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Why Are Opioids Addictive?

person taking opioids

Why are opioids addictive?
Opioids are highly addictive because they flood the brain with endorphins and dopamine, which produce feelings of pleasure, satisfaction, and euphoria. The “high” is so powerful and unlike any natural rush of endorphins and dopamine that the only way a person can experience those feelings again is by using opioids. There are several other genetic, environmental, and lifestyle factors that all contribute to the likelihood of developing an opioid addiction.

What are Opioids?

Opioids are a class of drugs that include synthetic opioids, prescription painkillers, and heroin.1 These drugs are all chemically related and interact with the same opioid receptors in the brain and body. Their effects result in feelings of euphoria, which encourages opioid abuse, dependence, and addiction.

The terms “opiates” and “opioids” are often used interchangeably, but there is a difference between the two. An opiate is a drug that is naturally derived from the opiate poppy plant and an opioid is a broader term that refers to natural or synthetic substances that bind to the body’s opioid receptors.

Opioids are classified as controlled substances by the DEA and their current scheduling is as follows:

Opioid Drug Scheduling
Schedule IHeroin
Schedule IIDemerol (meperidine)

Dilaudid (hydromorphone)

Dolophine (methadone)

Duragesic or Sublimaze (fentanyl)

Morphine

Opium

OxyContin

Percocet (oxycodone)

Vicodin

Other hydrocodone medications

Schedule IIIBuprenex

Subutex

Suboxone

Temgesic

Other buprenorphine products

Schedule IVTramadol
Schedule VSome codeine medications (e.g., Robitussin AC)

Source: https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

Side Effects of Opioid Use

When they are used responsibly as prescribed by a doctor, prescription opioid drugs provide effective relief from moderate to severe pain. However, when opioid drugs are abused, they can cause the following short-term side effects:

  • Depressed breathing
  • Drowsiness
  • Constipation
  • Nausea
  • Unconsciousness
  • Coma2

 Long-term opioid abuse may also result in:

  • Tolerance
  • Physical dependence
  • Opioid withdrawal
  • Addiction2

Causes of Opioid Addiction

If a person is addicted to opioids, he or she may feel like they are impossible to live without. An addicted person may also experience irresistible cravings for opioids and succumb to uncontrollable, compulsive opioid use. There is no single cause of opioid addiction, rather, the factors that contribute to opioid addiction often include a person’s genetics, environment, and lifestyle factors.

Researchers believe that many of the genes involved in the body’s reward and pleasure center also play a role in addictive behaviors and opioid addiction. According to the U.S. National Library of Medicine, the genes that are responsible for making opioid receptors may vary, which lead to differences in the opioid receptors’ structure and function. In turn, this also influences how the body responds to opioid drugs.3

There are also several environmental and lifestyle factors that may cause opioid addiction. They include:

  • A history of substance abuse
  • Depression
  • Psychiatric disorders
  • Childhood abuse/neglect
  • Personality traits like impulsivity and sensation-seeking
  • Poverty
  • Associating with people who abuse opioids

Generally, a combination of all the factors listed above determines a person’s likelihood of developing an opioid addiction.

Opioid Addiction Risk Factors

Any opioid use, even short-term, can lead to tolerance, dependence, addiction, and overdose. Therefore, anyone who takes opioid drugs is at risk of becoming addicted to them. Although it is impossible to determine who will become addicted and who will not, here are some of the most common risk factors for opioid addiction:

  • Personal or family history of substance abuse
  • History of criminal activity and/or legal problems
  • History of severe depression and/or anxiety
  • Previous drug or alcohol rehabilitation
  • Association with drug users or high-risk environments
  • Mental disorders/psychiatric problems
  • Young age
  • Thrill-seeking behaviors
  • Heavy tobacco use
  • Poverty/unemployment
  • Stressful life circumstances4

Opioid Addiction Statistics

Opioid addiction is common in America and it doesn’t discriminate based on gender, social class, profession, race, age, or any other social standing or class. Here are some recent opioid addiction statistics that illustrate the growing opioid abuse problem in the U.S.

  • More than 130 people die every day from opioid-related drug overdoses.5
  • The estimated total economic burden of prescription opioid abuse in the U.S. is $78.5 billion a year.5
  • 47,600 people died from opioid overdoses in 2017.6
  • 886,000 people used heroin in 2017.6
  • 81,000 people used heroin for the first time in 2017.6
  • 15,482 deaths were attributed to heroin overdoses in 2017.6
  • 11.4 million people misused prescription opioids in 2017.6
  • 2 million people misused prescription opioids for the first time in 2017.6
  • 2.1 million people had an opioid use disorder in 2017.6
  • 28,466 deaths were caused by synthetic opioid overdoses other than methadone in 2017.6
  • An estimated 23 percent of people who use heroin will develop opioid addiction.7
  • In 2017, the number of overdose deaths involving opioids was 6 times higher than in 1999.8

Opioid Addiction: Treatment and Prevention

Opioid addiction can’t always be prevented, but there are several measures that individuals can take to protect themselves from the risks of prescription drug abuse and opioid addiction. A few strategies include:

  • Closely following the directions or instructions provided by the pharmacist when taking prescription opioid drugs.
  • Being aware of potentially dangerous drug and alcohol combinations and interactions.
  • Talking to a doctor before changing prescription doses.
  • Not taking anyone else’s prescription opioids or sharing yours.
  • Storing prescription opioid drugs safely.9

If you or a loved one is addicted to opioid drugs, there is a way out and you can recover with the right support. Evidence-based treatment methods in detox, rehab, and aftercare can help ensure a full recovery from addiction while also initiating positive behavioral changes, attitudes, and healthy social interactions with sober peers.

Admitting you’re addicted and you need help is difficult, but it’s the first step to reclaiming your life. Call (512) 605-2955 to speak with a Nova admissions representative today to find out how we can help you take hold of a fresh start and begin your new life in recovery.

 

References:

  1. https://www.drugabuse.gov/drugs-abuse/opioids
  2. https://www.ncbi.nlm.nih.gov/pubmed/18443635
  3. https://ghr.nlm.nih.gov/condition/opioid-addiction
  4. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
  5. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
  6. https://www.hhs.gov/opioids/about-the-epidemic/index.html
  7. https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
  8. https://www.cdc.gov/drugoverdose/epidemic/index.html
  9. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented

Battling Prescription Drug Abuse in Texas

prescription drugs

Like most states in the U.S., Texas is facing a severe problem with abuse of and addiction to prescription opioids. 

What is Prescription Drug Abuse?

Prescription drugs are carefully controlled substances that are prescribed by a doctor to an individual patient for a specific condition. Taking a drug that was prescribed to someone else, in a higher dose than prescribed, or with the specific intent to get high is abuse.

Some individuals are abusing prescription drugs by altering them; for example, crushing tablets to snort or inject the powder thus amplifying the drug’s effects.

What Makes Prescription Drugs Addictive?

Many prescription drugs produce feelings of euphoria and calmness when they are taken in large doses. Although they are not intended to be taken this way, people may develop a tolerance over time and start taking larger doses to feel the effects. Additionally, when prescription drugs are taken with other addictive substances like alcohol, heroin, or methamphetamine, the pleasurable side effects are often enhanced. Due to the extreme addictive qualities of prescription opioid drugs, scientists and researchers are working to develop alternative drug options, such as meloxicam, to treat chronic pain.

Most Abused Prescription Drugs

Some prescription drugs are more likely to be abused than others. This often depends on their pleasurable effects and how easy they are to get.

According to the National Institute on Drug Abuse (NIDA), after marijuana and alcohol, prescription drugs are some of the most commonly abused substances in America. The Substance Abuse and Mental Health Services Administration estimated that in 2017, 11.1 million people misused prescription painkillers.1 That’s a huge increase in opiate abuse compared to 2012 when just 4.9 million people in the U.S. were abusing them.

According to the NIDA, the classes of prescription drugs most commonly abused are opioid pain relievers, stimulants for treating Attention Deficit Hyperactivity Disorder (ADHD), and central nervous system (CNS) depressants. These categories include drugs like:

What is the Cause of Prescription Drug Abuse?

Opioid medications are typically prescribed for painful conditions, including dental work and injury-related pain.2 Morphine is often used before and after surgical procedures to alleviate severe pain. Prescriptions for codeine are more commonly used for mild pain but are also given to relieve symptoms like coughing and diarrhea.

These drugs all have legitimate medical uses, but they are also being used in unintended ways and for durations longer than necessary, and they are often diverted or sold to those who do not have legal prescriptions or genuine conditions requiring these medicines.

During the “America’s Addiction to Opioids” presentation, which was given to the Senate Caucus on International Narcotics Control in 2016, Nora Volkow stated, “Several factors are likely to have contributed to the severity of the current prescription drug abuse problem. They include drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes and aggressive marketing by pharmaceutical companies. These factors together have helped create the broad environmental availability of prescription medications in general and opioid analgesics in particular.”3

What are the Risks of Prescription Drug Abuse?

Many individuals assume that prescription drugs are safer than illegal substances, but this assumption is false. There are many risks of prescription drug abuse.

  • Harmful side effects or overdose: Prescription drugs are given for a specific purpose. Nearly all drugs have side effects, and when prescribing a drug, doctors are aware of any possible effects and have considered them with regards to the overall treatment plan. When prescription drugs are taken outside of their intended purpose, the user is at risk for adverse health effects including the possibility of overdose or a reaction to another drug or alcohol.
  • Addiction: Nearly all of the most commonly abused prescription drugs have the potential for addiction. The risk of addiction becomes further amplified when the drugs are taken improperly and abused.
  • Abuse of other illegal substances: Additionally, abuse of prescription drugs can be a dangerous gateway to the use of illegal substances. The NIDA reports that nearly half of young people who inject heroin surveyed in three recent studies reported abusing prescription opioids before starting to use heroin.

Prescription drug abuse is serious and is on the rise in the United States. Taking drugs prescribed to someone else or taking drugs beyond their intended use is abuse and the individuals doing so face dangerous side effects and addiction.

Prescription Drug Addiction in Texas

According to the report “Substance Abuse Trends in Texas,” hydrocodone is the most prevalent prescription opioid used for nonmedical purposes in Texas. The report also indicates an increasing problem with abuse of codeine cough syrup and attributes the rise, in part, to music promoting “sippin’ syrup” and several cases of popular singers getting in trouble because of their use of “syrup.”

  • In 2015, Texas providers wrote 15.9 million prescriptions and there were 617 prescription opioid-related overdose deaths in the state.4 Experts say most of the people addicted to opioids in Texas are not abusing heroin. Instead, they’re taking prescription painkillers like Oxycodone and OxyContin.5
  • In 2017, about two-thirds of opioid-related exposure calls to the Texas Poison Center Network were made for commonly prescribed opioids, and of the 1,174 Texas deaths involving opioids in 2015, 517 involved opioid painkillers.6

Trends in Texas center around illicit pain clinics, pharmacies, and physicians. The most desired pharmaceuticals continued to be the three that constitute what is known as the Houston Cocktail: hydrocodone, carisoprodol (Soma), and alprazolam (Xanax). The DEA reported prescriptions from Houston pain management clinics were filled in pharmacies as far north as Oklahoma, as far east as Alabama and as far west as El Paso.

Large numbers of patients from Louisiana and other states travel to the Houston area for the purpose of prescription fraud. Pill crews recruit “patients” to fraudulently obtain multiple prescriptions from pain clinics, which are filled at local pharmacies and then given to the pill crew leader for illicit distribution. Houston area physicians were also found to be mailing prescriptions to patients in other states—primarily Louisiana and Mississippi.

Monitoring Prescription Drug Abuse and Controlling Diversion

Texas House and Senate committees continue to examine ways to limit prescription drug abuse and agree that Texas should interactively share its drug monitoring database with other states. State lawmakers also propose that doctors should be encouraged to use online databases identifying patients who “doctor shop” for medications.

Since diversion of prescription drugs is a significant abuse problem, The Texas Prescription Monitoring Program was created to monitor controlled substance prescriptions. This program provides an efficient, cost-effective tool for investigating and preventing drug diversion.7

Medical practitioners and pharmacists use the Texas Prescription Monitoring Program to do the following things:

  • Verify records and inquire about patients
  • Help detect possible illicit use
  • Generate and disseminate information regarding prescription trends

Naloxone Available Without A Prescription for Texans

Another recent effort to combat the increase of deaths from opioid overdose involves the drug naloxone. Naloxone can be administered to someone actively overdosing on opioids and can reverse the effects of opiates almost immediately.

In 2016, advocates and public health experts convinced state lawmakers to pass a Senate bill to expand the availability of naloxone in Texas.8 In February, Walgreens announced it was rolling out a comprehensive initiative to make the life-saving drug available without a prescription at its pharmacies in 35 states and Washington, D.C.9

Addicted to Prescription Drugs? Find Prescription Drug Addiction Treatment

If you are addicted to prescription drugs, you’re not alone. There is plenty of help available for people who are suffering from the misuse of prescriptions. If you are curious about where to get help for prescription drug abuse, an addiction treatment program like Nova Recovery Center can help you achieve sustained sobriety. To learn more about our inpatient and outpatient treatment for prescription drug abuse, call us today to speak with a member of our admissions team.

 

References:

  1. https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report
  2. https://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-opioids%20title=
  3. https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse
  4. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/texas-opioid-summary
  5. http://www.kut.org/post/opioid-abuse-rise-texas-and-advocates-say-state-needs-act-fast
  6. http://www.texashealthinstitute.org
  7. https://www.pharmacy.texas.gov/PMP/
  8. http://www.kut.org/post/walgreens-provide-opioid-overdose-reversal-drug-without-prescription-texas
  9. https://www.chaindrugreview.com/walgreens-sharpens-aim-at-drug-abuse/

Treating Heroin Cravings with Virtual Reality

Heroin use has been on the rise since 2002, doubling over the course of ten years. With this increase in heroin use comes the need for new and improved forms of treatment.

While medications and traditional therapy are important in the continued fight against heroin addiction, researchers are beginning to look toward new innovations to provide alternate forms of treatment.

The Heroin Problem

Morphine is a naturally occurring opioid pain reliever derived from opium poppy plants that can be synthesized into heroin. Typically, heroin appears as either a white or black powder that can be smoked, snorted or injected.

Whatever the method of use, heroin reaches the brain quickly, creating a euphoric high. As a derivative of morphine, heroin interacts with the opioid receptors in your brain that control pleasure and pain centers, blood pressure and breathing.

As heroin is used repeatedly, the receptors in the brain grow accustomed to the steady influx. This creates a dependence that quickly develops into addiction. When the heroin is withheld, the brain reacts to the absence and sends the body into withdrawal.

Heroin addiction can be difficult to beat, but with proper medication and therapy, it’s possible to overcome. Fortunately, as technology evolves, new possibilities for treatment develop.

Innovative Therapy: Virtual Reality

At the University of Houston, the Graduate College of Social Work is developing a new form of heroin addiction treatment that involves virtual reality. Using cutting-edge technology, researchers are utilizing virtual reality to simulate situations that might trigger heroin cravings.

Two different scenarios have been created that can be considered high-risk situations for relapse. Both scenarios involve a house party, but one features snorted heroin while the other shows heroin being injected.

The room has a variety of cameras projecting 3D images that are viewed through 3D glasses, making the environment seem real. In this way, participants can simulate interacting with people and objects. Using this room, a participant would walk around the party and experience situations that could trigger cravings.

Accompanying this virtual experience is the steady hand of a trained therapist helping the participant to work through the experience and utilize the coping skills they have learned. Unlike traditional therapy, which often involves role-playing in an office, the virtual reality experience immerses the participant in craving-inducing scenarios, albeit from the safety of a clinical setting.

Does Virtual Reality Therapy Work?

The University of Houston’s virtual reality therapy is still experimental. There haven’t been many studies demonstrating effectiveness, but the possibilities are promising.

Being able to go beyond the limitations of simple imagination exercises and engage in scenarios involving temptation could be revolutionary for heroin addiction treatment. Studying the brain and body’s response to stimuli during these situations may lead to new understandings of addiction and treatment.

Therapists and clients will also be able to work together to develop better coping skills in a safe environment, hopefully leading to reduced cravings and decreased risk of relapse in the real world.

Heroin abuse and addiction aren’t going away, but with advances in technology come new treatment approaches. For those who struggle with heroin addiction, these new technologies may help them learn to lead sober lives.

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