cases, antagonists will be prescribed to help an addict manage the detoxification process, and they will usually form the first stage of supervised treatments for an opioid addiction.
Agonists, on the other hand, are designed to mimic the effects of endorphins that occur naturally in the brain. They react with specific, targeted receptor sites located in the brain to produce an opiate effect, leaving users feeling calm and relaxed, and helping with pain relief.
As agonists are most commonly found and used in a range of medical settings, the effects can be very strong, and most of the substances that are classed as agonists come with an extremely high potential for addiction and abuse.
Common examples of these include Hydrocodone Oxycodone Heroin, Morphine Fentanyl, and Buprenorphine.
What Are The Main Types Of Opiates?
There are a number of opiates that tend to feature prominently in stories of addiction and abuse, and the names of these will be familiar to many of us. Some of the most common types of opiates include:
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Codeine
Codeine was originally designed to offer relief for coughing and mild pain and is considered to be less potent when compared to other opioid painkillers. It is only available with a prescription in its pure form but also appears in various forms in a number of medications that are available over the counter.
Codeine is most commonly abused by young adults, with a recent trend seeing the substance combined with sugary drinks, in an effort to create a mixture that was commonly known as “Sizzurp” or “Purple Rain”. Long-term use can result in dependence and addiction.
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Darvocet/Darvon
Darvocet, also known as Darvon, was a propoxyphene-based painkiller, designed to treat and target pain. The addictive nature of the substance resulted in thousands of deaths and hospitalizations during the peak of use, and prescriptions for Darvocet or Darvon are no longer written.
Despite this ban, there is still a thriving black market that trades the substances. This is a highly addictive opioid and can cause serious illness and a high risk of fatality.
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Demerol
Demerol, the brand name for Meperidine, was once a hugely popular option for helping to alleviate moderate to severe pain in patients, but its popularity amongst medics and prescribers has faded in recent years thanks to the highly addictive nature of the substance.
Meperidine is known to produce effects and feelings of euphoria in a similar manner to morphine, and so has a high chance of being abused by patients.
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Dilaudid
Often referred to as hospital-grade heroin, Dilaudid has a place as an extremely powerful form of painkiller, but it must be administered under supervision, and the patient watched closely for any signs of ill effect.
The nature of the extended-release tablets allows patients to receive a dose over an extended period of time, and this can result in abuse and addiction. Dilaudid abuse has the potential to be fatal, resulting in serious breathing problems which can result in death very quickly.
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Fentanyl
Fentanyl is another highly addictive drug that has become more common and prevalent on the streets, but this synthetic painkiller was designed to be prescribed only in cases of severe, acute pain, as it is up to one hundred times more powerful than Morphine.
If Fentanyl is combined with other strong painkillers such as heroin, overdose is extremely likely, and death is common – this can be a real issue with street drugs, which tend to be cut with a number of substances.
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Hydrocodone
Another well-known name in the world of opioid drugs, Hydrocodone is the central ingredient in a number of very powerful painkillers and is a key element in medications such as Vicodin.
In most cases, Hydrocodone will be mixed with Ibuprofen or Acetaminophen to reduce the effects, but pure Hydrocodone medications have also been approved by the FDA, and these can be dangerous if abused.
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Methadone
Methadone is perhaps more commonly known for its role in treating addiction cravings in those who are suffering from an addiction to substances such as heroin.
Despite this use, Methadone itself can also be used to treat moderate to severe pain, and is a very addictive substance – this means that prescriptions and treatments are carefully monitored, and doses set by doctors and other professionals who are experienced in treating and managing addiction.
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Morphine
Morphine is amongst the best known of all opioid drugs and plays a key role in helping to alleviate serious, chronic pain from victims of accidents or injuries.
It also holds a record as being one of the most addictive substances that we know of and is repeatedly responsible for a huge number of unintentional drug-related fatalities across the country each year.
Morphine addiction typically occurs following a patient being involved in a serious accident or injury, and experiencing huge amounts of pain – it is easy for the body to build up a tolerance, resulting in the patient craving a higher dose to offer the same pain-relieving effects.
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Oxycodone
Oxycodone is a painkiller that is typically sold under a number of familiar brand names including Percocet and OxyContin. It has a very high potential for abuse and is a common factor in many cases involving addiction to opiates.
What Are The Symptoms Of Opioid Addiction?
Also known as substance abuse, the symptoms, signs, and indications of an opioid addiction may be psychological, behavioral, or physical.
It can be hard for a patient or individual to accept or admit that there is an issue, but one of the most common signs that things are slipping out of control is when an individual finds themselves unable to stop taking the opioids, or if they are unable to stop taking more than the dose that has been prescribed to them by their doctor.
This is a sign that their tolerance to the drug has increased, resulting in a higher dose being required to achieve the same effects.
Some clear symptoms and indications of opioid abuse may also be:
- Physical agitation, especially if the opioids are not readily available
- Mood swings
- Irritability
- Reduced motivation for daily life
- Depression
- A slow or shallow breathing rate
- Poor decision-making
- Abandoning responsibility
Doctors and other medical professionals will use a medical assessment to determine whether an individual is suffering from opioid use disorders. Testing for mental health disorders will also usually take place at this stage.
Can Opiate Addiction Be Avoided?
In most cases, many patients will be able to take and use opiates and opioids safely for a specific, prescribed use, and not suffer long-term addiction.
It is important to remember, however, that this potential is always there, and that your risk will be increased if you are using opioids to manage long-term pain.
As a rule, opioid medications should not be taken for more than a week at a time – according to experts, using opiates for over a month at a time increases your risk of dependency, and can set you on the pathway to addiction.
What Treatments Are Available For Opioid Addiction?
While addiction is extremely unpleasant, dangerous, and distressing, it is important to stress that it does not have to be the end of the road – there are a number of treatments and solutions that can help.
It is also important to remember that an addiction to opioids and opioid abuse is a chronic illness, and so will need to be treated and managed in the same way that any other long-term chronic illness would be, with ongoing monitoring and management by your chosen medical professional.
A good place to start is by visiting your family doctor – they will have the experience and training to help ensure that you are given the help and support that you need to take the first steps towards recovery, and will be sympathetic and understanding.
Drug counselors and treatment centers can also be an option, but it is a good idea to speak to someone who knows and understands you personally, as well as your medical history, to ensure that you are constantly supported.
Remember, addiction is an illness, and there is no shame in seeking help. There is no need to worry about shame or judgment – all medical professionals will be focused on helping to ensure that you are set on the path that will help you to recover.
Treatment for an opiate addiction will look different for each person, but the end goal is always the same: to help you stop taking the opioid or drug, and to help avoid your use of it in the future.
Withdrawal Symptoms
When you first stop taking opioids, you should expect your body to react in a process that is known as withdrawal. Symptoms may include high levels of anxiety, as well as nausea.
Remember, your body has come to rely on you taking this drug in order to function and feel normal, and so will have a strong reaction when this substance is taken away. Some of the most common symptoms of opiate withdrawal include:
- Anxiety
- Insomnia
- Restlessness
- Goosebumps
- Runny nose
- Body aches
- Yawning
- Vomiting or feelings of nausea
- Watery eyes
- Excessive sweating
- Widened (dilated) pupils
- Diarrhea
- Belly cramps
- Shaking
- Rapid breathing
- Fever
- High blood pressure
- Increased heart rate
- Seizures
- Hallucinations
Most withdrawal symptoms will start to appear around 12 hours after the last time that you take the drug, and the intensity and severity of your symptoms will depend on how long you have been taking the drug, how long the drug is designed to stay in the system, and your general overall health.
Withdrawal symptoms can last for between a few days and around two weeks and tend to be worse in the early stages.
It is also likely that your withdrawal symptoms will be more severe if you were given a drug to reverse the effects of opioid overdose – this tends to bring symptoms on more quickly, and more severely.
Issues with higher blood pressure and an increased heart rate may also occur alongside this, so it is important that you are properly monitored by a medical professional.
You will have two options when withdrawing from opiates: you can go “cold turkey”, which is when you stop taking opiates and all other drugs, and simply force your body to ride out the process, or you can opt for a medication-assisted treatment – this is when other drugs are prescribed by doctors to help wean you off opiates more gradually.
This is usually recommended, especially for long-term users, as it can reduce the risk of your body reacting badly or going into shock.
With a drug-assisted withdrawal, there are a number of medications and drugs that your doctor may prescribe – these will be intended to alleviate the severity of any withdrawal symptoms, and can also help you to manage and suppress your cravings, reducing the risk that you will want to take more of the drug.
The three main options are methadone – which is commonly used in heroin addiction – buprenorphine and naltrexone.
Both buprenorphine and methadone are both designed to target the same centers in the brain as those that are targeted by opioids, and so can help to reduce the severity of withdrawal symptoms.
The key difference is that these substances will not offer the “high”, relaxation, or buzz that many users seek to gain from their drug consumption. Instead, the focus is on helping your brain to balance and heal, reducing its dependence on opiates in order to function normally.
The length of time that buprenorphine and methadone may be prescribed for will vary from patient to patient – the National Institutes of Health has confirmed that they are safe to take for a lifetime without adverse effects.
It is crucial that if you are prescribed these substances, you do not quit them without first talking to your doctor – this puts you at a higher risk of going back to abusing opioids.
You may also be prescribed naltrexone, and this is designed to prevent the risk of relapse, rather than working as an aid to stop you from taking the drug.
Rather than helping to reduce or eliminate cravings and withdrawal symptoms, naltrexone instead blocks you from feeling the high that you would normally enjoy when you take your chosen option – this cuts off the pleasure aspect of the drug-taking and can help to make it less appealing for your brain.
In addition to the drugs described above, your doctor is also likely to recommend that you seek psychological and emotional treatment, as addiction is more than merely physical. There are a number of behavioral treatments available, including cognitive therapy, counseling, and group or family therapy.
These sessions will help you to manage symptoms of depression and anxiety, and can also help you build tactics and toolkits for handling cravings and avoiding opiates, as well as exploring your reasons and motivations for becoming addicted.
In many cases, these sessions can also help to rebuild and repair damaged family relationships, which are sadly an all-too-common side effect of opiate and other drug addictions.
Your doctor or treatment provider will be able to recommend and refer to the best emotional and psychological treatments available for you, so speak to them as part of your recovery plan to hear their thoughts and get their advice.
Final Thoughts
Opiate addiction can be painful, destructive, and dangerous – but it can also be treated, and there is plenty of help and support available to help you beat your addiction, and come out the other side.
Taking that first step and accessing this support, however, is entirely in your hands – you have to be the one to make that all-important first move.
By having a better understanding of the causes and motivations behind addiction, experts have been able to ascertain a better understanding of the nature of addiction, as well as the underlying science of addictive substances.
This research has directly helped to inform the range of treatment plans available, and helps experts to provide the treatment that you need to kick substance use disorders for good, allowing you the chance to enjoy long-term recovery, health, and happiness.
No matter how tough things seem it is never too late to make a change and fix your life – if you think that you are suffering from an opiate addiction, don’t be afraid to contact your doctor today, and take that all-important first step to recovery.