Opioids

Opioids have been both a miracle and a curse for modern man. They provide fast, profound relief from pain but also the possibility for dependence and abuse. A recent report from the CDC finds that opioids have caused more deaths than cocaine and heroin combined.

Opioids describe an entire family of related drugs that are primarily used to treat pain. Some drugs of abuse, such as heroin are technically considered opioids, however those are discussed separately because of their differences.

Perhaps the most widely known opioid is morphine, but there are dozens of others in use today, including:

  • Oxycodone
    • Percocet (Oxycodone plus Acetaminophen)
    • Percodan (Oxycodone plus Aspirin)
    • Oxycontin (Controlled-release Oxycodone)
  • Fentanyl
  • Codeine
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Propoxyphene (Darvon)
  • Methadone

Short Term Effects

Physicians use opioids to relieve pain. These drugs bind to receptors in the brain and spinal cord that normally transmit or process information about pain. Opioids block these signals and change how one experiences pain.

Unfortunately, this is not their only effect. Opioids also cause pleasurable sensations and euphoria, which makes them very easy to abuse.

The intensity of the euphoria is dependent on the type of opioid used and the route in which it is administered. For example, a relatively small dose of morphine injected directly into a vein might cause strongly pleasurable sensations while high dose methadone taken orally may not cause a “high” at all.

Short Term Damage

There are few problems that occur with prescribed opioid use over the short term. Many people can take oral opioids after a dental procedure or surgery and have no ill effects.

Opioids slow down the speed at which the gastrointestinal tract moves, so even short term treatment may cause nausea, vomiting, and constipation. The primary short term issue that occurs from opioid abuse is overdose (described below).

Long Term Damage

Long term users of opioids will experience both tolerance and dependence.

Tolerance is the state in which higher doses of a drug are needed to create the same effect. In other words, the same dose is no longer enough, so the abuser needs more to get “high.”

Physical dependence, on the other hand, is when the body develops a “need” for the drug. In someone that is physically dependent of opioids will have withdrawal symptoms when they do not have access to the drug.

For opioids, withdrawal symptoms include:

  • Restlessness
  • Craving
  • Aches and pains
  • Trouble sleeping
  • Diarrhea
  • Goose bumps (hence the name “cold turkey”)
  • Tremors

Overdose

An overdose of opioids can be fatal.  Opioids

These drugs depress the region in the brainstem that controls breathing. Very high doses of opioids can essentially shut off the automatic drive to breathe.

At these levels, there is also a loss of consciousness. Someone that takes a large dose of opioids will fade out of consciousness and then lose the drive to breathe, leading to suffocation and death.

Symptoms and Signs of Abuse

Someone that is actively intoxicated with opioids will appear drowsy, detached, or sleepy. They may appear to be breathing unusually slowly.

Unfortunately early abusers can mask most signs of abuse with other day to day activities, making detection difficult.

One sign of opioid abuse is possession of pain prescriptions from multiple doctors. Individual doctors usually keep very close track of the total amount of opioids prescribed to any one patient.

Opioid abusers travel between doctors’ offices and emergency departments in search of new prescriptions.

If abusers purchase their opioids from street dealers, detection is more difficult. Pills of different colors, shapes, and sizes found in the same container are a strong clue.

It is much more likely to discover an opioid abuser during a period of withdrawal. They will irritable, restless, and appear sick (“dope sick”).

Adverse Interactions

Even people taking opioids for medicinal purposes and with a prescription should not mix opioids with other drugs that affect the central nervous system unless directed by a physician.

Drugs that interact with opioids with severe consequences (respiratory depression) are alcohol, antihistamines, benzodiazepines, and barbiturates.

 


Find a rehab that specializes in treating an Opioids addiction.

 

1              CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers — United States, 1999–2008 MMWR; November 1, 2011.