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“Opioid” is an umbrella term that refers to both naturally derived and synthetic pain-relieving drugs that originate from or are based on the poppy plant. The term “opiate” refers specifically to drugs that only utilize natural products of the opium poppy. For example, the illegal drug heroin is classified as an opiate because it’s derived from the poppy plant. In contrast, prescription medications are termed “opioids” because they incorporate synthetic compounds in their composition. Both opiates and opioids carry significant risks, including dependence, addiction, overdose, and potentially death.
Opioid medications are commonly prescribed by health care providers for pain relief resulting from injuries, surgeries, toothaches, or other medical and dental procedures, as well as to ease chronic pain. However, research suggests that long-term opioid use for chronic pain might be ineffective and carries a risk of addiction.
Some of the widely known prescribed opioids include:
Regardless of whether they are regulated or unregulated, prescribed or illicit, all opioids carry the risk of misuse and addiction. Also, when opioids are combined with substances like alcohol, cocaine, or other drugs, various reactions and effects can occur.
The drug’s form—like powder, pill, liquid, or tar—is one of the key differences. The potency, duration of impact on the brain, and risk or potential for physical dependence and addiction may also vary across opioids. Some prescription drugs are classified as “controlled substances,” meaning they are regulated and hence manufactured in a standard manner.
Illegal substances such as heroin pose a heightened risk of overdose due to their unregulated production and distribution. When combined with other prescribing opioids, medications, or illicit drugs like cocaine, they can produce hazardous reactions and effects.
When opioids enter the bloodstream, they travel to the brain, where they attach to opioid receptors on nerve cells, primarily in areas involved in the perception of pain and reward. These receptors are also found in the brainstem, which controls automatic processes critical for life, such as blood pressure and arousal.
Once the opioids have latched onto these receptors, they block pain signals sent from the body through the spinal cord to the brain. This results in a decrease in the perception of pain, even though the cause of the pain may still exist. At the same time, opioids influence areas of the brain associated with pleasure and reward by causing a release of large amounts of dopamine, a neurotransmitter that helps regulate emotions, motivation, and feelings of pleasure. This release can induce a profound sense of well-being and euphoria, which makes the experience of taking opioids highly rewarding and reinforces the behavior of taking the drug.
The highly addictive nature of opioids is tied to this powerful effect on the brain’s reward system. The surge of dopamine and associated feelings of pleasure are much more intense than the natural rewards the brain typically experiences, such as those related to food, social interaction, or love. Over time, the brain becomes accustomed to these intense surges and starts to perceive them as normal. When the drug use is stopped or even reduced, symptoms of withdrawal can emerge as the brain struggles to regain balance without the drug.
Another reason opioids are so addictive is the development of tolerance and dependence with prolonged use. Drug tolerance occurs when opioid users bodies become used to the presence of the drug and need higher doses to achieve the same effect. Physical dependence refers to the body’s adaptation to the drug, leading to withdrawal symptoms when opioid use is reduced or stopped. These symptoms can be very unpleasant and include restlessness, muscle aches, insomnia, diarrhea, vomiting, and cold flashes with goosebumps–this is called withdrawal.
Physical dependence on opioids can develop quickly, although the exact timeline it takes to become physically dependent varies from person to person. Factors such as the specific opioid used, the dosage, the frequency of use, individual physiology, and overall health all contribute to how quickly dependence develops. The desire to avoid withdrawal symptoms can make it tough for people addicted to opioids to stop using, thus perpetuating the cycle of addiction and increasing the life-threatening risk factors associated with severe health complications, including opioid overdose and even death.
Are you looking for information on addiction treatment options, or just need someone to talk to? We are here to help. The treatment specialists at Hillside Detox are available 24/7 to offer support, resources, and care for you or your loved one.
While individual experiences and specific symptoms vary when it comes to opioid use disorder, generally, opioid abuse involves both physical and psychological processes. Similar to other substance use disorders, opioid addiction and dependence can develop gradually, often unnoticed, until a crisis arises.
As with all kinds of drug or alcohol addiction, a family history of drug or alcohol abuse can make you more likely to develop dependence.
If you or a loved one display any of these signs, it is crucial to seek professional medical help immediately—call (781) 332-4135. The team at Hillside Detox is available 24/7 to offer guidance and support. Untreated opioid use disorder can have severe consequences on a person’s life, including drug addiction, overdose, and potentially death.
A significant, singular dosage of heroin or any opioid drug can lead to extreme respiratory depression (a state where breathing slows or ceases entirely), possibly leading to accidental drug overdoses and fatalities. Opioid misuse is also linked to higher suicide risk.
Signs of an overdose may involve:
The potency of heroin is unpredictable, as other substances like fentanyl are often mixed in to increase its volume or enhance its effects. Heroin frequently appears in drug abuse death reports by medical examiners. To avoid addiction and overdose, it is best to stay away from opioids and heroin entirely. If you or a loved one are struggling with opioid use disorder, seek professional help as soon as possible. With the right support, individuals struggling with opioid use disorder can be free of substance abuse.
A number of factors can increase an individual’s risk of experiencing an overdose, including:
Opioid withdrawal refers to the body’s adaptation process to reduced or discontinued opioid use. Stopping opioid medications or illicit opioid use abruptly without medical supervision can lead to challenging withdrawal symptoms, often deterring those struggling with opioid addiction from seeking the help they need.
The severity and duration of withdrawal depend on the specific drug being used as well as the individual’s history of substance abuse. Generally, symptoms are most prominent within two to four days after ceasing use and can last up to 10 days. Symptoms usually reach their peak intensity during the first 72 hours post-cessation.
Common symptoms of withdrawal from opioids include:
During the peak of opiate or opioid withdrawal, symptoms usually include extreme anxiety, shaking, tremors, and muscle cramps. Pain in the joints and bones often appears as well.
Long-term impacts of opioid withdrawal, such as anxiety, depression, and cravings, can persist for months or even years after the last drug use. Recovering individuals may also experience increased sensitivity to real or imagined pain, along with heightened vulnerability to stressful events.
A desire to return to a “normal” state, escaping the enduring sense of unease or dysphoria, puts those recovering from opioid addiction at high risk of relapse. This can tragically lead to accidental overdose, respiratory suppression, and death.
The popularity and recreational use of these substances depend on factors such as potency, cost, and accessibility. In recent years, an opioid called Isotonitazene, or “iso,” has been associated with a rise in opioid overdose deaths. Iso, a synthetic opioid more potent than fentanyl, is legal in most parts of the United States. Like other “designer drugs,” iso is engineered to differ chemically from its banned counterparts while mimicking similar brain effects. Regardless of their legal status, newly developed synthetic opioids continue to flood the market, posing an ever-present and life-threatening risk of addiction, overdose, and death.
Considering the unique treatment and recovery challenges associated with opioid use disorder, including severe withdrawal and heightened susceptibility to relapse and accidental death, the most effective substance use disorder treatment for opioid addiction requires a multifaceted treatment approach that combines certain medications, a comprehensive continuing care level, and close monitoring of addiction medicine use.
As a component of our substance use treatment process, physicians at Hillside Detox conduct an assessment that includes a physical exam and a comprehensive psychiatric evaluation in addition to collaborating with patients to determine the most suitable substance use disorder treatment path for their unique needs. However, we generally treat opioid use disorder by integrating medication-assisted treatment (MAT), counseling, and behavioral therapies. This methodology provides patients with ample time in treatment to develop healthy new habits and absorb critical recovery information. This approach involves Twelve Step facilitation and other evidence-based therapies (including integrated care for co-occurring disorders when appropriate), aiming ultimately for abstinence from opioid use.
Patients may receive Suboxone, a combination of buprenorphine and naloxone, during detox to alleviate and/or prevent withdrawal symptoms and reduce cravings. Some patients might be recommended for a monthly, extended-release injection of Vivitrol, or naltrexone, to curb cravings, reduce anxiety and prevent relapse. This medical intervention, when paired with psychological support through counseling and behavioral therapies, offers a comprehensive treatment plan that ensures the well being of the patient. Different medications also work to treat pain, treat vomiting, and treat acute opioid withdrawal.
Methadone is often prescribed for those struggling with more severe opioid addiction for periods of several months or longer. While methadone is commonly used to mitigate opioid and heroin withdrawal, buprenorphine is often deemed a more suitable medication than methadone. This preference is based on the inclination towards transitional and temporary medication-assisted treatment over long-term maintenance medicine.
As specified by the National Institute on Drug Abuse and the Centers for Disease Control and Prevention, among other national institutes like the Substance Abuse and Mental Health Services Administration, the U.S. is in the midst of an opioid epidemic. The far-reaching impacts of widespread opioid dependence and heroin addiction are affecting individuals, family members, and communities nationwide.
At Hillside Detox, we are committed to providing individualized, compassionate care to those struggling with opioid dependence. With the right support, guidance, and treatment plan, you can overcome addiction and lead a happy, healthy, and fulfilled life. We encourage you to call (781) 332-4135 for more information on our addiction treatment programs.
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