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The Impact of Opioids

Author: Rajina Ranadive, M.D.
January, 2018 Issue

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The opiate crisis is affecting everyone. It’s crucial that we protect ourselves, our loved ones and our community from opiate abuse, misuse, addiction and overdose. The best way to do that is with information, so we can recognize this when it happens to us or to someone we care about. Opiates, which include prescription pain medications such as hydrocodone, codeine, oxycontin, fentanyl and heroin, killed more than 33,000 people in the United States in 2015. Six out of every 10 drug overdose deaths involve an opioid.

What are opioids?

An opioid is a substance found in poppy seeds that activate powerful reward centers in the brain to produce endorphins, which then creates a temporary sense of well- being. When it wears off, you may want to take more opiates to replicate this feeling. This is the first step to addiction. Repeated opiate use causes a decrease in endorphin production and makes one want higher doses to achieve the same effect. This is how tolerance develops. 
Nearly 2 million Americans older than age 12 used or were dependent on prescription medications in 2014, according to the Center for Disease Control. Pain medications are prescribed for nociceptive and neuropathic pain. Nociceptive pain is caused by damage to body tissue such as after a burn, fracture or inflammation, such as arthritis. This pain is often described as sharp, aching and throbbing. Acute pain tends to be nociceptive in nature. Its pain that comes on quickly, lasts less than three months and eventually resolves as the tissue heals. 
Neuropathic pain is caused by injury or malfunction to our nervous system. It’s often described as a stabbing, pricking, burning or tingling. Chronic pain typically lasts longer than three months or past the time of normal tissue healing. Neuropathic pain tends to be more chronic in nature such as Herpes neuralgia, diabetes and spinal stenosis. Chronic pain can also be due to underlying medical disease, injury, medical treatment or inflammation. 

Long-term impact

A survey conducted between 2001 and 2003 revealed the prevalence of pain conditions such as arthritis, rheumatism, chronic neck and pain and frequent severe headaches to affect an estimated 43 percent of adults in the United States. Researchers estimate 9 to 11 million adults (approximately 4 percent of the U.S. adult population) were prescribed long-term opiate therapy in 2005. But medical evidence only supports short term benefit of opioids for reducing pain and improving function in non-cancer pain patients. Very few studies support long-term benefits of opioids in chronic pain. 
 
Chronic opioid use increases the likelihood of addiction, overdose, heart attacks and motor vehicle injury. Opioids are safest when used in acute pain conditions for a minimum of three days. The risk of long-term dependence on opiates increases after taking it for only five days. If you require opiate pain medications beyond this time frame, take it for the lowest possible dose for the shortest possible time. 
Factors that increase the likelihood of addiction are genetic, psychological and environmental. Unemployment, stressful circumstances, heavy tobacco use, young age, person or family history of substance abuse, depression and anxiety all play important roles in people who develop this addiction. 

Preventing addiction

To prevent addiction in your family and community, safeguard the opioid medications you are prescribed by your doctor. Use only medications that are prescribed to you in the manner they are prescribed, and be sure to keep them locked in a safe place and not in your medicine cabinet. When you no longer need your opioids, dispose them appropriately. Many local police stations have take back programs that you can inquire about. If you suspect addiction or dependence to prescription pain medications in yourself or a loved one, start by reaching out to your primary care physician to discuss your situation. 
 

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