Opioid Addiction, Abuse & Types
Opioid overdose and opioid use disorders are increasingly common in the United States. Across the nation, approximately 130 people die each day due to opioid overdoses. Deaths from opioid overdoses have quadrupled over the past 20 years.
This guide will help you understand what opioids are and how they are different from opiates. You will learn about the different types of opioids and find out how to recognize the signs and symptoms of opioid use disorders and overdose. Information about treatment resources will be provided in the closing section.
What Are Opioids?
Opioids (narcotics) are pain relievers that work by binding to opioid receptors in the brain and spinal cord. They can lessen the intensity of a person’s pain, and they alter how pain is perceived by the brain.
Morphine, the first opioid medication, was created in 1803. Like other early opioids, it was derived directly from opium, a substance that comes from the seed pods of poppies. Today, many newer opioids, including fentanyl, are produced synthetically in laboratories.
Opioids are often prescribed by doctors to treat pain from injuries and chronic health conditions, including cancer. They are frequently administered when patients are recovering from surgery.
After taking an opioid at the recommended dose, people typically feel sleepy, and constipation is a common side effect. Some individuals could develop nausea and vomiting, too. Opioids can cause impairments in judgment and decision-making, and they may cause users to act impulsively.
To reduce the risk of physical dependency, doctors aim to prescribe opioids for the shortest period of time that is needed to treat an individual’s pain. In cases of acute pain from surgery and injuries, people are typically given an opioid prescription for no more than three days.
Individuals with chronic pain may be given opioids for a longer period of time. Doctors will closely monitor them during treatment, and the opioids will generally be prescribed as part of a treatment plan that includes physical therapy, massage, or other treatments that do not use medications.
Opioids vs. Opiates
Technically, the term “opioid” is used to describe any drug that binds to the brain’s opioid receptors. Opioids include both natural drugs derived directly from poppies and synthetic versions that are produced in laboratories. All opiates are part of the opioid family. To be classified as an opiate, an opioid must be extracted from the poppy plant; it cannot be synthetic.
Types of Opioids
There are three major types of opioids. Each type is classified according to how it is made.
1. Natural Opiates
Natural opiates are derived from the opium of the poppy plant, and they are considered to be alkaloids. Examples of natural opiates include thebaine, codeine, and morphine.
Today, thebaine is used as an intermediary to manufacture other types of opioids, such as oxycodone. Codeine may be used on its own for acute pain that is of a mild or moderate intensity. It is used in combination with other drugs when treating a cough.
Morphine is available in immediate and extended-release tablets, and it can be injected by a health care professional. Immediate-release morphine is considered for acute and chronic pain, and extended-release formulations are intended for chronic pain.
2. Semi-Synthetic Opioids
Semi-synthetic opioids are derived from natural opiates and manufactured in labs. Heroin, oxycodone, hydromorphone, and hydrocodone are examples of semi-synthetic opioids.
Heroin is an illegal street drug that is derived from morphine. Oxycodone comes in capsule and tablet forms. Immediate-release oxycodone is used for both acute and chronic pain, and the extended-release option is intended for patients with chronic pain who need 24-hour pain relief.
Hydromorphone is used for acute and chronic pain, and it is available in tablet, liquid, and injectable formulations. Hydrocodone is used most often in combination pills that also include non-opioid pain relievers. For example, hydrocodone-acetaminophen is commonly prescribed for the treatment of cancer pain.
3. Synthetic Opioids
Synthetic opioids are entirely man-made in laboratories, and they do not contain ingredients that are derived from plants. Tramadol, methadone, and fentanyl are all synthetic opioids.
Tramadol comes as a cream, capsule, or tablet. Patients typically use the immediate-release oral tablet to treat moderate to severe acute pain, and the extended-release formulations are used to provide 24-hour pain relief for individuals with chronic pain. Tramadol cream is beneficial for some patients with musculoskeletal disorders. Tramadol is combined with acetaminophen to treat severe pain for up to five days.
Methadone is used to treat chronic pain in people who require 24-hour treatment. It is frequently used to treat people with opioid use disorders as well. Fentanyl is available as a transdermal patch and an oral lozenge, and it can be administered by injection. It can be used for chronic pain in patients who already take other opioids, and it is commonly used to treat breakthrough pain associated with cancer.
What Are the Potential Signs of an Opioid Use Disorder?
Opioid use disorders can cause physical, mental, and behavioral changes. People may feel drowsy, and they could experience weight loss. Flu-like symptoms might occur frequently, and some individuals may have sleep disturbances or changes in sleeping patterns. Decreases in libido could be present.
Mentally and behaviorally, patients with opioid use disorders could be unable to regulate their opioid use due to uncontrollable cravings for opioids. They may continue to use opioids even if they are experiencing worsening depression or other mental health side effects associated with these medications. They might also feel that they need more and more of the opioids to achieve euphoria and relieve pain.
When opioid use disorders are present, the individual may withdraw from social activities, and they could isolate themselves from family and friends. There may be new financial difficulties that occur suddenly, and people could repeatedly ask family and friends to borrow money. School and work performance may be negatively impacted, and patients could start having relationship conflicts with family, friends, and co-workers.
People with opioid use disorders could have withdrawal symptoms if they are unable to obtain opioids or if they drastically reduce their dose due to lack of supply. If this happens, family members and friends might notice that the person has mood swings and appears sweaty. Diarrhea could occur as well.
What Are the Signs of an Opioid Overdose?
People who have overdosed on opioids will often have small, constricted pupils that look like pinpoints. Breathing may be very slow and shallow, and the individual might choke or make gurgling noises. The person’s body could be limp, and he or she may fall asleep or lose consciousness. The skin might look pale or blue, and it will generally feel cold to the touch.
If these symptoms occur, an ambulance should be called immediately so that the individual can receive life-saving care. Family members or caregivers can administer naloxone if it is available, and they should aim to keep the person awake and breathing. It can help to lay the individual on his or her side to reduce the risk of choking, and caregivers should stay with the person until paramedics arrive.
Opioid Use Disorder and Opioid Overdose Statistics
Currently, over 11.5 million people in the United States are believed to misuse opioids every year. In addition, more than 2.1 million individuals are diagnosed with opioid use disorders each year.
An estimated 21% to 29% of patients who are prescribed opioids for chronic pain will end up misusing them, and 8% to 12% of these individuals are ultimately diagnosed with opioid use disorders. Roughly 75% of the more than 77,000 annual drug-related deaths in the United States are linked to opioids. Between 2016 and 2017, opioid overdoses increased by 30%.
Why Should You Get Help for an Opioid Use Disorder?
To recover from an opioid use disorder, the patient must go through a process known as withdrawal (detox). This rids the body of all of the opioids, and it is the first step in the recovery process. Withdrawal can produce uncomfortable symptoms. Generally, symptoms begin within 24 hours of stopping the opioid, and they can continue for a week or more.
People could experience medical issues during detox, and many individuals are unable to safely complete detox by themselves. Abdominal cramps, high blood pressure, insomnia, anxiety, sweating, restlessness, and a rapid heartbeat are a few of the symptoms that commonly occur during detox.
Substance use specialists recommend medically supervised detox at a treatment facility to give the patient his or her best chance of a successful recovery. During medically supervised detox, patients are routinely monitored for symptoms. Medications can be administered to ease the discomfort and stress of the detox process so that people have a better chance of completing it.
Treatment centers also provide psychological support and individual therapy sessions to boost the patient’s mental and emotional health during and after detox. They provide structure and time for the patient to explore the reasons behind his or her opioid use disorder. Therapists guide the patient in this task. Most importantly, they help the individual in taking the first steps to rebuild his or her life by healing relationships and discovering a new sense of purpose.
What Treatment Resources Are Available?
If you have been impacted by an opioid use disorder, it is important to know that you are not alone and that help is available. Your primary care doctor can provide information about local resources that can assist you, and your community health department can offer guidance as well.
People in the New England area may wish to ask their health care professional about attending a residential program at the Green Mountain Treatment Center or the New Freedom Academy. These facilities offer a holistic approach to recovery from opioid use disorders, and they are considered in-network for most major health insurance plans.
Green Mountain Treatment Center
Located in Effingham, New Hampshire, the Green Mountain Treatment Center is a secluded retreat that provides medical detox facilities and 24-hour medical monitoring as needed. Clinicians at the center are all trained in addiction medicine. During treatment at Green Mountain, patients follow a 12-step curriculum that is integrated with individual and group psychotherapy sessions.
Green Mountain patients can receive cognitive behavioral therapy, dialectical behavior therapy, and trauma therapy, and each therapy session is tailored to their specific needs. They are also provided with holistic therapy options, including adventure therapy, exercise, yoga, and meditation. Gender-separate programs and accommodations are offered, and meals are prepared by a chef.
New Freedom Academy
New Freedom Academy is a 20-bed treatment center that is located on 17 acres of woodland in Canterbury, New Hampshire. This facility specializes in medication-assisted treatment of opioid use disorders, and clinicians are available at all times of the day and night. During their stay at New Freedom Academy, patients have one-on-one therapy sessions, and they can receive treatment for any co-occurring mental conditions that may be present.
New Freedom Academy residents also participate in process groups and motivational interviewing. To help heal the mind and body, residents are encouraged to take part in yoga, meditation, and exercise at the center. These activities help reduce stress and increase endorphins.
Patients at New Freedom are also given access to family recovery workshops to help them strengthen their relationships with their loved ones. These workshops take place each week at an off-site location. As with the Green Mountain Treatment Center, residents at New Freedom Academy are provided with gender-separate living accommodations, and nutritious meals are prepared by a chef. Paintball, mini-golf, and bowling outings are offered so that residents can bond with each other.
With help and support, patients and families can recover from opioid use disorders and live in a healthy, positive way.