Opiates are substances whose active ingredients mainly come from opium, the dried latex obtained from the opium poppy plant. They are also referred to as opium alkaloids, and opium has more than 20 strains of opiates with six occurring in higher amounts. Examples of opiates used in the medical industry include morphine, codeine, papaverine, and thebaine, with the first two being the oldest painkillers. Thebaine is not used in its natural form, but rather, it's converted into hydrocodone or oxycodone to make Vicodin and Percocet correspondingly. Just One Recovery Center in Orange County, CA, has many years of experience in handling opiate addiction, and we have prepared this informative guide with details on various forms of opiate addiction.

Statistics of Opioid and Opiate Use in California

The term 'opiate' is often confused with an opioid. Opioid refers to synthetic drugs that have a similar chemical composition with opiates. Addiction to opiates is so prevalent that the American Society of Addiction Medicine (ASAM) declared it as a national epidemic.

In 2017 alone, there were 2,199 overdose deaths linked to opioid use in California, translating to 5.3 deaths per 100,000 people. The National Institute of Drug Abuse (NIDA) surmised that prescription opioids were the main causative factor of these deaths, with the highest increase found linked to fentanyl, which is a synthetic opioid. Fentanyl is a fine powder that makes it easy to mix into other drugs, and it is also used to develop counterfeit prescription pills.

The CDC records indicate that doctors in California prescribed 39.5 opioid-related medicines for every 100 people, which is significantly lower than the national average of 58.7 prescriptions. These statistics are indicative of a problem that could grow in the coming years.

What is Drug Abuse?

Abuse of prescribed medications refers to any inappropriate use that is characterized by the following:

  • Consuming more doses of a drug than prescribed by a qualified physician
  • Taking medication that is not prescribed to you, e.g., from friends
  • Mixing medication with substances like alcohol to amplify their effects

Even when taking medicines for specified reasons, prolonged use exposes one to substance use disorder (SUD), which is characterized by failing health, and not functioning normally at work, home or school. This disorder ranges from mild to severe, and the most extreme case being an addiction.

What are the Consequences of Opiate Abuse?

Not every person who takes prescription meds ends up dependent or addicted, but for those who do, the main traits of addiction are as follows:

  • Loss of employment or economic pursuits owing to prioritizing substance use over attending to work duties
  • Financial struggles mainly from allocating too much money to acquiring new prescriptions through doctor shopping or the streets
  • Legal entanglements due to being charged with possession sans prescriptions
  • Failed relationships with family and friends

Types of Opiates

As mentioned above, opiates are commonly used in medicine to make painkillers either in their natural or processed forms. There are two main categories of opiates: antagonists and agonists.

Antagonists: these drugs function by attaching themselves to the opioid receptors without producing an opioid effect and are therefore not as addictive, but there is potential for abuse. Antagonists such as Naloxone and Naltrexone are commonly used in the initial steps of rehabilitation to detoxify the body. Other examples of antagonistic opiates include Vivitrol, Bunavail, ReVia, and Narcan.

Agonists: these opiates activate receptors in the brain with the full agonist opioids activating the brain's opioid receptors to produce a full opioid effect. These opiates have a high potential for abuse and subsequently, addiction, and they are known to mimic the effects of endorphins found in the body. Morphine and fentanyl are the most common agonists followed by oxycodone and heroin, which are controlled substances.

Below is a list of the most prevalent full opiates that contribute to the high addiction rates registered in California:

  1. Heroin

Heroin or diacetylmorphine is an opioid drug developed from morphine, and it can either be in powder (white or brown), or it can be a black sticky substance called black tar heroin. Street names for heroin include hell dust, big H, and smack. There are various ways of consuming heroin: intravenously, sniffing, smoking, snorting, or speedballing, where it is mixed with crack cocaine.

The effects of heroin are immediate as it enters the brain fast and binds to opioid receptors on the cells responsible for regulating heart rate, pain, breathing, pleasure, and sleep. OxyContin and Vicodin are gateway drugs for heroin as empirical evidence shows that 80% of heroin addicts have abused prescription opioids. Other studies, however, show that fewer than 4% of people who misused prescriptions switched to heroin within a five-year timeframe.

Short Term Effects

Heroin acts fast, and users reportedly experience a surge of euphoria soon after it enters the body. Apart from the rush, other common effects of heroin include:

  • Arms and legs feel heavy
  • Mind feels cloudy
  • Dry mouth
  • Alternating states of conscious and semiconscious
  • Excessive itching
  • Nausea and throwing up

Long Term Effects

People who are addicted to opiates may suffer from the following issues down the line:

  • Collapsed veins for intravenous users
  • Lung complications such as pneumonia
  • Liver and kidney diseases
  • Damaged tissue in the nose for those who sniff or snort
  • Mental disorders like an antisocial personality disorder
  • Stomach cramps and constipation
  • Sexual dysfunction for men
  • Irregular menstrual cycles for women

Recovering from Heroin Overdose

The incidence of heroin overdoses has grown in the past years, and this usually follows after consuming high doses that trigger a life-threatening reaction or even death. Breathing rate slows down or stops entirely, thus leading to hypoxia, which happens when the brain is deprived of oxygen. Not all heroin overdoses are fatal, and if medical help is administered soon enough, the person can start breathing again. One dose of naloxone rapidly binds to opioid receptors and blocks the effects of heroin, but sometimes, more than one treatment may be required. Naloxone can either be administered intravenously, using a handheld auto-injector or and through a nasal spray. In such life and death situations, getting professional help is vital.

  1. Oxycodone

Oxycodone is a powerful pain reliever that is accepted widely in the medical community, but sadly, it is one of the most abused prescription drugs in California and nationwide. The United States Department of Justice found that more than 13 million people abuse oxycodone, including preteens. This cavalier attitude leads people to consume this drug as pills or by mixing with alcohol. The most common brand names for oxycodone-based drugs are Percocet, OxyContin, and Roxicodone while street names include oxy, hillbilly heroin, oxycotton, percs, Roxi's, and OC's.

The state enacted state laws allow naloxone (Narcan) which is an overdose antidote to be sold over the counter and in 2016, $3 million was allocated to distribute Narcan to communities. More so, law enforcement agencies give Narcan to officers, and even schools keep it on hand, but the problem prevailed. In 2017, Sen. Anthony Portantino proposed a ban of oxycodone prescriptions for people under 21 to protect the most vulnerable populations before this pandemic is contained. The senator referred to "oxy" as a gateway drug to heroin.

An investigation by the LA Times surmised that oxycodone wears off before the 12-hour timeframe that is advertised by Purdue Pharma thus necessitating more doses. The manufacturer is hauling in billions in revenue as the population sets off on a swift and dangerous path to addiction. Another study found that cracking down on this painkiller triggered a surge in heroin as addicts aggressively seek a more affordable alternative.

The table below illustrates how addiction to oxycodone develops in three stages: recreational use; dependency; and addiction.

 

Recreational use

Dependence

Addiction

·     Taking more than required

·     Sharing with friends for leisure

·     Taking oxy when feeling blue

·     Intense euphoria during use

·     Withdrawal symptoms start

·     Taking extra pills to get high

·     Craving oxy after it wears off

·     Feeling off-balance without it

·     Using oxy becomes a top priority

·     Engaging in reckless behavior

·     Financial strife due to oxy use

·     Health and relationships fail

 

Apart from euphoria, other immediate effects of taking oxycodone include happiness, less anxiety, drowsiness, dizziness, and a boost of confidence.

  1. Methadone

Methadone is a synthetic opioid prescribed to handle moderate to severe pain, and it is consumed in three forms: tablet, liquid, or powder. Those who consume it unlawfully will mostly inject themselves, thereby heightening the risk of contracting viruses like HIV. It is generally considered safer than the more highly addictive oxycodone, but physicians still monitor patients closely to detect any signs of abuse. Methadone works by altering how the brain and nervous system respond to pain to help you achieve that sense of relief, and its effects are slower than what stronger painkillers yield. Methadone is known to negate the high you get from heroin, morphine, oxycodone, and heroin.

Apart from managing pain from injury or surgical procedures, methadone is used as replacement therapy when treating opioid addiction. It produces the same effects as the opioid in question while negating withdrawal symptoms, so the patient doesn't experience cravings. Essentially, this drug replaces the opioids in your body only with lesser effects.

Short-term use of methadone has the following side effects: nausea, itchy skin, restlessness, sweating profusely, declined libido, among others. Effects of long term use include, but not limited to, the following:

  • Experience hallucinations or confusion
  • Labored breathing or shallow breathing
  • Breaking into hives or rashes
  • Chest pain or brisk heartbeat
  • Swelling of tongue, lips, face, or throat
  • Lightheadedness

Risk Factors that Prohibit Use of Methadone

Not every patient is eligible for a methadone prescription even if they are receiving treatment for opioid addiction. You should not take methadone if you have the following conditions:

  • Heart rhythm disorder or any heart condition
  • Any condition necessitating sedatives
  • Lung disease or issues with breathing
  • History of seizures or brain tumors
  • Problems with thyroid, gallbladder, or pancreas
  • Liver or kidney ailments
  • Imbalance of electrolyte
  1. Morphine

Morphine is a standard prescription for people suffering from debilitating chronic pain.

Nonetheless, it is highly addictive and is linked to a large amount of inadvertent drug-related deaths in America. Recent statistics indicate that at least 10% of the population has abused one form of opiate prescriptions or another in their lifetime. More so, an upwards of 60% of morphine addicts got the drug from friends or relatives, which goes to show the pervasiveness of abusing this drug.

Side Effects of Morphine

Typical effects of morphine include pain relief, drowsiness, a false sense of well-being, euphoria, and relaxation. When taken in large doses, users may experience the following effects:

  • Slurred speech
  • Heightened blood pressure
  • Inability to focus
  • Swollen face
  • Unquenchable thirst
  • Muscle cramps and stiffness
  • Extreme sleepiness

Consistent abuse of morphine is leeway to addiction, and it starts with developing a tolerance where you routinely need larger doses to feel its effects. The user then experiences withdrawal symptoms when they don't have morphine in the system, and this makes quitting very difficult. After physical dependence, the next step is psychological dependence, and things spiral out of control. The user compulsively takes morphine while shunning the harmful consequences.

Morphine and heroin addiction are quite similar and curing the former is an arduous task. Abrupt withdrawal is not recommended, so the best approach is to manage the addiction medically through detoxification. This process rids the body of this substance so you can resume normalcy and refrain from further consumption, and inform your physician.

  1. Opium

Opium is a narcotic developed from a kind of poppy plant, and humans have used it for thousands of years. From this single drug, a host of other medications have emerged such as morphine, heroin, painkillers like OxyContin and Percocet. Opium combined with all these derivatives forms what is collectively known as opiates which are then classified as opioids along with synthetic drugs like fentanyl. 

The US has been grappling with an opium crisis for decades so much that it has been declared as the deadliest drug for Americans under 50 years. As the death toll continues to skyrocket, the opioid commission advised President Trump to declare a national emergency. Going by 2017 data, overdoses from opioid-related drugs claimed more lives than guns or car accidents, and the rate is higher than HIV-related deaths when the epidemic peaked.

  1. Buprenorphine

This drug acts as an antagonist by blocking other opioids while some are producing some level of opioid effect to repress cravings and withdrawal symptoms. Buprenorphine also acts as a partial agonist by activating opioid receptors in the brain but not as high as full agonists. The National Alliance of Advocates for Buprenorphine Treatment warns against categorizing this drug as an opioid blocker or a replacement therapy. Its primary purpose is to help patients participate in counseling and other interventions so they can make the desired changes that lead to healthier patterns. When this is done correctly, the addict reaches a sustained state of remission.

What are the Signs of Opiate Abuse?

Opioid painkillers include fentanyl and morphine, which are prescribed by doctors to manage pain, but the calming effects of these opioids can be highly addictive. People who don't consume them as prescribed expose themselves to patterns of abuse that pave the way for addiction. The majority of these cases start as taking opiates in larger doses or more times than required as the body becomes more accustomed to these chemicals.

Some people have a higher tolerance level, which means they need to consume more opiates to get the desired effects. Once a dependency forms, it leads to cravings where the person cannot function until they get a dose, and this goes on despite harmful effects. Opiate abuse can manifest itself in physical and behavioral forms with the most common signs as below:

  • Presence of needle marks on arms and legs from intravenous use
  • Reckless decision-making and behavior, e.g., involving finances
  • Dangerous activities like driving while intoxicated
  • Having constricted pupils
  • Unexpected and dramatic mood swings
  • Disoriented sleeping habits and inability to stay awake
  • Red on the arms or legs from excessive itching
  • Withdrawal from normal activities like hanging with friends
  • Visiting multiple doctors to obtain more prescriptions

What Happens after Detecting Opiate Abuse?

Once you notice a family or friend, or yourself exhibiting the above signs, it is imperative that you seek help immediately. If your pain has been challenging to manage, thus necessitating higher doses, this bad habit could have triggered a pattern of abuse without your knowledge. Talk to your doctor about changing your pain medication or finding healthier ways of dealing with pain. Seeing a substance abuse counselor is the next vital step, even if your problem is not too far gone.

At Just One Recovery center, we offer inpatient detox programs and inpatient rehabilitation services. Inpatient rehab has specialized programs for people suffering from substance use disorder, including opiates. We help patients unearth the underlying factors that led them to abuse drugs through extensive counseling and then work with them to kick their habits and avoid triggers during recovery.

Find an Opiate Addiction Rehab Center Near Me

Opioids are an integral component of modern medicine, and empirical evidence proves they have measurably enhanced the quality of life for millions of patients, especially those who are struggling with acute pain of cancer. The International Narcotics Control Board noted that annual prescriptions of opioids are much higher than anywhere else globally. On a broader sense, the medical system needs to evaluate pain management and use monitoring programs to curb distribution while availing prescriptions for justifiable cases. If you or your loved one is battling an opiate addiction in Orange County, contact Just One Recovery at 714-538-8085 for a consultation and start your journey to recovery.