Opioid Use Disorder | Do I Have An Opioid Abuse Disorder?

Opioids are highly addictive drugs that can be found in natural form, derived from the opium plant or synthetic form, created in a laboratory. Opioids are generally prescribed from a family doctor in an attempt to treat moderate to severe pain, but they can also be obtained from illegal methods. Opioid drugs include natural opioids like morphine and codeine, synthetic opioids like fentanyl, and semi-synthetic opioids like hydrocodone, hydromorphone, oxymorphone, and oxycodone. The illegal drug heroin also is considered an opioid.

What is opioid use disorder? Opioid use disorder is a chronic lifelong disorder that upon repeated use of the substance can result in serious consequences like disability, relapse, and death.  Opioid use disorder definition according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is a problematic pattern of opioid use leading to clinically significant impairment and distress. Further, opioid use disorder is considered a medical condition that is defined by a person not being able to stop using opioids, and their behaviors are centered around opioid use which is interfering with their daily life. This disorder consists of an overpowering desire to use opioids matched with an ever-growing tolerance and relentless withdrawal symptoms when trying to stop.

Opioid abuse disorder affects over 16 million people worldwide, more than 2.1 million Americans, and there are more than 120,000 deaths worldwide and 47,000 deaths in the United States that are caused by opioid use. Misuse of opioids may lead to dependency or addiction. Dependency on opioids is when someone has an opioid use disorder and experiences withdrawal symptoms like cravings and sweating. Addiction is a chronic brain disease that makes a person constantly seek drugs even though it is causing them harm.

Signs of Opioid Abuse

Someone who is struggling with an opioids use disorder might not have any immediate symptoms. With time, a person may start to display symptoms that indicate they have a problem and need help. Some common signs of opioid abuse are poor hygiene such as not bathing, brushing teeth or changing clothes, drowsiness, intense cravings, can’t control opioid use, weight loss, changes in sleep patterns, isolation from family and friends, stealing money or items from family, friends, or businesses, and new financial difficulties.

People who are abusing drugs like opioids might alter their behavior. Some more possible signs of opioid abuse are mixing with different groups of people or changing friends, loss of interest in activities, eating more or less than normal, being more energetic than usual like talking fast or saying things that don’t make sense, drastic mood changes, missing appointments, and getting in trouble with the law.

Opioid Use Disorder Symptoms

The Centers for Disease Control and Prevention (CDC) discusses the DSM-5 diagnostic criteria for opioid use disorder. In order to be diagnosed with opioid use disorder, at least 2 of the following 11 criteria should be seen in a 12 month period. Opioid use disorder symptoms or the criteria include taking increased amounts of the drug for a longer period of time than intended, desire or attempts to stop opioid use but cannot, spending a lot of time trying to get the drug or recovering from use, cravings, problems fulfilling obligations at work, home or school, continued opioid use despite social issues, giving up activities because of drug use, opioid use in physically dangerous settings, continued opioid use despite physical or psychological problems linked to opioid use, developing tolerance, and experiencing withdrawal or taking opioids to reduce withdrawal.

Withdrawal symptoms of opioid use are abdominal cramping, cravings, agitation, diarrhea, pupil dilation, anxiety, high blood pressure, sneezing, sweating, rapid heartbeat, tearing, insomnia, and shakiness.

Opioid use can lead to physical dependence in as little 4-8 weeks. In people who use opioids often, stopping can lead to severe symptoms including pain, cramps, anxiety, chills, insomnia, cravings, nausea, dilated pupils, restlessness, and vomiting. Given the severity of these symptoms people often relapse and use the drug again to ease their symptoms.

Treatment

If you or someone you love is suffering from an opioid use disorder that best thing you can do is to seek treatment from a high-quality rehabilitation facility. Rehabilitation clinics combine medications and counseling and behavioral therapies to provide a comprehensive approach to treatment. This can greatly enhance a person’s chances of a successful recovery and life-long abstinence.

The medications that are used to treat opioid use disorder or methadone, buprenorphine, and naltrexone. Methadone and buprenorphine decrease withdrawal symptoms and cravings. Naltrexone is different from methadone and buprenorphine because it takes away the high that a person normally experiences with taking opioids. Naltrexone works great at preventing relapse after a person has been off opioids for 7-10 days.

The types of counseling treatments that are provided to help a person overcome their opioid use disorder are individual counseling in the form of cognitive-behavioral therapy, motivational enhancement therapy and contingency management as well as group counseling, and family counseling. These counseling sessions work by changing a person’s attitudes and behaviors related to drug use and helps a person build healthy life skills.

Prevention and Public Health

If you or a loved one is already addicted to opioids, one way to prevent an overdose is Naloxone (Narcan, Evzio). Naloxone is a life-saving medication that when used in the case of an emergency can reverse an opioid overdose. Naloxone works by blocking opioid receptors to prevent opioids from getting into the brain. It can reverse and block the effects of opioids and return normal breathing to someone whose breathing is shallow or stopped because of an opioid overdose. It is available for use by family members or friends in the form of a nasal spray, Narcan, or auto-injectable, Evzio.

There are a lot of different ways you can prevent opioid misuse, especially around adolescents.  One way to prevent opioid use is to talk with adolescents about drug prevention services. Talking is the first step in building a strong relationship that is centered around trust and support. Psychological support can also be provided from peers or mentors which can be effective in preventing opioid drug use.

Finally, the most effective way to prevent an opioid use disorder is to avoid opioids altogether. If you or a loved one is seeking treatment for pain it is best to speak with a family doctor about opioid-free pain medications to avoid bringing opioids into your home. Healthcare providers can offer you or a loved one different treatment options before prescribing opioids for acute or chronic pain.

References

• Detoxification and substance use disorder treatment. SAMHSA.
• Module 5: Assessing and Addressing Opioid Use Disorder (OUD). Centers for Disease Control and Prevention.
• Opioid Abuse. American Society of Anesthesiologists.
• Opioid Addiction. John Hopkins Medicine.
• Opioid misuse and addiction. MedlinePlus.
• Opioid misuse and addiction treatment. MedlinePlus.
• Opioids and Adolescents. hhs.gov
• Opioid Use Disorder. American Psychiatric Association.
• Opioid Use Disorder. StatePearls.
• Opioid Overdose. Centers for Disease Control and Prevention.
• Opioid Overdose Reversal with Naloxone (Narcan, Evzio). National Institute on Drug Abuse.
• Ten Tips to Prevent and Accidental Overdose. FDA.
• Recovery In a Quiet and Welcoming Environment. Sunshine Behavioral Health.