Prescription Opiate Addiction
What are Opioids?
Opioids include illegal drugs such as heroin and synthetic fentanyl as well as prescription pain relievers like oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and others. They are generally safe when taken for a short time as prescribed by a doctor but because they can also create a sense of euphoria, they can be misused. Even regular use as prescribed by a doctor could lead to dependence and then if misused it can lead to addiction, overdose, or death.
Percocet is also a prescription pain medication that contains oxycodone and acetaminophen. It is not an opioid in the strict sense, but can be abused in a similar manner.
Extent of problem in the U.S.
Healthcare providers began to prescribe opioid pain relievers at greater rates in the late 1990s after being reassured by the pharmaceutical companies that patients would not become addicted to them. This increase led to widespread misuse of prescription and non-prescription opioids before it became obvious that they could, indeed, be misused and were addictive. The U.S. Department of Health and Human Services declared the opioid epidemic a public health emergency in 2017 after overdoses rose to over 42,000 deaths in 2016 alone, more than any previous year on record. It is estimated that 40 percent of opioid overdose deaths involve a prescription medication.
Respondents of a survey on use and abuse of prescription pain relievers listed that the reasons for abusing a pain reliever included relieving physical pain; relax or relieve tension; experiment; feel good or get high; help with sleep; help with feelings or emotions; increase or decrease the effects of other drugs; and because they are hooked and have to have the drug. The most common response for the last misuse of a prescription was to relieve physical pain, which is why they are prescribed initially.
About 21 to 29 percent of patients who are prescribed opioids for chronic pain misuse them and between eight and 12 percent develop an opioid use disorder, or addiction. Of those who abuse prescription opioids, about four to six percent will transition to heroin.
Signs of addiction
If someone is abusing opioids, there may be some physical signs such as euphoria or extreme happiness after taking a dose, sedation or tiredness after the euphoria is gone, confusion, restricted pupils, nodding off or loss of consciousness, and slower breathing rate. People who are beginning to use opioids may feel itchy, nauseated, or vomit, be constipated, have slower reaction times, and drowsiness.
Physical symptoms of opioid addiction may be harder to spot than certain behaviors. They may withdraw from previous activities and commitments, like school or work; lose interest in previous hobbies; begin different habits and routines; become angry and irritable; be anxious or nervous, secret or dishonest; neglect their physical appearance; and go to extreme measures in order to obtain more drugs, as the body builds up a tolerance.
Symptoms of opioid withdrawal can begin as early as six hours after the last dose, depending on if the person has taken a short-acting or long-acting opioid. Early withdrawal will cause tearing up, muscle aches, agitation, insomnia, excessive yawning, anxiety, running nose, sweating, racing heart, hypertension, and fever.
Symptoms will reach their peak around 72 hours after dose and may last around a week. These can seem like the flu with nausea, vomiting, stomach cramps, diarrhea, goosebumps, depression, and drug cravings.
If an opioid overdose occurs, it can be reversed if naloxone is administered immediately. Naloxone is an opioid antagonist and binds to the opioid receptors to reverse and block the effects of other opiods in a person’s system. Normal respiration can be quickly restored to a person whose breathing is dangerously slow or has stopped due to an overdose of heroin or prescription opioid medication.
Naloxone can be given in three FDA-approved forms: injectable, auto-injectable, and prepackaged nasal spray. Injectables require professional training and generic brands of the vials are offered by different companies listed in the FDA Orange Book under “naloxone.” Auto-injectables are under the brand name EVZIO and are pre-filled auto-injection device that is injected quickly into the outer thigh. The device provides verbal instructions on how to deliver the medication once it is activated, like an automated defibrillator. NARCAN is a prepackaged nasal spray and is needle-free, requires no assembly, and is sprayed into just one nostril while the patient lays on their back.
Normally, the liquid injectable form needs to be distributed by a paramedic, doctor, or other first responder who is specially trained. Depending on state law, the auto-injector or nasal spray may be administered by anyone. Some states require a physician prescription for naloxone while others allow pharmacies to distribute without one.
Dosages depend on the formulation and some patients may need more than one dose to restart respiration. Once the dose is given, the patient should be monitored until emergency services arrive and then for at least two hours by medical professionals after the last dose of naloxone is given to ensure breathing does not slow or stop. Side effects are only possible in people who already have opioids in their system and are uncomfortable but not life-threatening. They include headache, blood pressure changes, rapid heart rate, sweating, nausea, vomiting, and tremors.
Overcoming addiction to opioids can be difficult. If you or someone you love is suffering from addiction, we can help.
We can provide a safe place for detoxification to occur while delivering other resources to help with healthy ways to address the reasons for why the addiction occurred in the first place. Our specialty is treating the patient wholly with a comprehensive, holistic approach to addiction recovery. The way to fully recover is possible with access to the right tools and complete understanding of the underlying causes.