Opioid Disorder

Opioid disorder is present in the proposed revision of DSM-5. This is a type of addiction disorder in which dependence upon opioids causes significant distress to the individual and also causes many health problems. Patients who are addicted to opioids usually also suffer from withdrawal symptoms when the drug use is stopped and require treatment to fight opioid disorder.

What are Opioids?

Opioids are used in surgeries or in the medical practice because of their use as effective and rapid acting analgesics or pain killers. Some of the medications that are classified as opioid agents are codeine, morphine and also sometimes referred to as narcotics. Morphine is commonly used in surgical practices all over the world in order to relieve the patient of pain prior to the operation or surgical procedure. Codeine is used for mild pain because it is not as efficacious as compared to morphine. Some other drugs that are used as opioid agents are propoxyphene, oxycodone, hydromorphone and hydocodone. Meperidine is also used in some regions of the world, but less commonly owing to the fact that it has various side effects. Some opioid agents are not restricted to their use as analgesics, but can also be used to treat certain condition such as diarrhea and coughs, for example codeine and dipenoxylate. Heroine is an opioid which is also known as diacetylmorphine, dimorphine and morphine diacetate. It is derived from the opium poppy and in the body it converts metabolically into morphine[2]. It is a street drug or a recreational drug that is usually injected by users and has a very high potential for addiction. Heroin addiction is equal to addiction to morphine and requires the same treatment.

Effects:

Opioids produce the desired effect when they attach themselves to certain specific proteins which are known as opioid receptors located in the GIT, the spinal cord and the brain. After adhering to these specialized proteins or opioid receptors, opioid agents can cause the blockage of the transmission of painful stimuli messages to the brain. They also induce sleep, drowsiness, constipation and can also decelerate the respiratory rate, but this depends upon the amount of opioid administered. Some of the opioid agents can also produce a sense of euphoria by affecting the regions of the brain perceiving pleasure.

Warning Signs:

The excessive usage or addiction to opioid agents can cause rapid and drastic changes in the personality and behavior of a person and may lead to opioid disorder. Many people tend to hide the symptoms and signs of opioid addiction in order to conceal the fact that they have been involved in substance abuse, but there are certain symptoms that cannot be concealed no matter what measures are taken for the purpose.

Physical Symptoms:

Some of the symptoms that are associated with the addiction to opioid agents are:

  • Slurred Speech
  • Impaired Coordination
  • Excessive Sweating
  • Abnormally Small Pupils
  • Fatigue
  • Altered Consciousness
  • Rapid Transitions Between Bursts of Energy and Lethargy
  • Itching
  • Needle Marks

Other Signs of Opioid Disorder:

Some other signs that can help in the diagnosis of opioid disorder are financial problems owing to the fact that opioids are rather expensive, legal problems, burned spoons which are used in opioid administration, lack of concentration resulting in poor performance at work or school, a change in the company of friends, unexplained disappearance of household items.

Possible Consequences:

The development of tolerance to the prescribed dosages of the drugs is one of the most common consequences of drug abuse. This causes the users to take greater amount of the substance in order to acquire the same effects which were once achieved with a much lower dosage. Another important consequence is physical dependency to the drug, also known as addiction whereby the body adapts to the regular usage of the drug and can present with serious withdrawal symptoms if the drug is decreased in amount or stopped after some time.

Withdrawal:

Opiod addicts who discontinue the drug often experience withdrawal symptoms and require treatment. Some may even require hospitalization and rehab. Rehab centers are ideal for treating opioid withdrawal as the symptoms can be monitored and treated.

Classic withdrawal symptoms include:

  • Pain associated with the bones and muscles
  • Agitation
  • Disturbed sleeping patterns
  • Irregular bowel habits
  • Cold flashes accompanied by goose bumps
  • Involuntary muscle movements usually associated with the lower limbs

Treatments:

There are many options that are available to treat opioid addiction. Research and experience has provided many treatment options for prescription opioid addicts and also heroin addicts. Medicines like methadone and levo-alpha acetyl methadol are affective in helping with the withdrawal symptoms. Behavioral therapy and counseling also play a very important role in helping opioid addicts overcome their addiction.

Detoxification:

The best approach to treat opioid addicts is to help them with a detox regime. This is not a complete treatment on its own, but is used in combination with other techniques to help with opioid withdrawal. A drug free existence is made possible with the help of this approach. Methadone is a type of synthetic opioid that helps eliminate the symptoms of withdrawal and reduces the drug cravings associated with opioid withdrawal. The drug has been in use for this purpose for over thirty years.

References:

http://www.dsm5.org/

Sawynok J “The therapeutic use of heroin: a review of the pharmacological literature”. Can. J. Physiol. Pharmacol

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