Both heroin and prescription painkillers stem from the pods of opium poppy plants. The sap-like residue that dries on the surface of these pods is harvested and synthesized into morphine. When this opium byproduct is boiled with acetic anhydride, heroin is the result. Prescription painkillers are synthesized from opium converted into morphine. Some prescription pain relievers may be combined with other drugs, like acetaminophen, to add to their efficacy in treating pain and discomfort.
The obvious downside to opiates is their addictive potential, which was first recognized in the early 1900s when heroin addiction became a prominent problem across the United States, per the Drug Enforcement Administration. Addiction is almost certain for most people who abuse these drugs on a long-term basis.
Consumer Reports notes there is little evidence that extended use of prescription painkillers is safe at all. Despite that, doctors routinely prescribe these drugs to treat chronic pain – a practice the Food and Drug Administration warned against in early 2016. Habitual use or using these drugs without medical reason means they are not being used as prescribed. In most abuse cases, there isn’t even a legal prescription involved. Among individuals aged 12 and older who abused prescription painkillers between 2010 and 2011, only 18.1 percent of them did so with their own prescription; rather, 54.2 percent got them from a relative or friend, per the Substance Abuse and Mental Health Services Administration.
It’s very difficult to stop using opiates without professional help. The withdrawal process is one of the toughest to endure, but it doesn’t have to be. Medical detox is recommended for opiate withdrawal, and medical professionals can help to alleviate the severity of withdrawal symptoms, ensuring the process is more comfortable. A detox experience that is more difficult to endure often leads to relapse. Thus, the chance of relapse is lower for someone who is more comfortable during this time.
Side Effects of Opiates
Opiates have very strong side effects. Even the mildest forms, like Demerol and Lorcet, can cause someone to have delusions and severe depression when taking them as prescribed. When abusing these drugs, there is no predicting the range of adverse events that can occur. Opiates commonly alter mood. They cause an individual who abuses them to feel fatigued and out of touch with reality in many cases.
Unfortunately, many people are under the impression that prescription drugs are safer than illicit ones, but they aren’t. It’s no safer to abuse a drug like Percocet than it is to abuse heroin.
Existing mental health disorders are often worsened by the abuse of depressants like opiates. Since opiates commonly cause respiratory depression, abuse of them can also limit the amount of oxygen that reaches the brain and other vital organs. This can lead to cell death, brain damage, and the failure of important organs over time.
Individuals who abuse heroin or other injectable opiates are at an increased risk of contracting HIV or hepatitis. AVERT notes HIV alone is 28 times more prevalent among people who inject drugs compared to the general population.
Heroin abuse can lead to a loss of white matter in the brain, which may impair decision-making processes, behavior regulation systems, and how well an individual tolerates and reacts to stress, per the National Institute on Drug Abuse. Some people who abuse heroin or crushed pills may suffer from an infection of the lining of the heart, which can cause further cardiac issues.
Collapsed veins are another common side effect of abusing these drugs when injected. Most people who abuse opiates will deal with constipation, which can become so severe that the bowel becomes obstructed. These individuals are at greater risk of infection overall due to opiates hindering the body’s immune system, but bowel obstructions can cause perforation of the intestinal walls, which may lead to sepsis and death in some cases.
Signs of Abuse
Knowing what to look for is the first step toward helping a loved one get better if you suspect they are abusing opiates. Look for:
- Obvious changes in behavior
- Erratic sleep schedules
- Increasing use of the drug despite the negative outcomes it has produced
- Legal ramifications as a result of opiate use and abuse
- Financial troubles
- Taking pills in larger amounts or more often than directed by a doctor
- Emotional lability
- Declined interest in appearance or overall health
- Sudden bouts of anxiety or depressive episodes
Withdrawal from Opiates
One of the most important decisions someone who abuses opiates can make is which path they will take toward healing their addiction. For many people, medical detox programs that use medications, like methadone and buprenorphine, to wean clients off the drugs they’re abusing begin the treatment process. Methadone, a full opioid agonist, fills opioid receptors and prevents withdrawal symptoms. Then, clients are slowly weaned off methadone over time as they undergo therapy to address addiction issues. Buprenorphine works in the same way; however, it is believed to have less potential for abuse, particularly when it is combined with naloxone, as in Suboxone.
When individuals are taking buprenorphine or methadone, withdrawal symptoms are typically minimal. In general, individuals detoxing from opiates may experience:
- Muscle twitches
The Treatment Process
In most programs, immediately after entering treatment, new clients are screened for a variety of issues. It is important to be open and honest during the intake process. This ensures that the recommended treatment plan will be in line with what the client actually needs.
Severity of addiction is assessed at the outset of treatment. Someone who has been abusing heroin for several years typically needs more intensive treatment and a longer withdrawal period than someone who just started abusing the drug a few months ago.
There are many facets to the development of addiction, and all these must be assessed when structuring a treatment plan. For example, individuals who suffer from mental illness are more likely to suffer from negative side effects like depression when abusing opiates, according to the National Alliance for Mental Illness. Some people won’t discover that they have any kind of mental health disorder until a clinician uncovers it during this screening process. Treating co-occurring mental health issues is important and must occur in conjunction with substance abuse treatment for optimal protection against relapse.
Certainly, the individual client is the main focus during treatment, but there are other things that need attention during treatment. The family unit is one of them. Clients may have lost the trust and respect of spouses, children, parents, siblings, and close friends. They might not know how to repair the damage that was done. Family therapy can serve as a positive way to diffuse arguments and learn how to communicate effectively. Many treatment centers also host family days that allows loved ones to learn more about addiction, socialize, and share meals with their loved one.
Difficulties in Seeking Help
Managing work or school responsibilities while in treatment can be tough. Luckily, there are many treatment centers that allow clients to structure their treatment around their work and school schedules. If taking time off is an option, it’s usually encouraged. The Family and Medical Leave Act does allow qualifying employees to take up to 12 weeks off work. While it is without pay, their job status is protected while they’re seeking help, per the United States Department of Labor.
Financial woes are often a factor that impedes the path to treatment for many who need it. Per SAMHSA, nearly a third – 30.8 percent – of people who needed treatment and didn’t get it between 2011 and 2014 cited the reason as financial. Many treatment centers will work with clients to ensure insurance covers as much of their care as possible. In addition, many centers offer payment plans to ease the financial burden, allowing people to pay off the cost of care over time.
Overall, individuals seeking treatment for opiate addictions have many options. Both inpatient and outpatient treatment is available. While many people begin treatment in an inpatient setting, they then transition to outpatient care as they grow stronger in their recovery. The longer the duration of treatment, the lower the likelihood of relapse.