Opioid addiction has reached epidemic proportions across the U.S. Breaking the cycle of addiction often requires support and intervention from the loved ones of people who suffer from this addiction. The Opioid Project is designed to help to break the cycle of addiction by educating people about the signs and symptoms and asking them to sign a pledge to save their loved ones by taking the steps that are needed to break the addiction cycle.

The pledge

The mission of the opioid project is to save lives. Overcoming an opioid addiction takes family support and encouragement. If your loved one has an opioid addiction, you need to take action to save his or her life.

Commit to taking the following pledge:

“I will look for signs of addiction and takes steps to intervene to SAVE my loved ones.”

Background

Opioids are drugs that were originally derived from the opium poppy, a flower that is prevalent in areas of southern Asia. Opium is a substance that is found inside of the seed pods of the opium poppy. Opioids such as codeine and morphine are made from the opium. Heroin is an opioid that is made by adding a chemical to morphine. Many prescription opiate analgesics are created in the lab by scientists by using a similar chemical structure, meaning that many of today’s opioids are not derived from the opium poppy.[1]

Opium has been used for thousands of years as a pain reliever and its euphoric properties. Some people believe that a reference to it is found in the Sumerian Clay Tablet, which contains a list of medications and dates to 2,100 B.C. The first direct reference to opium is found in the writings of Theophrastus in the third century B.C.[2] In the 1800s in the U.S., opiates were not regulated and were widely available to treat all sorts of conditions. In 1914, the Harrison Narcotics Control Act was passed in response to an increase in morphine dependence and heroin use. Cancer patients were instructed to wean themselves off of opioids until they were at the ends of their lives.[3]

After decades during which opioids were mostly avoided, a renewed interest in opioids for the treatment of pain in the late 1980s because of a belief that pain was under-treated in the U.S. and Europe. In the early 1990s, interest turned to expand the availability of opioids to treat chronic, non-cancer pain, which led to an increase in opioid prescriptions. Pharmaceutical companies began synthesizing new opioids such as hydrocodone and oxycodone. In 1996, Purdue Pharma received an FDA approval for OxyContin, an extended-release form of oxycodone that the company claimed was safer than others and had a low risk of addiction. However, OxyContin had a high risk of addiction, leading countless people to abuse it by grinding it up and snorting or injecting it.

The current opioid epidemic began in the early 2000s and exploded. According to the Centers for Disease Control and Prevention, out of 700,000 Americans who died from drug overdoses from 1999 to 2017, almost 400,000 died after overdosing on prescription and illicit opioid drugs.[4] During the one year period from Jan. 2, 2016 to Jan. 1, 2017, 64,070 people died of opioid overdoses.[5]

Opioids are meant to treat moderate to severe pain, and they work by interrupting the pain signaling system in the central nervous system. These drugs have traditionally been used to treat the severe pain that people with cancer experience. The drive to have these drugs prescribed for non-cancer pain initiated the wave of addiction that followed.

Big Pharma helped to drive the opioid epidemic by engaging in aggressive and misleading marketing campaigns. Purdue Pharma mounted an especially aggressive marketing campaign for OxyContin, holding dozens of national pain conferences that were attended by more than 5,000 pharmacists, doctors, and nurses to spur them to prescribe OxyContin for non-cancer pain. The marketing efforts worked. The number of prescriptions for OxyContin to treat non-cancer pain grew from 670,000 in 1997 to 6.2 million in 2002.[6] By 2020, the U.S. market for opioid medications is expected to reach $18.4 billion.[7]

Addictive potential of opioids

With the aggressive and potentially misleading marketing campaigns by Purdue Pharma and other drug companies, a substantial increase in addiction to opioids occurred. While the companies made claims that their drugs were safe and carried little risk for abuse, millions of people became addicted to them. Opioids carry a high risk of addiction because of the way that they work in the brain and body.

When people take opioids, the drugs enter the bloodstream and attach to opioid receptors on nerve cells that are located in the brain in the neural synapses. The neural synapses are spaces between the axon of one nerve and the dendrite of another. The dendrites have opioid receptors to which opioid drugs attach. When the drugs attach to the receptors, they block the ability of pain signals to be sent through while also stimulating the midbrain to flood the brain with dopamine. Dopamine is a neurotransmitter that is responsible for feelings of pleasure and of wellbeing. The effect of opioids on the midbrain is what causes addiction to take hold.[8]

Initially, people feel compelled to use more opioids to try to repeat the pleasurable effects that they first felt. As the abuse and addiction progress, however, the compulsion grows beyond simply trying to recreate pleasure and becomes beyond the person’s control. Many opioid users are driven to continue abusing opioids because of the severity of the withdrawal symptoms.[9]

As people take more and more opioids, repeated exposure causes changes to their brains. Because of these changes, the brain begins to function in a normal way when the drugs are present and in an abnormal way when they are not. Opioid medications affect the brain stem, which regulates autonomic functions such as heart rate, blood pressure, and breathing. When people take opioids, it causes respiration to slow, the heart rate to slow, and the blood pressure to fall. Opioids also decrease stress and anxiety. When people stop taking opioids, they may experience racing heartbeats, fast respiration, and heightened blood pressure. They can also feel substantial stress and anxiety and severe pain.

Normal people are impacted by opioid addictions

There is a substantial public stigma against drug addiction, and addicted people also feel a significant amount of shame about their drug abuse. Because of the combination of shame and social stigma, many people avoid getting the help that they need to break their addictions.[10] Some people who are addicted may try to hide their use of drugs from others with whom they are close, making it important for you to understand that anyone can be impacted by opioid addiction. By understanding the signs of abuse and addiction, you can take steps to get your loved ones the help that they need to conquer their addictions.

Opioid addiction impacts people of all socio-demographic backgrounds.[11] The profile of someone who is addicted to opioids is not the typical profile that you might envision when you think about a drug addict. Many people who suffer from opioid addictions initially received legal prescriptions for opioids after suffering injury accidents or to treat chronic pain conditions. They then developed a tolerance to the drugs and needed more to receive the same benefits the drugs initially provided. Some people were overprescribed opioids, leading them to the cycle of addiction. Opioid medications have addictive properties that are analogous to heroin, leading to the destruction of countless lives.

In addition to the people who are addicted to opioid medications, millions of others are also impacted by the epidemic. Opioid addictions can negatively impact the relationships that addicts have with others and cause economic and financial harm to their families and friends. By getting help for a loved one who has an opioid addiction, the cycle can be broken, allowing both you and your loved one to move forward with your lives in a more positive way.

Signs of opioid dependency

Opioids carry a high risk of dependency and abuse. In the field of medicine, someone who has developed an opioid addiction is said to suffer from opioid use disorder. A person who is suffering from opioid use disorder may have uncontrollable cravings for the drugs and suffer from compulsions to seek out an increasing amount of opioids. Opioids can change the chemistry of the brain, making people feel like they need drugs just to feel normal and to avoid the symptoms of withdrawal. When people develop an opioid dependency, it can interfere with their daily lives. Some of the signs that your loved one might be addicted to opioids include the following:

• Uncontrollable cravings for opioids
• Not being able to control the use of opioids
• Changes in sleep patterns
• Drowsiness
• Frequent bouts of flu-like symptoms
• Weight loss
• Reduced libido
• Poor hygiene
• Changes in prosocial habits such as exercising
• Isolating himself or herself from friends and family
• New financial problems
• Problems with work
• Small pupils
• Slurred speech
• Shallow breathing
• Stealing from family, friends, and businesses to support their addictions [12]

If you use opioids and are concerned that you might have developed a dependence on the drugs or an addiction to them, you might experience the following symptoms:

• Severe cravings for opioids
• Excessive sweating when unable to secure opioids
• Mood cycling from euphoria when using to a general feeling of discontent when not using
• Decreased sex drive
• Chronic constipation
• Increased sensitivity to pain
• Frequent nausea

If you see these signs in your loved one or believe that you are addicted to opioids, you need to get help.

 

Getting help

If you see some signs that your loved one is abusing opioids, it is important for you to take action. While it might be uncomfortable for you, the worst thing that you can do is to ignore and to tolerate the problem. You will need to confront your loved one in a supportive way and tell him or her about your concerns. People whose families refuse to avoid the problem and who will not tolerate their opioid addictions are much likelier to recover than people whose families look the other way.

Calmly talk to your loved one about his or her addiction and why it is important for him or her to get help. Encourage him or her to go into detox and treatment. To obtain a referral to an opioid addiction treatment center or state program in the area in which you live, you can call the Substance Abuse and Mental Health Service’s National Helpline at 1-800-662-HELP (4357).[13] This is a free referral service that operates 24 hours per day and seven days per week. Family members and people who are struggling with opioid addictions can call the helpline to receive treatment referrals. If your loved one is underinsured or uninsured, the helpline can refer him or her to a state program in your area. If he or she has insurance, he or she should check with his or her insurance company to obtain a list of treatment providers that are approved.

S.A.V.E.

One way to remember the steps to help someone is to remember the acronym SAVE:

See the symptoms
Ask questions
Visit a doctor and call for help
End an addiction

Sources

[1] https://www.drugabuse.gov/publications/drugfacts/prescription-opioids

 

[2] https://www.ncbi.nlm.nih.gov/pubmed/17152761

 

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993682/

 

[4] https://www.cdc.gov/drugoverdose/epidemic/index.html

 

[5] https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf

 

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

 

[7] https://pharmaintelligence.informa.com/~/media/informa-shop-window/pharma/images/informa_opioid_snapshot_infographic.pdf

 

[8] https://www.drugabuse.gov/sites/default/files/mom_opioids.pdf

 

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/

 

[10] https://www.hazeldenbettyford.org/recovery-advocacy/stigma-of-addiction

 

[11] https://www.ncbi.nlm.nih.gov/books/NBK458661/

 

[12] https://www.hopkinsmedicine.org/opioids/signs-of-opioid-abuse.html

 

[13] https://www.samhsa.gov/find-help/national-helpline