Opioids are a class of substances that have been the subject of a great deal of media attention recently due to the alarming number of people who abuse and overdose on these drugs. This article will explain what opioids are, why people abuse them, how serious the problem has become, and the effects the opioid epidemic has on society and individuals. In addition, this article will explore what the federal government is doing to combat opioid abuse and where you or loved one can get help for opioid addiction.
Opioids are drugs that include prescription painkillers, such as oxycodone, hydrocodone, fentanyl, morphine, and codeine, as well as the illegal drug, heroin. Doctors prescribe the various opioids to manage pain and, to a lesser extent, to suppress coughing. When a person takes an opioid, the drug attaches to the opioid receptors in the brain, which initiates a neurochemical process that leads to pain relief and, potentially, a dose-dependent euphoria.1
The Drug Enforcement Administration (DEA) classifies many of the prescription painkillers as Schedule II, which means that the drugs have a known potential for abuse, and could place those who use them at risk for developing physical and psychological dependence. The DEA classifies heroin as a Schedule I drug, which means that it has a high potential for abuse, as well as no currently acceptable medical use.2
While prescription opioids have legitimate medical uses for the management of moderate to severe pain, countless people abuse opioids merely to experience the euphoric rush that these drugs are capable of producing. When people abuse opioids, they may experience some desirable effects, such as: 3
While opioids are generally safe when taken for a short time under the supervision of a doctor, many people enjoy the pleasurable feelings associated with their use and want to keep experiencing these feelings. This may lead to the misuse or abuse of opioids, as people may:3,4
Using opioids in ways other than prescribed, such as crushing the tablets to snort or inject the drug, is dangerous. A tablet may, for example, be specially-formulated to provide a person with a slow and steady supply of an opioid to control pain for several hours. However, crushing the table to snort it essentially bypasses this controlled-release mechanism and greatly intensifies the speed of onset and intensity of the drug effects. Such intentional misuse can markedly increase the risks of addiction and overdose, which can lead to severe medical consequences and even death. 5
Opioid abuse is a national crisis afflicting millions of people. Some alarming statistics related to opioid use and abuse include:1,6
With a problem this large, many people wonder how it all began. In the late 1990s, physicians began to prescribe opioids in greater numbers than ever before. To some extent, these prescribing practices reflected a push within the medical field to recognize the importance of adequate pain management in clinical settings, but also coincided with claims from the pharmaceutical companies who created these opioids that they were not addictive. The number of opioid painkillers sold to physicians’ offices, hospitals, and pharmacies almost quadrupled from 1999 to 2010, yet overall, Americans had not reported higher levels or greater amounts of pain. This increase in prescriptions led to nation-wide diversion, misuse, and abuse of opioid painkillers. 7,8 It came to light that these drugs are, in fact, addictive, leading us to where we are today.
The emotional impact of the opioid crisis is overwhelming for individuals and families, but the economic burden of the opioid crisis is an immense problem as well. A recent study estimates that the economic impact of the opioid crisis amounts to 78.5 billion dollars a year.7,9
This economic impact is a result of: 7,9
Prescription opioids can have negative short-term effects, including:10,11
Chronic opioid abuse can lead to even more serious, long-term consequences, including:11
If you use opioids intravenously, you may be at risk for additional health issues, such as:11
Some risks associated with snorting opioids include:11
In addition, many people who abuse drugs get into legal trouble from selling drugs, or engaging in other criminal behaviors to support a drug habit, such as prostitution and stealing. Furthermore, people who abuse drugs are often at risk of experiencing accidents or injuries related to buying or selling drugs.11
Neonatal abstinence syndrome is another problem related to opioid abuse. Pregnant women who consistently take opioids greatly increase the chance that their baby will be born with significant physiological dependence to them as well. When the child is born, the child goes through withdrawal from opioids. The effects of neonatal abstinence syndrome can include:12
Over time, a person develops tolerance to opioids. This means that the person will no longer experience the full effects of the drug as they once did. The body needs more and more opioids to experience the same euphoric sensations as before. However, as the person begins to take more opioids to overcome their tolerance, the danger of addiction and overdose increases.
Overdose is a constant concern with opioid abuse. The signs of an opioid overdose include:13
Shallow breathing is a sign of respiratory depression, which can result in death as it becomes progressively worse in overdose situations. Naloxone is an opioid antagonist drug that can quickly reverse an opioid overdose by competitively binding to opioid receptors in the brain, thereby blocking further drug effects mediated by those receptors. There are three formulations of naloxone approved by the FDA for treating opioid overdoses:14
In most states, injectable naloxone can be used only by trained professionals. Laws vary from state to state over who can administer Narcan and EVZIO. In some states, anyone can give the medications to someone in need, while other states require a doctor’s prescription to acquire these medications. Some states allow pharmacies to dispense Narcan and EVZIO without a prescription, including:14
The cost of Narcan and EVZIO varies from state to state, and there are some organizations that offer these medications at a discounted cost. Some insurance plans also cover the cost.
If you give someone naloxone, call 911 and keep them under constant observation until medical help arrives. Do not attempt to move the person or provide any other type of treatment.14
The federal government, through the U.S. Department of Health and Human Services (HHS), is responding to the opioid crisis by focusing on five main priorities:7
In addition, the National Institutes of Health (NIH) is working with pharmaceutical companies and research groups to:7
If you or your loved is struggling with an opioid addiction, help is available. A vital first step towards recovery is entering a professional detox program. Detox may sound like a scary and confusing process if you are not familiar with it but it is extremely beneficial and can reduce discomfort and pain. Detox is essentially the process of eliminating a drug from the body and stabilizing the patient. Detox medications are often used to mitigate withdrawal symptoms and reduce drug cravings.
Detox programs typically last for a few days to a week or two, during which time you will undergo a medical and psychological assessment, receive monitoring of your physical condition, and receive emotional support from a team of counselors and other mental health professionals.
Detox can take place in a variety of settings. These include:
It is important to know that detox is only the beginning of recovery from opioid addiction. Once you have been stabilized and your body is free of mind-altering drugs, you may think that your opioid addiction is behind you. However, it is critical that comprehensive substance abuse treatment follows detox from opioids. Without addiction treatment, during which you learn to change the behaviors which led to the use of opioids in the first place, relapse becomes increasingly likely. There are several options for opioid addiction treatment, including:
Whether a treatment takes place in an inpatient or outpatient setting, there are numerous therapeutic approaches and program varieties available to you: