A recent increase in opioid-related drug deaths has led the Center for Disease Control (CDC) to call the problem a national epidemic while the U.S. Department of Health and Human Services has declared a public health emergency. Public health officials and medical professionals alike are scrambling to find the best solution for misuse of opioids while also accounting for the legal uses of the drugs. All this has turned national attention to the dangers of continued and prolonged opioid use. Many are wondering what the side effects of long-term opiate use are, how opioids work, and what they are used for.
Opioids: What You Need to Know
Opioids can be difficult to understand at first. To begin, they are often not only referred to as opioids but as opiates as well. The two terms are commonly used interchangeably, but they have distinct meanings and usages. Originally, the word opioid was used to describe only synthetic substances which mimicked opium, a substance derived from poppy plants. Today, however, it is used to define the entire class of substances that are either naturally derived from, or used to synthetically simulate opium. Opiate, on the other hand, refers specifically to a natural drug derived from the opium poppy. In other words, an opiate can be an opioid, but an opioid is not always an opiate. Whether the drug is in its natural or synthetic form, it can cause serious side effects and be dangerously addictive.
Are They Legal?
Yes and no. Nearly all opioids are classified by the Drug Enforcement Administration (DEA) as Schedule II controlled substances. This means that they have a medically accepted purpose and are legal to use under the supervision of a medical professional, but they have a high potential for abuse which can lead to severe psychological or physical dependence and overall are considered dangerous. The exception to this is heroin which is classified as a Schedule I substance. Drugs classified as Schedule I are defined as substances with no currently accepted medical use and a high potential for abuse.
All of these drugs can be abused, potentially leading to addiction, even if they are prescriptions. Some opioid abusers may refer to all of these drugs using slang terms which help evade police attention. Some of the street names for a variety of opioids include H, hammer, skag, gear, smack, horse, elephant, rock, nose drops, black tar, China white, white, Chinese H, white dynamite, and dragon.
How do Opioids Work?
Simply put, opioids mimic chemicals naturally found in the brain and body that attach to tiny parts of nerve cells called opioid receptors. There are three types of opioid receptors in the brain known as mu, delta, and kappa. Each of these receptors has a different effect when stimulated. For example, mu receptors are responsible for opioids’ pleasurable effects and their ability to relieve pain. Opioids act on many areas of the brain and nervous system, including the following:
- Limbic System Responsible for emotions, opioids which land here can create feelings of pleasure, relaxation, and contentment.
- Brainstem Controlling automatic bodily functions, like the heartbeat, opioids received in this area can slow breathing and heart rate and reduce feelings of pain.
- Spinal Cord Receiving sensations from all over the body and sending them to the brain, opioids here suppress these signals which decrease the sensation of pain, even after serious injuries.
Whether it is a prescription medication or street drug, like heroin, the intensity of the effects depend on how much is taken, how often, and by what method. Opioids which are injected, act faster and more intensely while those swallowed as pills take longer to reach the brain making them slightly safer, though still with high potential for abuse.
What are They Used For?
The intended medical use of opioids are to help manage moderate to severe pain in patients. In most cases, opioids are prescribed following a medical procedure or to manage chronic pain. Common legal opiate drugs include:
- Morphine A highly addictive, naturally occurring substance found in the opium plant.
- Meperidine Similar to morphine, this is a synthetic prescription medication that produces similar effects.
- Codeine A less powerful but still addictive substance, it is primarily used as a cough suppressant. Codeine is typically prescribed in conjunction with other medications.
- Hydrocodone A semi-synthetic opioid, it is the most frequently prescribed opiate medication on the market. Its brand names include Lortab and Vicodin.
- Oxycodone Another semi-synthetic opioid whose common brand names are Percocet and Oxycontin.
- Fentanyl A highly addictive opiate that is produced synthetically, making it known as a synthetic opioid analgesic. Fentanyl is commonly prescribed as a skin or transdermal patch.
Despite having an accepted medical use, even those individuals who are prescribed opioid medications are at risk for abuse and addiction, especially in those cases of long-term use.
Side Effects of Opioid Use
As with most drugs, opiates come with the risk of certain side effects. The risk of developing the side effects increases in intensity the longer the drugs are used. Opiates usually result in the user experiencing a sort of high; the faster-acting the drug is, the more intense the high. Heroin, for example, produces an extreme high as a result of its very short half-life which is between 15 and 30 minutes. Morphine, on the other hand, is much longer and lasts around 4 to 6 hours, producing a less intense high. Short-term effects of opioid use include feelings of euphoria, pain relief, drowsiness, and sedation.
When opioids are used for an extended period of time, the side-effects become much more dangerous regardless of whether an individual is taking them as prescribed or abusing them. The side-effects of long-term opiate use include:
- Nausea and vomiting
- Abdominal distention and bloating
- Liver damage, especially prevalent in abuse of drugs
- Brain damage due to hypoxia (the lack of oxygen), resulting from respiratory depression
- Development of tolerance, leading to increased dosages having minimal effect
This last side-effect is the most commonly recognized, also known as addiction. It is surprisingly easy to become addicted to opioids without realizing it. Recognizing the signs you have an opiate addiction can also be very difficult in the beginning. Even codeine, a commonly prescribed painkiller, is addictive. Opiate dependence is diagnosed when an individual cannot stop use of the drug despite any negative consequences of being on it, such as stealing drugs or money to fund their habit. Relationships with others might break down as a result of their drug use and work performance may suffer, resulting in financial problems.
As an individual begins to lose control of their life, abusing opioids becomes more and more likely. The side effects of opiate abuse and opioid withdrawal symptoms are fairly varied and may include drowsiness or lethargy, paranoia, respiratory depression, and nausea. Opiates also cause the irises of the eye to relax, creating pinprick or pinpoint pupils. This is one of the most recognizable signs of opiate abuse as it is hard to disguise. Due to the intense high produced by the interaction of opiates and the brain, these drugs remain extremely addictive and can cause measurable symptoms of addiction in just three days or less.
The longer opioid abuse is not addressed or confronted, the more likely an overdose becomes. An overdose occurs when an individual uses too much of an opioid such as Vicodin, OxyContin, morphine, or heroin. The side effects of opiate overdose can include a diminished level of consciousness, depressed or slowed breathing, and a resulting lack of oxygen to the brain known as hypoxia. When not treated quickly or effectively, death is a distinct possibility with opioid overdoses. Though alcohol, sedatives, or a mix of opioids (either prescription or illicit) are frequently involved in many opioid-related overdose deaths, opioid overdoses do sometimes occur after a person accidentally takes too much of their prescription medication. Symptoms of an opioid overdose include:
- Marked confusion, delirium, or acting drunk
- Frequent vomiting
- Pinpoint pupils
- Extreme sleepiness, or the inability to wake up
- Intermittent loss of consciousness
- Breathing problems, including slowed or irregular breathing
- Respiratory arrest, or the absence of breathing
- Cold, clammy skin
- Bluish skin around the lips or fingernails
Depressed breathing is the most dangerous side effect of opioid overdose. Lack of oxygen to the brain can result in permanent neurologic damage and may also trigger the widespread failure of other organ systems, such as the heart and kidneys. If a person experiencing an opioid overdose is left alone and asleep, the individual could easily die as their respiratory depression worsens.
Help for an Overdose
Whether they struggle with addiction to these medications or not, it is easy for people to take too much of a prescription painkiller such as Vicodin. If an overdose is suspected, call 911 immediately to get emergency help. While waiting for emergency medical attention to arrive, the patient should be rolled onto their side to prevent choking in the event that they vomit while unconscious. If the individual is conscious, keep them awake and talking as much as possible. Do not leave a person who has potentially overdosed on opioids alone as their symptoms and overall health can quickly worsen.
Once the individual is receiving medical attention, a number of lifesaving treatments may be utilized including:
- Airway management or intubation, to ensure the individual can breathe
- Activated charcoal administration to minimize further absorption of any ingested toxins
- Gastric lavage, or stomach pumping, to help rid the body of any unabsorbed toxins
- Defibrillation to address cardiac irregularities
- Venous line access for administration of intravenous fluids to stabilize hydration and to correct any electrolyte imbalances or hypoglycemia, which may be a result of vomiting
Naloxone administration may also be utilized in addition to the above treatment. Naloxone binds to the same receptors in the brain as opioid drugs and prevents the drug from creating a “high” for up to one hour after administration. If given early enough, naloxone may effectively reverse an overdose for a period of time, which can be enough time for additional life-saving medical interventions to begin.
While opioids have a medical purpose, it is clear that they are dangerous and highly addictive drugs. In as little as three days, an individual can become addicted to the effects the drugs produce which is why it is important to monitor patient dosage carefully when prescribing painkillers. Individuals who are prescribed the drugs should closely examine their own behavior and feelings while using the drugs and work alongside their doctors to maintain independence from the drugs. Doing so will help avoid any long-term effects, specifically dependency, and decrease the risk of addiction.
To find an opiate addiction treatment center, call Haven House today. Our trained and professional staff will teach you how to get off opioids, deal with symptoms of withdrawal, and transition to a positive life.