Why Opioids Are Addictive
This may not come as much of a surprise but a study conducted by a nonprofit organization known as the Group Health Cooperative has shown that illicit and illegal users are not the only people who overdose on opioid painkillers. In fact, in a group of 10,000 people who received prescriptions for opioid drugs over a single 90-day period, fifty-one of them experienced at least one overdose, and six people actually died from overdosing on their drugs.
Fifty-one out of ten thousand may not seem like a significant number of people, but consider that several million people are prescribed opiate drugs every year, just in the United States, and you wind up with hundreds of deaths from drug abuse before you even think about cataloging the number of overdoses and deaths caused by illicit opiate abuse. Even worse, the number of people abusing opioid drugs is increasing every year.
Brief Overview of Opioid Use in America
Opiates have been prescribed in the United States for decades, but since the late 1990's their use has grown exponentially, largely because of increased numbers of prescriptions for drugs like OxyContin and Vicodin. Even though heroin use has remained at a low level, it has been supplanted by prescription painkillers to the point where every month, more than five million people are obtaining them illicitly, and about half that number use them illicitly for the first time every year.
How do recreational opioid users get their drugs? There are several ways:
- 55% get their drugs for free from a family member or friend with a legitimate prescription, while another 14% buy them from such people.
- 19% get their drugs from one doctor, and 1.6% go to multiple doctors.
- 3.9% resort to drug dealers or other strangers
How Does Opioid Addiction Happen?
Even though the numbers above show that most opioid abusers are getting their drugs illicitly, even normal prescription use can be dangerous. No one who uses opiates is completely addiction-proof because tolerance increases very quickly, addiction develops almost unconsciously, and withdrawal symptoms can be severe. In fact, opiate addiction can happen in just a week of regular use.
Opiate drugs are designed to alter the behavior areas of the brain that are known as "opioid receptors." Normally, these receptors cause people to experience the feelings of reward and pleasure, and they also manage the natural painkilling abilities of the human body. When opioid drugs are used on a regular basis, however, those receptors gradually become desensitized - they no longer respond to regular pleasure stimuli. At the same time, the brain is rewired to require more opioids in order to feel any kind of pleasure or pain relief.
The more the brain becomes used to opioid stimulation, the more drugs a person must take in order to feel the same effect. The strongest effects of drugs like OxyContin and Vicodin are always felt from the first few doses, which is why prescription users often take more than the suggested dosage to feel relief.
This need to take higher and higher doses of a drug in order to offset their increased tolerance to it is what leads to overdosing. Some of the most severe overdoses occur when a patient stops their opioid use for a few days - when a prescription runs out, for example - and then begins taking it again. The body can readjust to a lower tolerance level fairly quickly, so when a person starts taking the drug again at an elevated level, it can overload the body and cause an overdose. The same patterns, in less severe form, cause an addiction.
Merely taking a prescription opiate is not the only factor in an addiction being formed, however. That same Group Health Cooperative study mentioned above also found that a significant number of people who develop opioid dependencies also suffer from other problems, including anxiety, clinical depression, or a history of (or genetic predisposition for) drug abuse or alcoholism. These other issues make them more likely to abuse prescription drugs.
As awareness of opioid use, abuse, and addition grows, the way such drugs are prescribed has changed. Most doctors now prescribe opiate drugs only as a last resort, and for a maximum period of two weeks. As well, they prescribe the lowest dose likely to be effective.
While preventing opioid overdosing is fairly easy, addiction can occur stealthily, developing in a week or two and becoming powerfully strong before there's any awareness of a problem. If you suspect that you or someone you love is addicted to a prescription opiate drug, see your doctor immediately. You may be able to stop cold turkey, but you should have medical support standing by. Otherwise, you may have to consider either methadone or suboxone replacement therapy to help break your addiction and wean yourself off the drug.
