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Opioid Addiction and Abuse

by Dr.Ajay Singh at 14.Oct.2017 on Addictions

Abstract:

Opioids have been used as pain relief medication for the past several centuries. But, in today’s age, apart from its medicinal use, they are also being taken recreationally, leading to rampant abuse and the growing menace of opioid addiction. This has severe implications on physical as well as psychological (mental) health.

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Opioids are the derivatives of the plant Papaver somniferum, commonly known as the poppy husk. They are medically used as analgesics to relieve moderate to severe pain.

They Are Classified As

  1. Natural opioids: those which occur naturally such as Codeine, and Thebaine.
  2. Semisynthetic opioids: those which partly consists of naturally-occurring opioids such as Morphine, Oxymorphone, and Heroin.
  3. Synthetic opioids: those that are synthesized entirely in the laboratory and do not occur naturally, such as Tramadol, Fentanyl, and Dextropropoxyphene.

 Mode of Administration:

  1. Oral route (ingestion via mouth): for tablets and syrup.
  2. Inhalation: for vapors and smoke.
  3. Intravenous, intramuscular, and subcutaneous routes: for injections.

The Intoxicating Effects Include:


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  1. A sense of euphoria.
  2. Lightheadedness.
  3. Increased anger and irritability.
  4. Pain relief.
  5. Enhanced sexual prowess.

As per the latest reports, there has been a paradigm shift in the consumption pattern in terms of switching from naturally-occurring opioids to synthetic opioids consumption, which has lead to a significant rise in physical illnesses as well as psychiatric illnesses.

  1. Physical illnesses associated with opioid use are tuberculosis, cellulitis, abscess formation, pulmonary hypertension, HIV (human immunodeficiency virus), hepatitis C, oral thrush, jaundice, chronic obstructive pulmonary disease, and edema.
  2. Psychiatric illnesses associated with opioid use are anxiety disorder, depressive disorder, psychosis, bipolar disorder, sexual disorder, and sleep disorder.

Withdrawal Effects Include:

  1. Body aches.
  2. Rhinorrhea (watering from the nose).
  3. Lacrimation (watering from the eyes).
  4. Sneezing.
  5. Goosebumps.
  6. Loose stools.
  7. Vomiting.
  8. Increased anger and irritability.
  9. Decreased sleep.
  10. Seizures.

Signs of Opioid Dependence


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  1. The person has a persistent craving for opioids.
  2. He/she has difficulty in cutting down on the daily dose of opioids. 
  3. A persistent increase in the quantity of opioids consumed, in order to feel their intoxicating effect.
  4. The appearance of withdrawal signs if the person does not consume opioids.
  5. Giving up other activities and neglecting one’s responsibilities to procure and consume opioids.
  6. Continuing with the drug abuse even after being made aware regarding its harmful physical and psychological effects by a healthcare professional. 

A diagnosis of dependence can be made if any three of the above-mentioned symptoms are present together at any given point in the past one year.

Treatment Modalities:

1. Pharmacological treatment:  The pharmacological treatment consists of two phases, detoxification phase, and maintenance phase.


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  • Detoxification phase comprises of flushing out opioids from the body under the cover of medications which are prescribed to counter the withdrawal phenomena.
  • Maintenance phase comprises of keeping the person abstinent from opioid use by the use of either opioid agonists such as Buprenorphine or opioid antagonists such as Naltrexone.

2. Non-pharmacological treatment: The non-pharmacological methods are used in conjunction with the pharmacological treatment to enhance the therapeutic regime. It comprises therapies such as the following.

  1. Motivation level assessment.
  2. Motivation enhancement therapy.
  3. Family therapy.
  4. Group therapy.
  5. Cognitive behavior therapy.
  6. Relapse prevention management.

For more information consult an addiction and substance abuse specialist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist/addiction-and-substance-abuse

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