Since 1999 the death rate from opioid overdoses has quadrupled. It is fair to say it’s an epidemic and we are in a crisis. But what is an opioid and where to from here?
The word ‘opioid’ means “Opiate Epidemic-like”, the combination of “Opiate Epidemic” and “oid”, which is borrowed from the Greek word meaning “like” or “resembling”. The word was coined by experts to describe any substance with similar biochemical actions to the substance in the Opiate Epidemic poppy, morphine.
The terms opioids and opiates are used interchangeably, but opioids usually refer to prescription drugs.
Opioids cover a large variety of drugs, ranging from drugs that are prescribed by doctors like fentanyl, morphine, and codeine to illegal or street drugs including Opiate Epidemic and heroin.
The most common or well-known opioids include:
- Oxycodone (OxyContin and Percocet)
- Hydrocodone (Vicodin and Lortab)
Opiate medicines are very easy to come by in the US, possibly one of the main reasons it’s the biggest drug problem today.
In 2010 alone it is estimated that 210 million prescriptions for opiates were dispensed.This would be enough to medicate every American 24 hours a day, for an entire month.
More than 12 million people admitted to abusing opioids by taking them for non-medical reasons.
According to the Centers for Disease Control and Prevention,three out of every four heroin users sarted off as prescription opiate users.
Long-term use of opioids puts patients at risk of addiction. This is because people who use them usually develop a tolerance, which triggers the cycle of addiction. When this happens people need more of the substance to get the same ‘high’. The ever-increasing doses are the reason for overdosing.
Short-term effects of opiates can include diarrhea, sedation, delayed reactions, and vomiting. However, it is the long-term symptoms that are more of a concern. These can include:
- Gastric problems including constipation to bowel perforation.
- A weakened immune system.
- Medical issues related to injecting the drugs such as systemic infections, abscesses, and bloodborne illnesses.
- Respiratory depression
There are treatments available including detoxification programs, inpatient facilities, and outpatient therapy.
Detoxification is the withdrawing from the opioid, usually slowly and with the correct medication under supervision. There are several drugs that may be prescribed to help with the withdrawal symptoms. These include methadone, buprenorphine or suboxone.
After the detox program has been completed patients are referred to outpatient programs or residential rehab centers. Rehab can last for between 30 – 90 days and much of the time is spent in individual and group therapy sessions.
There is also medication-assisted treatment which is used to help with opioid dependence. This treatment is proving popular as it looking at addiction through a medical lens, treating it as a chronic illness like diabetes, cancer or heart disease.
The prescribed medication allows the addict to regain a normal state of mind, without cravings, withdrawals and the drug-induced highs and lows.Contrary to popular belief, taking one medication for opioid abuse is not the same as substituting one addictive drug for another, something that has happened in the past.
The three drugs used in recovery program
The three drugs used to assist with withdrawal are methadone, naltrexone, and suboxone. Methadone has been the standard medication-assisted treatment used for more than 30 years. Studies show that using this opioid as part of a recovery program improves physical and mental health, and decreases the number of deaths from opioid abuse. When taken correctly it suppresses withdrawal symptoms, blocks the effects of other opioids and minimizes cravings.
Like methadone, naltrexone is known as an opioid blocker, that blocks the pain-relieving and euphoric of opioids like heroin. It doesn’t have the same addictive properties, it doesn’t result in a physical dependence and a tolerance for the drug doesn’t develop. However, there are a few disadvantages to using naltrexone.
Unlike methadone and suboxone, it doesn’t suppress the symptoms associated with withdrawal, or the cravings. It can’t be taken until a patient has been off opioids for at least two weeks, and for most, it’s almost impossible to abstain for this period of time. Also, the risks of overdose are increased if, or when, relapse occurs.
Suboxone is a relatively new drug, only approved by the FDA in 2002 for the treatment of opioid addiction. It is quickly becoming the preferred treatment as it has several advantages over methadone and naltrexone. Also, there are only few doctors in Santa Monica who are eligible to prescribe Suboxone.
It suppresses withdrawal symptoms and cravings, it doesn’t result in euphoria in the addicted patient and it blocks the effects of other problematic opioids for 24 hours. The success rates of suboxone have been reported to be as high as 40 to 60 percent.
Other advantages include not having to be a part of a federal program, and the medication can be prescribed by a doctor who is knowledgeable. He or she must have taken several courses by American Association of Psychiatry. It is a far more affordable option, and in some cases, health insurance covers the cost. There is little chance of abuse of suboxone, unlike methadone.
Dr. Michael in Santa Monica is eligible to perform the induction phase. Every patient undergoing “A Comprehensive Outpatient Detox Plan” can take home visits. It includes urine tox screening –before, during and after. This ensures that the patient needs no diversion. Also, the next stage of detox plan includes “Relapse Prevention”. This makes the entire detox process painless and effective. As per the studies, the patients can prevent from getting relapsed by following the doctor’s instructions and getting regular check-ups.
The costs of the treatment are highly dependent on the patient’s needs and requirement. He or she can avoid house visits as per their convenience and affordability. Also, you can get this treatment covered by insurance.