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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/

Are Sleep Aid Medications Gateway Drugs?

sleep aid medications

According to a 2017 review published in the journal The Gerontologist, about 1 in 5 adults use an over-the-counter sleep aid medication to get some shut eye.1 While the study cited Benadryl as being one of the most commonly used sleep-inducing drugs (even though it’s actually intended to treat allergy symptoms), the long-term use and misuse of over-the-counter and prescription sleep aids like Sonata, Doral, Trazodone, and Ambien may increase a person’s risk for developing a substance use problem with more harmful drugs or illegal substances. (more…)

Parents Should Lock Their Medicine Cabinets

medicine cabinet

You may have heard some families are locking their medicine cabinet in their homes, and you may think that seems a bit ridiculous. If you haven’t gotten the memo yet, parents it’s time to clean out your medicine cabinets and lock prescription opioid painkillers away. Teen prescription drug abuse is becoming a serious problem in the United States today. According to the Partnership for a Drug-Free America: 1 in 5 teens has abused prescription pain medication. Adolescents are abusing these “safe” physician prescribed drugs more than heroin, methamphetamines, and cocaine. The White House Office of Nation Drug Control Policy has said that: Every day, 2,500 kids aged 12-17 abuse a prescription painkiller for the first time and more people are getting addicted to prescription drug abuse. Parents are supplying the drugs without even realizing it. (more…)

Prescription Drug Abuse Predicts Heroin Use

The rise in prescription drug abuse has created an unexpected trend, a rise in the use of the opioid drug heroin. According to the National Institute on Drug Abuse (NIDA), 1 in 15 people who abuse prescription pain relievers will try heroin within ten years.

According to the NIDA, in 2010 about 1 in 20 or 12 million people used prescription pain medication when it was not prescribed for them. A report by the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals “that people aged 12 to 49 who had used prescription pain relievers nonmedically were 19 times more likely to have initiated heroin use recently than others in that age group. The report also shows that four out of five recent heroin initiates (79.5 percent) had previously used prescription pain relievers nonmedically.” As prescription drug abuse increases, the number of people who will attempt and become addicted to heroin is expected to dramatically rise in the near future.

Cheaper and Easier

Many young people who are abusing prescription drugs are switching to heroin due to the cost. Prescription drugs are expensive costing between $5 to $50 per pill depending on the type, while heroin can cost as little as $10 per balloon and can be easier to buy. Newsweek reports that there has been a shift is the demography of those who are using heroin, “Heroin addicts these days are more likely than ever before to be rich, white and suburban . . . that shift is likely attributable to the unanswerable demand for one of medicine’s greatest—and most controversial—discoveries: prescription opioids.” As restrictions have been passed to make prescription opioids more difficult to obtain, many who are already addicted are turning to heroin. Rafel Lemaitre of the White House Office of National Drug Control Policy says, “It’s hard to talk about the heroin problem without talking about the prescription drug problem.”

Prescription drug abuse in and of itself is an alarming trend and researchers are now pursuing alternative drugs with less addictive qualities, such as meloxicam, in an effort to reduce abuse, addiction, and overdose-related deaths. However, as those who are addicted to prescription drugs seek a cheaper and more accessible high through heroin, it is becoming an increasingly dangerous situation and risks exposing young people with little to no knowledge of dangerous drugs to a precarious future of addiction and possibly death.

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