How are opioids used?
Opioids are used medically to treat severe and chronic pain. They are fast acting and effective, so one of the main uses is to help patients manage post-operative pain. However, they can also be used to manage the pain associated with major injuries. Opioids also have a sedative effect, so can be useful in situations where a patient is not just in pain, but may also be experiencing some stress or anxiety with their situation.
While opioids are used to manage chronic pain, the risks of opioid abuse and addiction means this use is much more limited. Typically, they will only be prescribed to help manage pain associated with a terminal or degenerative disease or condition. Milder opioids can and are used for injuries and conditions that are expected to resolve themselves before a dependency can be formed.
Opioids that are commonly used include less potent drugs like codeine and Vicodin, which might be prescribed by a doctor to manage injury pain. Drugs like morphine or fentanyl — a powerful synthetic opioid — are only likely to be used in clinical settings or in controlled circumstances when a patient is in severe pain.
Heroin is also an opioid drug, made in much the same way as morphine, although it has no recognized clinical use. Methadone is another opioid which is most used as a substitute to help people manage their withdrawal from other opiate-based drugs.
What is opioid abuse and addiction
When used as clinically directed opioids should be safe to use, and doctors will be careful to avoid situations in which an addiction can form. However, may people do develop an addiction following a medical prescription as well as following illicit and recreational use of the drugs, many can develop an addiction despite believing they are not a ‘typical’ addict.
While opioid abuse can be defined as any use that is not medically prescribed, it can be hard to spot abuse and addiction developing. As the condition for which it was prescribed gradually resolves, it can be hard to judge how much the opioid is still needed for pain relief, and how much it is being used for its other effects, and patients can misunderstand what their body is telling them.
Addictions all start because the brain has altered its neural pathways to need a drug or behavior to activate the reward centers. Opioids carry a big risk of addiction because they are designed to work in much the same way. The body will naturally produce endorphins to manage pain, and opioids stimulate the production of those endorphins, but to a much stronger effect. Endorphins also create feelings of warmth and pleasure, and so opioids also have this same effect, creating a tolerance and then dependence as the brain needs the drug to function normally.
The model of drug addiction for a recreational drug user is familiar, and, because they are taking a drug that is not medically needed, much easier to spot developing.
When someone has been prescribed an opioid, it can be much harder. Someone with an injury, for example, may initially use the drug primarily for pain relief. However, as their injury heals, it might be they continue taking the drug less to manage the pain and more for the pleasure it provides. And since pain is a subjective measure, they might seek to extend their prescription unnecessarily. The transition to dependence and addiction might be gradual and difficult, or even impossible, to spot.
The ready availability of some opioids, especially the less potent ones, also means that the risk of recreational use by people who have not been prescribed the drugs is much higher.
What are the risks of opioid addiction?
Opioids are powerful drugs, so when abused, there is a high risk of addiction. However, addiction is not fully understood, so it’s not possible to predict why some people form addictions readily while others can use opioids without developing any dependence. There are several risk factors that are known, such as a personal or family history of addiction. The risks are also higher if taken with other drugs, especially depressants like alcohol. And being in an environment that exposes the patient to other addicts or stressful situations can make addiction more likely. There is also a link between addiction and co-occurring conditions, such as depression or anxiety.
Opioid abuse can have several side effects. The drugs will depress respiration and heart rates. This will have physical effects, including low blood pressure, cold skin, and even discolored extremities because of the poorer circulation. They can also cause confusion and disorientation.
In overdoses, opioids can affect motor control, and depressed respiration and heart rates can have severe effects. In extreme cases the lack of sufficiently oxygenated blood can cause brain damage and death. It is vital to seek medical help immediately when an overdose is suspected.
Even without the severe side effects, like any addiction, opioids can have a devastating effect on people’s lives, impacting their ability to operate normally and damaging the professional and personal relationships. Anyone who believes they, or someone they love, has a problem with opioids should look at treatment for their problem as soon as possible.