The opioid epidemic in the United States has reached crisis levels that have medical, social, and government officials’ attention. In 2017, President Donald Trump formally declared the opioid crisis a public health emergency, an important step in addressing the epidemic of opioid misuse that has affected groups across age, race, sex, occupation, and much more. Data show that more than 100 deaths a day occur as a result of opioids across the nation, and observers predict the epidemic will get worse before it gets better.
Opioids are a class of prescription medications that are used to treat moderate-to-severe pain that results from surgeries or severe injuries. Doctors started treating pain as a serious medical issue in the 1990s and began prescribing OxyContin and Percocet to people with chronic pain. This group of drugs, which includes the illegal drug heroin, reduces the number of messages the brain receives about pain. This happens when opioids interact and bind with opioid receptors on the nerve cells in the body and brain.
Chronic opioid use also floods the brain’s pleasure center with dopamine; this is why users experience euphoria when they take it. Chronic, repeated opioid use can flood the brain with artificial endorphins. Over time, the brain will come to rely on these artificial endorphins and will stop producing them on its own.
Opioid medications are designed for short-term use. They are considered safe when taken as prescribed by a doctor for a limited time. However, when these drugs fall into the wrong hands, the feelings of euphoria and relaxation and pain relief they are commonly known for making them easy for people to misuse and abuse. Prescription drug abuse means users either:
Even people who have legally obtained opioid prescriptions can still develop a dependence on them after regular use, and this dependence can lead to addiction. If you or someone you know is using opioid medications and decides to stop using them, do not do so abruptly. Quitting a drug abruptly without a doctor’s consultation can worsen conditions and trigger uncomfortable withdrawal symptoms. These symptoms include seizures, nausea, vomiting, diarrhea, insomnia, numbness, and tingling in the extremities, fever, and mood changes, among others.
Here are some of the opioids that are contributing to the epidemic:
A liquid pain reliever and cough suppressant that causes respiratory depression and other harmful effects that occur with prolonged use. Street names: Captain Cody Cody, Schoolboy, Doors and Fours, Little C cough syrups
A synthetic, fast-acting opioid pain reliever that works similar to morphine; it is used during labor and delivery for pregnant women. Street names: Smack, Dust, Juice, D, or Dillies.
Chronic use of this prescription drug can cause mood or behavior disorders and lead to heroin use. Street names: Dust, Juice, Smack, D, Footballs
A powerful synthetic opioid medication that is used intravenously as in medical settings; it is estimated to be 80 to 500 times stronger than morphine. Street names: Apache, China Girl, China Town, Dance Fever, Friend, Goodfella, Tango & Cash
An illegal opioid drug made from morphine that comes from the Asian opium poppy plant that changes the physical structure of and physiological changes in the brain with chronic use. Street names: China White, H, Smack, Black Tar, Mud, Dragon, Mexican Brown, Thunder
An opioid sold under the names Vicodin, Norco, and Lortab. It is the most frequently prescribed medication, according to the Drug Enforcement Administration. Street names for Vicodin: Vikes, Vics, Vicos, Idiot Pills
An opioid that is primarily used in the treatment of opioid addiction. Methadone maintenance is designed to replace harder, more dangerous opioids. The treatment helps people abstain from heroin and other illicit drugs. Street names: Done, Junk, Metho, Dolls, Dollies, Methadose.
A prescription opioid pain reliever used to treat moderate-to-severe pain that comes from the opium found in the poppy plant. It should be taken with care as it can slow a person’s breathing. Street names: Mister Blue, Morpho, Dreamer, God’s drug
A synthetic opioid pain medication derived from thebaine, which is found in the Persian poppy plant; it is the ingredient in OxyContin and Percocet
An opioid pain reliever that is the brand name for the narcotic oxycodone hydrochloride. OxyContin differs from pure oxycodone because it contains a time-release feature. People bypass this time-release feature when they crush OxyContin pills and snort them. At high doses, OxyContin produces strong euphoric effects. Street names: Blue, Oxy, Hillbilly Heroin, Kicker, Oxycotton
A prescription opioid used for short-term pain management is a combination of oxycodone and acetaminophen (the active ingredient in over-the-counter pain relievers Tylenol). Street names: Percs, percodoms
A brand-name opioid medication that contains buprenorphine and naloxone (a drug that blocks opioids from binding opioid receptors). Street names: Boxes, Bupes, Oranges, Sobos, Stops, Stop Signs
Known as Ultram under its brand name; it is a prescription medication used to treat mild-to-acute pain and depression. Street names: Trammies, chill pills, ultras
People who are addicted to opioids may exhibit the following symptoms:
People who have used opioids and developed an addiction can recover at a licensed drug rehabilitation facility. Once they have been admitted, they typically start with medical detoxification.
During this process, medical professionals monitor clients around-the-clock as they are weaned off the drug safely. This may include tapering off the opioid medication used, which is when doses are gradually reduced over a set period to allow the body time to adjust to not having the drug in its system.
After a medical detox is completed, clients typically enter a residential treatment program where they will address the physical and psychological addiction. These treatment programs can be tailored to an individual’s needs and preferences. Inpatient treatment, which can last from 28-90 days in a facility, depending on the program, involves therapies that can help the person overcome their addiction. Treatment also can incorporate 12-step programs, holistic therapy, family therapy, individual counseling, and group counseling.
There is also an outpatient treatment for people who may be in the early stages of opioid addiction or have a mild case of it. Outpatient therapy does not require an on-site stay at a treatment center, an arrangement that gives clients more flexibility as they work drug treatment into their schedules. However, outpatient clients are still required to attend structured sessions three to five times a week or more, depending on the situation.
Recovering opioid users may want to consider using aftercare services to help them focus on their recovery goals and reduce their chances of relapse. Some people pursue follow-up medical care and ongoing therapies to help manage post-acute withdrawal symptoms, known as PAWS, that can happen long after dependence on the drug has passed.
Whether opioid medication comes from the naturally occurring poppy plant or a laboratory, people who take opioids must be careful. When used within therapeutic ranges as prescribed by a doctor, opioids are effective in treating pain. However, at higher doses, opioids can slow a person’s breathing and heart rate. The euphoric effects of opioids make people want to abuse them more, and indulging often leads to addiction or death.
However, even though the physical consequences of maintaining an opioid addiction are high, the side effects of quitting cold turkey can just as brutal. As with most powerful drugs, it is dangerous to detox alone without medical supervision. Anxiety, irritability, insomnia, and aching muscles can quickly lead to depression, severe cramps, and vomiting. For this reason, the best course of action is to seek medically supervised detox at an approved facility to avoid the worst of the opioid withdrawal symptoms.
Deaths from opioid abuse almost always begin with an overdose. While not all overdoses are fatal, each one poses a serious threat. Even if you survive your overdose, you could still suffer from breathing problems and even permanent brain damage. During an opioid overdose, a user’s pupils will constrict and they will experience respiratory depression. This is often followed by seizures, vomiting, and spasms that can be harmful if not controlled. The lethality of an overdose comes from respiratory failure. According to the American Society of Addiction Medicine, opioid overdoses account for more than 60% of all overdose-related deaths in the U.S.
The drug Naloxone or Narcan has been a valuable tool in the arsenal of first responders to immediately reverse the effects of an opioid overdose. It is sold over the counter and can be administered through the nose or injected directly into the skin. However, it can sometimes take several doses of Narcan to bring a victim back to consciousness, and it does not save them from any permanent consequences.
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