Opioids have been used throughout history to dull the pain of those injured and ill. The therapeutic use of opium is among the world’s oldest know drugs. Derived from the opium poppy this drug is an analgesic (a painkiller) that is used to decrease the perception of pain and reaction to pain as well as to allow the user to develop a tolerance to the pain they are experiencing.

While opioids are extremely effective at treating pain it is also highly addictive, with many developing a physical dependencies to opioids throughout history.

What is an Opioid?

An opioid is a psychoactive chemical, an analgesic, that is derived from the opium poppy. The drug works by binding to opioid receptors that are found within the gastrointestinal tract, central and peripheral nervous system. When the opioid drug reaches these receptors the pain experienced is dulled. While this drug is highly affective with many beneficial effects it also carries the risk of many side effects.

Common Types of Opioids

  • Paracetamol/Acetaminophen
  • Dextropropoxyphene
  • Codeine
  • Tramadol
  • Tapentadol
  • Anileridine
  • Alphaprodine
  • Pethidine
  • Hydrocodone
  • Morphine
  • Oxycodone
  • Methadone
  • Diamorphine
  • Hydromorphone
  • Oxymorphone
  • Levorphanol[
  • 7-Hydroxymitragynine
  • Buprenorphine
  • Fentanyl
  • Sufentanil
  • Bromadol
  • Etorphine
  • Dihydroetorphine
  • Carfentanil
  • Heroin

Medical Uses For Opioids

The use of opioids is to control pain within the individual. Opioids are used to treat acute pain in post-operative patients. The drug is also commonly used to treat severe and chronic pain that is common with terminal conditions such as cancer and degenerative conditions. Opioid use in any patient such be done cautiously and monitored by a medical Doctor. Regular use of opioid can easily lead to a tolerance, which causes the patient to require higher doses of the drug to achieve the desired effects. If not carefully monitored opioid use can in time lead to a physical and psychological dependency.

Recreational Use of Opioids

Opioids are commonly used as a recreational drug because of their ability to produce euphoric effects. Misuse of opioids can also be giving the medication to people who it is not prescribed to for treatment of pain or selling the medication, both of which are punishable by time in jail. The illicit form of opioids is heroin. It is commonly used recreationally for its euphoric effects as well as its ability to numb the individual from any physical and/or emotional pain they are experiencing. Heroin is only of the most difficult opioid addictions to overcome.

Common Adverse Effects to Opioid Use

  • sedation
  • constipation
  • sense of euphoria
  • cough suppression
  • nausea
  • vomiting
  • drowsiness
  • itching
  • dry mouth
  • miosis
  • Opioid dependence
  • withdrawal syndrome (with a dependency)

Infrequent adverse Effects to Opioids

  • respiratory depression
  • confusion
  • hallucinations
  • delirium
  • urticaria
  • hypothermia
  • bradycardia/tachycardia
  • orthostatic hypotension
  • dizziness
  • headache
  • urinary retention
  • ureteric or biliary spasm
  • muscle rigidity
  • myoclonus
  • flushing

Opioid Addiction

Long term use of an opioid often leads to the body developing a tolerance, requiring more of the medication to achieve the desired effects. As a time goes on the body will begin to become dependent on the drug to keep away pain and to “feel normal”. When the body is dependent on opioids when stopping its use the individual will experience withdrawal symptoms that vary in severity, ranging from discomfort to pain. Most who have developed an addiction to opioids will require the assistance of a treatment center to stop its use.

Treating an Opioid Addiction

Opioid addiction is one of the most difficult addictions to over come. Many who go through the recovery processes often relapse, this is why it is so important to continue with NA meetings and to maintain a strong support group. The first step to treating an opioid addiction is detoxification and then maintenance medications along with counseling. It is possible to treat an opioid addiction and recover from it but the individual must be ready and willing to give up opioids to be successful in remaining clean and sober.

Detoxification

The detoxifification process is done to cleanse the body of the chemicals and toxins related to opioid use. This is done during the withdrawal period with symptoms that can be painful for the individual. It is important to go through detox in a medical facility to ensure the safety of the opioid addict. There is risk of mortality due to withdrawal syndrome. Withdrawal symptoms can be maintained by medications such as Methadone and buprenorphine (both oipiods). The objective of using these two medications during the detox process is cross-tolerance, replacing one opioid with another, and to slowly ween the individual off the medication.

Therapy and Counseling

During an inpatient or outpatient treatment for opioid addiction it is important to go through therapy and counseling to allow the patient to work through the psychological aspects to their addiction. They will be able to gain tools required to maintain their recovery when returning to their “normal life”.

Opioid Maintenance Therapy

It is common to maintain ones addiction through Pharmacological therapy for illicit opioid use, heroin addiction. Medications such as Methadone and bupinorphine can be used during opioid maintenance therapy. It is the idea of cross-tolerance similar to what is used during detox for all opioid addictions. These medications help to control withdrawal symptoms and cravings for heroin. Over time the patients medication dose is lowered as they are weened from the medication.

The Opioid Epidemic

Opioids are an age old drug used to treat both acute and chronic pain. It is used today under Doctor supervision, yet many still develop a tolerance. Approximately 12 million people were prescribed opioid medications in 2010. There is a growing problem with the illegal distribution and sale of opioid prescriptions for recreational use. Illicit opioid use, heroin, has long been a problem too, adding to the problem. A 2007 study showed that 78% of those seeking helps for an opioid addiction were never prescribed the medication. Over the past decade there have been more deaths due to opioid use than the combination of cocaine and methamphetamine. With a growing number of opioid related deaths and an outrageous number of individuals addicted to opiate throughout the nation this is truly become an epidemic.

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