The United States is battling an opioid overdose epidemic that, until in recent years, had never been seen before. This public health emergency has consumed the nation, and getting a handle on the use of prescription pain relievers has become a top priority of political and public health care leaders across the nation. It’s difficult to keep up with the numbers of people dying of overdoses as the statistics change, but they all paint an alarming picture.
“Opioids (including prescription opioids and heroin) killed more than 33,000 people in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid,” the U.S.Centers for Disease Control and Prevention reports on its site.
A federal government preliminary count announced in 2017 shows that opioid medications and illicit drugs such as heroin were involved in at least 50,000 U.S. adult deaths in 2016. In 2017, President Donald J. Trump declared the opioid crisis a public health emergency, a significant step in the battle against opioid misuse, abuse, dependence, and addiction.
With all the talk about opioid addiction in the news media, awareness of these potent drugs and their effects certainly has grown. Still, there may be some uncertainty as to exactly what they are and what they do.
Opioid drugs are medications that are prescribed to treat moderate-to-severe pain usually experienced after surgeries or severe injuries. The use of these drugs started in the 1990s when physicians prescribed drugs such as OxyContin and Percocet to treat chronic pain as a serious medical issue. This group of drugs also includes the illicit drug heroin.
This liquid pain reliever is a cough suppressant that can cause respiratory depression with prolonged or excessive use. On the streets, codeine is known as Captain Cody Cody, Schoolboy, Doors and Fours, Little C, and cough syrups.
This man-made, fast-acting opioid pain reliever works similar to morphine. The medication is also used during labor and delivery for pregnant women. Slang names for Demerol include Smack, Dust, Juice, D, or Dillies.
Excessive use of this prescription drug can cause mood or behavior disorders and cause people to move onto heroin. Dust, Juice, Smack, D, and Footballs are all street names for Dilaudid.
Fentanyl has been said to be the potent, deadly ingredient in illicit drugs such as cocaine and heroin. This powerful synthetic opioid medication that is used intravenously in medical settings is estimated to be 80 to 500 times stronger than morphine. Street names include Apache, China Girl, China Town, Dance Fever, Friend, Goodfella, and Tango & Cash.
Heroin is an illicit drug made from morphine that comes from the Asian opium poppy plant. Excessive use changes the physical structure and physiological changes in the brain. Slang names include China White, H, Smack, Black Tar, Mud, Dragon, Mexican Brown, and Thunder.
This opioid is sold under the more recognizable names Vicodin, Norco, and Lortab. It is the most frequently prescribed medication, according to the Drug Enforcement Administration. Vicodin is called Vikes, Vics, Vicos, and Idiot Pills.
An opioid that is primarily used in the treatment of opioid addiction. Methadone maintenance is designed to replace harder, more dangerous opioids. The treatment helps people abstain from heroin and other illicit drugs. Street names include Done, Junk, Metho, Dolls, Dollies, and Methadose.
A prescription opioid pain reliever used to treat moderate-to-severe pain that comes from the opium found in the poppy plant. It should be taken with care as it can slow a person’s breathing. Street names: Mister Blue, Morpho, Dreamer, and God’s drug.
A synthetic opioid pain medication derived from thebaine, which is found in the Persian poppy plant; it is the ingredient in OxyContin and Percocet.
An opioid pain reliever that is the brand name for the narcotic oxycodone hydrochloride. OxyContin has a time-release feature, which makes it different from oxycodone. Crushing up the pills for snorting or injection bypasses the medication’s time-releases. This powder form makes for high doses that bring on produce strong, pleasurable euphoric effects. Blue, Oxy, Hillbilly Heroin, Kicker, and Oxycotton are all names for OxyContin.
Percocet is a prescription opioid used for short-term pain management that is a combination of oxycodone and acetaminophen (the active ingredient in over-the-counter pain relievers Tylenol). They may be called by their slang names Percs and percodoms.
Suboxone is the brand-name opioid medication that combines buprenorphine and naloxone (a drug that blocks opioids from binding opioid receptors). Slang names for it include Boxes, Bupes, Oranges, Sobos, Stops, and Stop Signs.
Ultram is the trade name for Tramadol, a prescription medication used to treat pain and depression. It also goes by the name chill pills, trammies, and ultras.
Opioids change how the brain processes pain. This happens when opioids bind with opioid receptors on the nerve cells in the body and brain. Excessive opioid use floods the brain’s pleasure center with dopamine, which overwhelms users with euphoria and feelings of well-being and pleasure. Chronic, repeated opioid use can flood the brain with artificial endorphins. In time, the brain will cut down on producing endorphins and become dependent on these artificial endorphins. When users decide to stop their opioid use, they will struggle with withdrawal symptoms as the body adjusts to not receiving the endorphins from the outside source.
Opioid medications are designed for short-term use, which is why many physicians considered them safe to use during a small window. However, the euphoria, relaxation, and pain relief from the medications can be addictive, leading people to misuse and abuse.
Prescription drug abuse, however, doesn’t only mean people who crush them up for use or use them with other drugs. Other abusive practices include:
Even people who have legally obtained opioid prescriptions can still develop a physical dependence on them with regular use. Dependence can lead to a psychological addiction, which may require professional treatment to end both.
Opioid addiction develops over time but not without tell-tale symptoms. If you spot any of these signs, you or your loved one may struggle with opioid addiction:
The above signs are general signs of addiction. Physical signs may also help you spot opioid addiction include:
One sure way to spot opioid addiction is if withdrawal symptoms occur if usage stops. These symptoms, which mimic the flu, can be uncomfortable. They include:
Equally challenging to maintaining an opioid addiction is making attempts to quit one. Many people will try to end opioid addiction just by stopping. But that, too, is dangerous to do without medical supervision.
If you or a loved one is using opioids and decides to stop using them, do not do so abruptly. Quitting a drug abruptly without a doctor’s supervision can worsen conditions and trigger these withdrawal symptoms.
If you or a loved one wants to stop using as soon as possible, do it safely by entering a treatment center that provides a medically supervised detox to avoid or manage the worst of the opioid withdrawal symptoms. Not doing that could lead you right back to using, which amounts to running the risk of overdosing.
Opioid addiction can be treated, and depending on the severity of the situation, recovery can begin at a reputable, licensed drug rehabilitation facility. This process typically starts with a medical detoxification that can last anywhere from three to 10 days.
During this process, medical professionals monitor clients around-the-clock as they are weaned off the drug safely. This may include tapering off the opioid medication used, which is when doses are gradually reduced over a set period to allow the body time to adjust to not having the drug in its system.
After a medical detox is completed, clients may opt to enter an inpatient, or residential treatment program, where they will address the physical and psychological addiction. These treatment programs can be tailored to an individual’s needs and preferences. Inpatient treatment, which can last from 28-90 days in a facility, depending on the program, involves therapies that can help the person overcome their addiction. Treatment also can incorporate 12-step programs, holistic therapy, family therapy, individual counseling, and group counseling.
There is also outpatient treatment for people who may be in the early stages of opioid addiction or have a mild case of it. Outpatient therapy does not require an on-site stay at a treatment center, an arrangement that gives clients more flexibility as they work drug treatment into their schedules. However, outpatient clients are still required to attend structured sessions three to five times a week or more, depending on the situation.
Recovering opioid users may want to consider using aftercare services to help them focus on their recovery goals and reduce their chances of relapse. Some people pursue follow-up medical care and ongoing therapies to help manage post-acute withdrawal symptoms, known as PAWS, that can happen long after dependence on the drug has passed.
Abusing opioids puts many users in a compromising situation, and most deaths start with an overdose. There are people who survive overdoses but, in many cases, they do incur permanent injury. Recovering users can still have breathing problems or permanent brain damage as a result of their drug use.
During an opioid overdose, a user’s pupils will constrict and they will experience respiratory depression. This is often followed by seizures, vomiting, and spasms that can be harmful if not controlled. The lethality of an overdose comes from respiratory failure. The American Society of Addiction Medicine reports that opioid overdoses account for more than 60 percent of all overdose-related deaths in the United States.
The drug Naloxone or Narcan has been a valuable tool in the arsenal of first responders to immediately reverse the effects of an opioid overdose. It is sold over the counter and can be administered through the nose or injected directly into the skin. However, it can sometimes take several doses of Narcan to bring a victim back to consciousness, and it does not save them from any permanent consequences.
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