By Julie A. Kmiec, DO
Statistics about opioid use
The number of people with opioid addiction in the US is growing. The increase in the number of people addicted parallels the increase in prescriptions of opioid analgesics. The number of opioid prescriptions nearly tripled from 1991 to 2009, to over 200 million. According to
the 2009 National Survey on Drug Use and Health, the number of new users of prescription opioids was 2.2 million. The number of persons addicted to prescription opioids rose from 1.5 million in 2002 to 1.9 million in 2009. Among persons aged 12 or older who used pain relievers nonmedically in the past 12 months, 55.3% got the drug they most recently used from a friend or relative for free, 9.9% bought them from a friend or relative, 17.6% reported they got the drug from a doctor, 4.8% got pain relievers from a drug dealer or other stranger, and 0.4% bought them on the Internet. Regarding heroin use, the number of new users of heroin rose from 91,000 in 2002 to 180,000 in 2009. The number of people who admitted to regularly using or addiction to heroin was 399,000. Opioid use and your health Opioid addiction may result in fatal overdose, miscarriage, and in injection drug users infectious diseases such as HIV and hepatitis C. Chronic intravenous drug users may develop collapsed veins, endocarditis (infection of the heart lining and valves), skin infections and abscesses at the injection sites including MRSA (methicillin resistant staphylococcus aureus). Additionally, the additives that are used to “cut” heroin may clog blood vessels in the lungs, liver,
kidneys, or brain, causing permanent damage to these vital organs. In 2007, there were 28,000 deaths from unintentional drug poisonings. Of these deaths, almost 12,000 involved prescription painkillers. People with addiction are about 4.5 times more likely to be also diagnosed with a mental illness. Studies have shown that people addicted to opioids have a higher rate of depression, anxiety, and/or personality disorders than people who do not use drugs. How someone becomes addicted to opioids Opioids, such as heroin and oxycodone, bind to opiate receptors in the brain. When opioids bind to these receptors, chemical messengers are released and the user experiences pain relief and/or a sense of euphoria. People with an opioid addiction often continue to use opioids to regain that sense of euphoria. When someone uses opioids on a regular basis, chemical changes occur in the brain at the level of opiate receptors. After a period
of time, someone who uses opioids regularly will respond differently than someone who rarely uses them. These changes are called tolerance and dependence. Tolerance means that it takes a larger amount of the drug to achieve the same level of response achieved when first used. Dependence means the neurons have adapted to the repeated drug exposure and only function normally in the presence of the drug. What happens when you try to quit using opioids? If you choose not to use opioids after physical dependence has developed you will go through withdrawal. Withdrawal is the process of your brain getting used to being without the drug it is dependent upon. Opiate withdrawal syndrome consists of sweating, tremor, cramps, chills, increased heart rate, restlessness, runny nose, yawning, sneezing, nausea, vomiting, diarrhea, weakness, low mood, anxiety, insomnia, dizziness, and cravings for opioids. Inability to tolerate withdrawal is a reason why some people continue to use opioids. Treatment for opioid dependence Some people who notice they have a problem with opioids are able to stop using them on their own. Others go through a detox program and then attend mutual support meetings, such as Narcotics Anonymous (NA). Some people get treatment for opioid dependence by attending counseling or drug rehabilitation programs. In addition to NA and psychosocial treatments, there are three medications that are approved by the Food and Drug Administration for treatment of opioid dependence that may aid in your recovery. These medications are naltrexone, buprenorphine, and methadone and they are described on the pages that follow.