The opioid crisis and cascade of symptoms

Opioid drugs are powerful pain relievers that should only be used under a medical doctor’s close supervision because they can cause serious harm, including addiction and death if they are misused.

Opioid medications include prescription drugs hydrocodone, oxycodone, methadone, morphine, fentanyl and an illegal one — heroin. These compounds are sold under various brand names and all have the milder side effects of causing fatigue, dry mouth, constipation, and nausea or vomiting.

More serious side effects are difficulty breathing, irregular heartbeat and excessive fatigue. Experiencing these side effects mean you should consult your doctor immediately. Medical advances in the field of addiction research have recently led scientists to gain new understanding of how various drugs affect specific parts of the brain and now many innovative medications are being tested and used to help recovering addicts.

The National Institute on Drug Abuse describes that drugs affect the reward pathways in the brain. These pathways exist to motivate people to repeat beneficial actions leading to health and happiness such as seeking food, sex, sleeping and bonding with others.

When drugs or alcohol are used, the reward function is overloaded with unnatural stimulation and our bodies become less able to stop pain and feel normal pleasure on its own.

Healthy activities no longer have the same pleasurable effects for those addicted to pain killers and abstinence from the drugs is physically painful. This is part of why it is so difficult to quit. Medication alone is unlikely to solve the problem without counseling and family support.

There is a cascade of symptoms which denote opioid addiction. Common among those symptoms are mood symptoms such as mood swings, depression, anxiety, and euphoria followed by irritability.

Behavioral symptoms include stealing narcotics from family and friends, forging prescriptions to obtain more drugs, robbing pharmacies and other medical dispensaries, not fulfilling family responsibilities, decreased performance at work or school, preoccupation with obtaining and using drugs, lying to others about drug usage, withdrawing from once-pleasurable activities, social isolation, restlessness, and lethargy.

Among physical symptoms, opiate addiction may include exhaustion, pain relief, respiration depression, sedation, muscle spasms, vomiting, insomnia, constipation, itching, nausea, sweating, seizures, coma and death.

Psychological symptoms of opioid addiction include memory problems, hallucinations, delusions, paranoia, decreased emotional and mental well-being leading to increased symptoms of mental illness.

The effects of opioid addiction are not simply personal, and can affect the entire family, and society.

The most common effects of opioid abuse include job loss, incarceration, divorce, domestic violence, child abuse, homelessness, and financial ruin; and on an individual level, bleeding ulcers, liver damage, damage to major internal organs, seizures, damage to brain structure and functioning, damage to memory formation, overdose, coma and death.

Opioid withdrawal causes very unpleasant symptoms. The symptoms and effects depend upon the length or the addiction, the amount of the drug used, and the frequency that the narcotic was abused. Withdrawal from opiate use should be monitored closely by medical personnel.

Some of the common effect of withdrawal include nausea, stomach cramping, bone and muscle pain, chills, diarrhea, vomiting, anxiety, intense craving for the drug, insomnia, dilated pupils, irritation and agitation, suicidal thoughts, seizures, fever spikes and coma.

Medical advances in the field of addiction research has advanced tremendously in the last few years simply because we have an opioid crisis on our hands: 33,000 Americans died of opioid overdoses in 2015 alone.

This has led state and federal guidelines to encourage doctors to co-prescribe opioids with a drug that reverses an overdose. Police and first responders are also stocked up on the overdose reversal drugs.

The types of medications used to treat addiction fall under four broad headings. There are drugs such as methadone that replace drugs such as heroin, an illegal drug.

Critics of course, argue that the replacement drugs simply replace one addiction for another.

There are medications that cause discomfort when drugs are used. The downside is that the drug does nothing for cravings and many people who are not totally committed to stopping their addiction will simply stop using the medication that causes discomfort. There are vaccines that prevent drugs from reaching the brain. This works for some people but not for others.

And there are medications such as naltrexone that reduces the cravings by blocking specific opiate receptors. However, if other therapies such as counseling and emotional support are not part of the treatment, the person can simply stop taking the naltrexone and go back on their drug of choice.

Addiction causes changes in the brain; many times, lasting changes. A recovering addict may stay sober for months only then to relapse, sometimes to pick up a new drug, or to take a large dose of their drug of choice. Anti-addiction drugs are not the final solution.

The best form of treatment is a combination of medication, counseling, and emotional support. The National Institute on Drug Abuse states that addiction happens because there is a need in one’s life that is not being met. Anti-addiction drugs are only part of the solution.

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Dr. Jane Riley, EdD., is a certified personal fitness trainer, nutritional adviser and behavior change specialist. She can be reached at janerileyfitness@gmail.com, 212-8119 cell/text. and www.janerileyfitness.com.

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