Opiate Addiction / Opioid Abuse

Opiates are essentially considered to be any of the numerous narcotic opioid alkaloids found naturally in the opium poppy (Papaver somniferum). The type of opiates consumed by individuals are many and have a variety of names you may have heard, to include codeine, hydromorphone, fentanyl, morphine, oxycodone, methadone, heroin, etc. All these opiates are prescription medications with the exception of heroin. The opiate narcotics used by human beings are often incredibly powerful and therefore addiction and loss of independence are always risks.

You may also have heard of something called an Opioid, but it is important to note that there is a distinction between the meaning of the words opiate and opioid.  Opiate is a word often used synonymously with the term opioid, but all opiates are limited to the naturally occurring alkaloids found in opium poppy plant resin.  Opioid, however, refers to a drug class which includes all opiates, all synthetic and semi-synthetic substances derived from opium, and opioid peptides (ex., endorphins).

Opioids are easily one of the world’s oldest known drugs. We believe the opium poppy has been used therapeutically since Neolithic times, and literally predates recorded history.

Here are some other important definitions:

Opiate Abuse: A patterned use of an opiate in which the user consumes the substance in inappropriately large amounts or with methods that are harmful to themselves or others. In addition, use of these drugs may lead to criminal penalties and possible physical, social, and psychological harm.

Opiate Tolerance: A common occurrence in individuals taking high doses of opiates for an extended period of time. It is characterized by the need to take more and more of the substance to feel the desired effects.

Opiate Dependence: When tolerance has been built and cessation of opiates leads to withdrawal symptoms the individual is considered opiate dependent.

Opiate Addiction: When tolerance has been built and dependence has formed, and the individual continues to take the drug despite personal harm and consequences. Opiate dependence and opiate addiction are generally considered to be the same thing.

FACT: In 2012, there were 156,000 persons aged 12 or older who used heroin for the first time within the past year.

FACT: In the US alone, over two million people are addicted to prescription opiates.

Heroin is an illegal opiate-based drug that has become more and more prevalent in the United States. It is quite addictive and understandably so, given that it is a derivative of morphine. While it is available on the street in different formats, it is most often sold as a white or brown-ish powder and ‘cut’ with substances like starch or sugar, quinine, or powdered milk.

Heroin is without a doubt extremely dangerous, but how many people use it, are dependent on it, and how many are new to it? Thanks to SAMHSA we have some pretty good figures…

SOURCE: SAMHSA, Center for Behavioral Health Statistics and Quantity, National Survey on Drug Use and Health, 2002-2004, 2005-2010 and 2011 (revised March 2012).

Opiates inhibit the pain signals that originate in the brain. If the pain signals of your brain are blocked it causes an individual to experience very little pain or even no pain sensations at all. When pain signals are blocked by opiates and opioids and the chemicals within your brain are altered it can produce euphoric sensations. Most people find these sensations quite pleasurable which is exactly what leads to opiate abuse, the building of opiate tolerance, and the very real possibility of dependence and addiction.

An area of the brain located in the midbrain called the VTA (Ventral Tegmental Area) contains neurons, brain cells, and chemical binding sites known as receptors. When an opiate reaches this part of the brain it attaches to receptors normally reserved for naturally occurring opiates in the brain (endorphins).

After this occurs a specific neurotransmitter (chemical signal in the brain that allows neurons to communicate), dopamine, floods the VTA and pleasure is experienced in the user. In addition to pleasure, a sense of physical, emotional, and mental well-being is experienced. This is why many addicted individuals also have associated (and frequently undiagnosed) mental health problems. They are using the drugs to alleviate their symptoms whether it is depression or anxiety. The reasons opiates work on the brain this way is because they imitate the naturally occurring endorphins.

Clearly there are many behavioral changes that opiate users can go through. However, some are strong indicators that opiate user is in a state of abuse or addiction. The outward appearance of opiate abuse or addiction can be different from user to user, but here are some key things to look for in opiate users that generally indicate.

Common symptoms of opiate abuse:

Common signs of opiate addiction:

The World Health Organization has also made some critical observations we should mention, namely that opiate addiction is often characterized by increased drug-seeking, or ‘doctor shopping’. They also state that the drug-seeking behavior of the opiate user is especially focused on obtaining drugs for their mood-altering effects — not their pain-relieving effects.

There can be no doubt that opiate addiction affects the social life, the psychological and mental well-being, and the physical health of a user. If you believe that you or someone you care for exhibits some of the key symptoms or behaviors listed above, please reach us for help.

Opiate abuse and addiction in the short or medium-term are clearly dangerous. The prospect of drug overdose is always present, and the poor judgment that so often accompanies opiate addiction and abuse can lead to problematic circumstances that jeopardize life and limb. However, living with an opiate addiction for a long period of time can truly devastate the body and mind, even if it does not claim the life of the user. The detrimental effects of extended opiate use can be present long after the cessation of opiates, and long-term opiate addiction and abuse can easily cause permanent damage.

Long-term opiate use wreaks havoc on the brain because large quantities of dopamine are released over time. Our brains were simply not built to handle the extreme levels of dopamine production associated with long-term opiate use! Brain circuits can literally get rewired, sadness and depression can result, and a wide variety of mental impairments could also be experienced. Also, it can take as long as a full year for the brain to begin naturally creating endorphins again.

Long-term opiate use can introduce yet other physical problems. Chronic constipation, infertility, and the loss of sex drive are common. In women, long-term effects may also include irregular menstrual cycles. Irregular hormone levels are to be expected from long-term use of opiates.

Those who take a lot of opiate-based prescription pain medications over time face another real threat – liver damage. Some pain medicines contain acetaminophen (Tylenol), and if enough is taken a opiate user’s liver can literally shut down. Recovery would require a liver transplant. Serious heart damage can also happen to long-term I.V. prescription drug users.

The way that opiates are administered is another important risk factor to consider. For example, heroin users who inject the drug have a much higher likelihood of being exposed to certain infectious diseases like HIV and Hepatitis. They are also at risk of forming abscesses or experiencing vein collapse. Those who “snort” opiates may not realize that, over time, the cells of their nasal passages are literally dying off.

All of these routes allow opiates to get to the brain quicker making the high more intense but shorter. This makes users more dependent on them. Ultimately, this can make withdrawal symptoms much more difficult.

Opiate addiction is a very serious thing and can’t be put off to the next day, or the next day, or perhaps that next will be the last.