Opiate Guide: Symptoms, Detoxification and Treatment

opioids and abuse

“Opioids” are the term used to describe both natural and synthetic painkiller drugs that are developed from or based on the poppy plant. “Opiates” refer to the substances that are directly created from the opium poppy. [1] Opioids are often prescribed by doctors to relieve pain after injuries, surgeries, and toothaches or dental procedures, though illegal substances such as heroin are also classified as opioids. Patients are given a prescription for a specified dosage and time period. However, over time the patient may feel that the drug is no longer as effective—this is caused by developing a tolerance to the drug, meaning that the substance has built up inside a person’s body. Extended use of opioids for pain management have been shown to be ineffective in studies, and the risk of addiction is significant.[3]

Some of the most commonly prescribed opioid medications are:

  • Morphine
  • Codeine
  • Hydromorphone (Dilaudid)
  • Hydrocodone (Vicodin, Lortab)
  • Oxycodone (OxyContin, Percocet)
  • Meperidine (Demerol)
  • Fentanyl (Sublimaze, Actiq)
  • Tramadol

Abuse Signs and Symptoms

Opioids relieve physical pain, but they also create euphoric feelings, leading to a high risk of misuse and addiction [4]. According to the American Society of Addiction Medicine (ASAM), addiction is “a primary, chronic disease”, and is characterized by the inability to stop using the substance, even when the individual’s health and relationships are affected. [2] Some of the signs of dependence are not obvious at first, and may not be recognized until a crisis occurs. A few of the warning signs of opioid addiction are:

  • Taking the drug in amounts not prescribed (taking too much, or for too long a time)
  • The inability to discontinue or cut down on use
  • An increase in time and effort spent getting, using and recovering from the effects of use
  • Intense cravings or a strong desire or urge to use
  • Problems at work, school, or relationships with family and friends due to use
  • Risky/ dangerous behavior caused by drug use
  • Continued use despite health, social, and professional consequences

Opioids interact with receptors within the human brain and nerve cells. When the drug is taken, the drug’s molecules fit together with the receptors in the brain, stimulating a release of chemicals that create euphoric feelings. Over time of regular use, the body does not respond with the same intensity, and tolerance builds up, so the individual has to take more of the drug to produce the same level of effect.

The long-term abuse of opioids affects the individual’s health both physically and mentally, including (but not limited to):

  • Drowsiness or coma
  • Speech and memory problems
  • Constricted pupils
  • Euphoria (while under the influence)
  • Slowed breathing
  • Dry mouth
  • Gastrointestinal distress/ problems
  • Skin rashes and infections
  • Weight changes
  • Collapsed veins and heart problems
  • Risk of HIV, hepatitis B or C

Withdrawal and Detox

Once someone’s body has become used to the level of drugs in their system, if the drug use is stopped, there are unpleasant withdrawal symptoms that act in opposition to the drug’s effect. For example, opioids relieve physical pain, so in withdrawal the individual experiences a sharp increase in aches and pains throughout the body. Withdrawal symptoms may occur as early as a few hours after the last dose of the drug, with the peak of symptoms occurring at 24-48 hours after last use, and subsiding in about a week [4]. Other withdrawal symptoms may include:

  • Restlessness and shaking
  • Muscle aches, pain, stiffness, spasms
  • Insomnia
  • Mood instability, especially anxiety/ panic and irritability
  • Itching
  • Rapid heart rate and raised blood pressure
  • Flu-like symptoms (sweating, body pain), fever
  • Yawning
  • Seizure risk

Treatment and Rehab

The decision to begin recovery from opioid addiction requires assistance and support throughout the process. The first step is generally in a medically monitored detox unit, where medical supervision is provided to help ease the uncomfortable symptoms of withdrawal in a safe manner. Depending on the client’s specific needs and thorough assessment, the use of MAT (medication-assisted treatment) may be utilized coupled with behavioral therapies and counseling to build a foundation for long term recovery.

Residential treatment provides a secure environment to reduce many environmental and social factors that prove challenging for achieving lasting sobriety. Clients are engaged in activities, individual and group therapies, and assistance from clinical and support staff to facilitate building coping skills and the tools needed to continue sobriety after their stay in the facility is completed. Care is taken to emphasize the importance of treating the client as a whole and treating substance addiction in the areas of mind, body, and spirit. This facilitates the client addressing not only their opioid addiction but any mental or physical difficulties that need addressing to maintain a healthy life after treatment.

Aftercare

Upon leaving inpatient treatment, clients are urged to continue their care utilizing Intensive outpatient programs (IOP), sober living housing, continued counseling, support groups, and a solid written aftercare plan. The continued exploration and healing of all aspects of the client’s life are vital to lasting sobriety.