Are Opioids Harmful?
Opioids are a class of drugs that include prescription painkillers such as oxycodone (Oxycontin), hydrocodone (Vicodin), codeine, and morphine; synthetic opioids including fentanyl; and the illegal drug heroin.1,2 Prescription opioids are prescribed to treat moderate to severe pain and are often prescribed following surgery or injury or for health conditions causing chronic pain including cancer.3,4
Prescription opioids are extremely useful in the management of pain, but they can have a dark side. They are among the most abused drugs in the United States as they’re easy to get hold of, readily prescribed, and very addictive—a dangerous combination.
Side Effects
The biggest advantage to opioids is that they’re very effective at controlling pain, and they’re relatively cheap. Prescription opioids can relieve pain and lead to a feeling of relaxation, but they may also have negative effects, including the following:3,5
- Drowsiness.
- Confusion.
- Nausea.
- Constipation.
- Slowed breathing/respiratory depression.
Hypoxia can lead to both short- and long-term psychological and neurological effects—including coma, permanent brain damage, and death.3,5 In addition to these side effects, the misuse of prescription opioids may also lead to physical dependence and addiction.4,6
Opiate abuse takes its toll on almost every major body system.View our infographic to see the true dangers of these drugs.
Dependence and Addiction
People who use prescription opioids over an extended period of time may develop an altered physiological state where they become physically dependent on it. Dependence on opioids is revealed when the user experiences withdrawal symptoms when not using the drug.6 The individual will need to stop using the drug gradually in order to avoid withdrawal discomfort.6
One of the best-known side effects of prescription opioids is addiction, and it’s surprisingly easy to become addicted without realizing it. Addiction is a disease but can result from taking drugs repeatedly, like dependence.6 An addiction, also known as a substance use disorder, occurs when a person cannot stop using a drug despite negative consequences impacting health, relationships, employment, and finances.7,8 Opioid addiction is identified as a compulsive urge to use the drug even when they are not required medically.8 According to the Centers for Disease Control and Prevention, as many as 1 in 4 patients receiving long-term opioid treatment struggles with opioid addiction.4
Opiates and Dopamine
Opiates initiate the release of a cascade of dopamine in the brain, which creates feelings of pleasure and reinforces the behavior, i.e., ingestion of the substance. See below:
Overdose
In the United States, more than 130 people die each day overdosing on opioids.12 In 2017, more than 70,000 people died due to drug overdose, with almost 68% of that total attributed to prescription or illicit opioids—with 47,600 opioid overdoses.12-14
If you are concerned that someone is experiencing an overdose, immediately call 911. This will allow for medical attention that may save a life. Medical personnel can administer naloxone, a medicine that can treat an opioid overdose if given immediately.5
Effects of Injection Drug Use
Naturally, taking the drug in nonstandard ways increases its side effects. The body is not, for example, designed to cope with a load of powder floating around in the bloodstream, but a number of prescription opioid misusers grind up tablets, mix them with water or alcohol, and inject them. This can lead to heart problems, including long-term heart infections, as well as pulmonary embolisms.9
A number of chronic infections such as viral hepatitis and HIV can be contracted as a result of unsterile needle techniques in conjunction with intravenous use of several opioids.10,11,12 Recently, rates of contraction of HIV have been noted in association with intravenous use of prescription medications such as Opana, or oxymorphone.10
Withdrawal Treatment
Opioid withdrawal can be extremely uncomfortable. Withdrawal symptoms may include the following:5
- Muscle and bone pain.
- Sleep problems.
- Diarrhea and vomiting.
- Cold flashes.
- Uncontrollable leg movements.
- Severe cravings.
Successful treatment often includes supervised detox to maximize comfort and safety during the withdrawal process and minimize the risk of relapse. One strategy to help with withdrawal is medication-assisted treatment (MAT), which includes medication and counseling.6 There are medications that can help treat opioid disorders, including methadone, buprenorphine, and naltrexone.1 These medications help patients manage their opioid use disorders. In addition to the possible use of medication, patients should also attend counseling sessions and undergo therapy to discuss the root of their drug misuse. Behavioral therapies for prescription opioid misuse can help people adjust their attitudes and behaviors connected to drug use, improve their health life skills, and continue additional forms of treatment (such as medication).5
Sources
- National Institute on Drug Abuse. (n.d.). Opioids.
- U.S. Department of Health and Human Services. (2018). What Are Opioids?
- National Institute on Drug Abuse. (2018). Most Commonly Used Addictive Drugs.
- Centers for Disease Control and Prevention. (2017). Prescription Opioids.
- National Institute on Drug Abuse. (2019). DrugFacts: Prescription Opioids.
- U.S. National Library of Medicine. (2018). MedlinePlus: Opioid Misuse and Addiction.
- National Institute on Drug Abuse for Teens. (2017). Tolerance, Dependence, Addiction: What’s the Difference?
- U.S. National Library of Medicine. (2017). Genetics Home Reference: Opioid Addiction.
- American College of Cardiology. (2019). Opioid Use Associated with Dramatic Rise in Dangerous Heart Infection.
- National Academies of Science, Engineering, and Medicine. (2017). Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use.
- Vuong, Zen. (2017). Keck School of Medicine of USC: From pill to needle: Prescription Opioid epidemic may be increasing drug injection.
- National Institute on Drug Abuse. (2019). Opioid Overdose Crisis.
- Centers for Disease Control and Prevention. (2019). Opioid Overdose.
- Centers for Disease Control and Prevention. (2019). Drug Overdose Deaths.
