What Is Drug Dependence
Drug dependence is when the way your body works changes because you have taken a drug for a long time. These changes cause you to have withdrawal symptoms when you stop using the drug. Withdrawal symptoms can be mild or severe, and may include:
If you have been taking a prescription opioid for a long time, work with your doctor. They can help you avoid withdrawal symptoms by gradually lowering your dose over time until you no longer need the medicine.
Medications For Opioid Addiction Include:
- Available as dissolving tablet, cheek film, extended-release injection, or 6-month implant under the skin.
- Can be prescribed by a doctor for use outside of a clinic.
- Can only be used in a certified opioid treatment program setting.
- Can be prescribed by any clinician who can legally prescribe medication.
- Only used for people who have not used opioids for at least 710 days.
Talk with a doctor to find out what types of treatments are available in your area and what options are best for you and/or your loved one. Addiction is a chronic, relapsing disease be sure to ask your doctor about the risk of relapse and overdose.
If you notice that someone may be struggling with opioid addiction:
Opioid Addiction Treatment Options
Opioid addiction can be treated with medical detoxification procedures such as anesthesia-assisted detox. This rapid detox treatment involves putting the patient under sedation during detoxification to reduce the amount and length of withdrawal symptoms. Such an accelerated opioid detox flushes the substance from the persons body, enabling them to quickly move on to post-detox recovery with a new lease on life.
Waismann Method conducts rapid detox treatments for opioid addiction in a private, full-service, accredited hospital. The medical team evaluates the patients needs before treatment to provide comprehensive care before, during, and after the detox procedure. Then the patient is discharged to an exclusive recovery center with aftercare support.
Waismann Methods approach to opioid detox and recovery treatment dramatically reduces the likelihood of complications and relapse during the withdrawal period.
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Emergency Responses To Opioid Overdose
Death following opioid overdose is preventable if the person receives basic life support and the timely administration of the drug naloxone. Naloxone is an antidote to opioids that will reverse the effects of an opioid overdose if administered in time. Naloxone has virtually no effect in people who have not taken opioids.
Access to naloxone is generally limited to health professionals. In many countries there is still limited availability of naloxone even in medical settings, including in ambulances. On the other hand, some countries have already made naloxone available in pharmacies without prescription. Several countries have introduced naloxone as over-the-counter medication and have also started proactive dissemination in communities.
In recent years, a number of programmes around the world have shown that providing naloxone to people likely to witness an opioid overdose, in combination with training on the use of naloxone and on the resuscitation of people following an opioid overdose, could substantially reduce the number of deaths resulting from opioid overdose. This is particularly relevant for people with opioid use disorder and leaving prison, as they have very high rates of opioid overdose during the first four weeks after release.
Opioid Withdrawal Treatment And Home Remedies
Because it can be hard to give up opioids safely, most people should get a doctorâs help to quit. They may:
- Give you drugs, like methadone or buprenorphine, that make your symptoms easier to deal with and help with cravings. Your doctor will give you smaller doses over time until you no longer need it.
- Give you drugs to settle your stomach, if you have vomiting or diarrhea, and recommend fluids to replace the water your body’s losing
- Give you drugs to control your blood pressure if itâs high because of withdrawal
You can treat other symptoms, like fever, headaches or joint pain, with common over-the-counter drugs like ibuprofen.
Some other things may help you through:
- Small, frequent meals or snacks of healthy foods
- Plenty of water or other fluids
- Meditation or something else that helps you stay calm
- A distraction to keep your mind off your symptoms, like talking with a friend
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Odd Items And Drug Paraphernalia
People may use opioids in a variety of ways. They are taken orally, snorted, smoked, and injected. Certain items, like piles of burned tinfoil, medication bottles with the labels ripped off, tiny pieces of balloons, or bloodied cotton swabs, are found in rooms or trash cans.
Other odd items related to opioid use include:
- Straws or tubes that someone has cut into smaller pieces
Going Doctor Shopping Or Moving On To Heroin Use
Doctor shopping refers to patients obtaining opioid prescriptions from multiple healthcare providers without the prescribers knowing the patient has another prescription. They also may claim to have lost their prescription and need another one filled or complain the pain is so bad they need a stronger prescription.
When prescription drugs are too challenging to obtain, they turn to more available opioids, like heroin. Heroin works similarly to most prescription opioids, fulfills the urges and cravings, and is more powerful when injected. Many heroin addictions stem from initial prescription opioid use.
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Inpatient And Outpatient Rehab
Once you complete opioid detox, the next step is to transition into a rehab program. Opioid addiction treatment occurs in either an inpatient or outpatient setting. Inpatient treatment involves residing at the treatment center for the entire program. You receive around-the-clock treatment and care, with little to no exposure to triggers. Inpatient provides more structure and intensiveness, which many people find beneficial.
Conversely, outpatient opioid addiction treatment offers more flexibility and less scheduling conflicts. You live at home while attending therapy and counseling during the day. The time commitment for outpatient ranges from just a few hours per week to several hours per day. If your opioid addiction is more severe but you are unable to attend inpatient, you may want to opt for a partial hospitalization program or intensive outpatient program .
Ultimately the right treatment setting for you depends on your opioid addiction, other substance use, mental health condition, physical health, priorities, schedule, and more.
Statistics Of Opioid Addiction
The United States Substance Abuse and Mental Health Services have discovered that next to marijuana, the nonmedical usage of prescription painkillers is the second most common form of illegal drug use. In 2007, SAMSHA reported that 5.2 million individuals 21% of people over the age of twelve used a prescription painkiller for nonmedical purposes. The US DEA believes that estimate to be closer to 7 million individuals.
In 2006, the Drug Abuse Warning Network reported that about 324,000 emergency room visits involved painkillers.
Causes
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What Are Opioid Prescriptions
Opioids are the class of drugs that are found in the opium poppy plants. Some medicines are made directly from the plants, while some are created using the same chemical structure in the lab.
The reason why opioids are used for medication is because of their pain-relieving nature. Although opioids can help patients relieve the pain, it makes them high simultaneously, so they are sometimes used for non-medical reasons.
Opioid Use & Abuse Statistics In The Us
A national study in 2018 estimated that among Americans aged 12 or older:7
- About 10.3 million people had misused opioids in the last year.
- About 9.9 million people had misused prescription opioids in the last year.
- Approximately 808,000 people had used heroin in the last year.
- Approximately 2 million people had an opioid use disorder.
- About 1.7 million people had a painkiller use disorder.
- Approximately 526,000 people had a heroin use disorder.
Hydrocodone was the most commonly misused prescription opioid, with about 5.5 million Americans aged 12 or older abusing it in 2018.7 Oxycodone was the second-most commonly misused prescription opioid, with approximately 3.4 million Americans aged 12 or older abusing it in 2018.7
Efforts to address the opioid epidemic have led to prescription opioids becoming less available, and people have turned to alternate routes to obtain them in some cases.8 People may buy prescription opioids from others, which can be very costly, while heroin has similar effects and can be cheaper and easier to access.6 In people who use heroin, 80% have a history of prescription opioid misuse.6, 8, 9
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Risk Factors For Opioid Addiction
Several risk factors may make a person more susceptible to an opioid use disorder.
These may include:
Numerous factors can contribute to opioid use disorder. These include:
Experiencing childhood neglect or abuse or living in poverty or a rural place are factors that have been associated with opioid addiction. Having easy access to opioids is another factor, as are certain personality traits like being impulsive or sensation-seeking.
Variations in certain genes are also believed to play a role in addiction.
Learn About Opioid Abuse & Addiction
Opioids are a type of drug that have both legal and illicit uses. Natural opioids come from the opium poppy plant, while synthetic opioids are created in labs. In controlled settings, opioids are powerful analgesics, or painkillers. When used recreationally, however, opioids reduce pain, cause sedation, and bring about feelings of euphoria. Morphine, oxycodone, hydrocodone, and codeine are all opioids that are commonly prescribed to treat pain, while heroin is an illegal opioid.
All opioids, even those legally prescribed, have the potential for abuse should they be used at high doses or for a long period of time. Opioids are so powerful because they activate built-in painkilling and reward circuits in the brain. They mimic brain chemicals that are associated with pleasurable feelings and pain reduction. With continued use, a persons craving for the pleasurable feelings brought on by opioids can begin to take over his or her life. Thankfully, help is available for those with an opiates addiction at Keystone Treatment Center.
Statistics
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What Is The Opioid Crisis
The opioid crisis is a complex public health issue. There are many factors that led us to the significant increase in opioid-related overdoses today. Some of these factors include:
- high rates of opioid prescribing
- the emergence of strong synthetic opioids in the illegal drug supply such as fentanyl and carfentanil
Incidence Of Opioid Addiction In The Us
The United States is in the midst of an opioid epidemic. The most recently available data suggest that roughly 1.6 million people in the United States live with an opioid use disorder. More than 10 million people in the United States misuse prescription opioids.
White people and males have the highest rates of opioid misuse and deaths from overdose. But there are disparities in access to treatment for minority populations, people of low income, and females.
Deaths from overdose are rising faster for non-Hispanic Black people and American Indians than other demographic groups. Pregnant people may be denied treatment or be afraid of legal consequences of seeking care.
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How To Get Help
Getting help can mean different things for different people and it can take many different forms. For some people it may mean complete abstinence or continued treatment using opioid replacement therapies such as methadone or buprenorphine.
There are also many health and social services available across Canada including non-medical therapies, such as counselling, or support from people with lived and living experience.
Find out what resources are available in your province.
How you can help. A small change can help reduce the cycle of stigma
Stigma around substance use can prevent people from getting the help that they need. You can help by:
Listening with compassion and without judgment, so a person who uses drugs feels heard and understood
Speaking up when someone is being treated disrespectfully because of their substance use and
Being kind with the words you use. Words Matter. Use people first language.
- Instead of junkie use a person who uses drugs
- Instead of addict use people who have used drugs
- Instead of drug abuse use substance use
Symptoms Of Opioid Use Disorder
OUD is characterized by symptoms such as the following.
Physical dependence: This is a physiological change that occurs when using a substance. When the person stops taking the drug, they experience withdrawal symptoms such as cravings and sweating. It is important to understand that a person can be physically dependent on opioids without unhealthy use. For example, a patient with cancer who has chronic pain may be physically dependent on opioids but not addicted to them.
Increasingly heavy, frequent, unhealthy or risky use: The person continues to use an opioid even though it causes problems with health, safety, financial security or personal relationships. A person with an opioid use disorder is unable to control the use of opioids, and behaviors associated with getting and using opioids increasingly interfere with daily life.
Cravings: These are overwhelming physical and emotional urges to take the drug, despite an understanding of potential consequences to well-being.
Other signs of an opioid use disorder: Someone struggling with an opioid use disorder may not show signs right away. Over time, there may be some signals that the person needs help, such as:
- Isolation from family members or friends
- Stealing from family members, friends or businesses
- New financial difficulties
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The Changed Set Point Model
The changed set point model of drug addiction has several variants based on the altered neurobiology of the DA neurons in the VTA and of the NA neurons of the LC during the early phases of withdrawal and abstinence. The basic idea is that drug abuse alters a biological or physiological setting or baseline. One variant, by Koob and LeMoal , is based on the idea that neurons of the mesolimbic reward pathways are naturally set to release enough DA in the NAc to produce a normal level of pleasure. Koob and LeMoal suggest that opioids cause addiction by initiating a vicious cycle of changing this set point such that the release of DA is reduced when normally pleasurable activities occur and opioids are not present. Similarly, a change in set point occurs in the LC, but in the opposite direction, such that NA release is increased during withdrawal, as described above. Under this model, both the positive and negative aspects of drug addiction are accounted for.
When Does Problematic Use Become A Substance Use Disorder
When someone regularly uses drugs or alcohol despite continued negative consequences, they may have substance use disorder.
It is a medical condition that requires treatment from health care providers. Substance use disorders can involve both psychological and physical dependence.
If someone you know has one or more of the following behaviors, they may be experiencing a substance use disorder:
- constant cravings for the drug
- compulsive drug seeking
- continuous use despite the harms that the drug is causing, such as:
- negative health effects
- lower grades or marks at school
- isolation from friends and family members
- extreme changes in behaviours and mood
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Critical Differences In Treating Opioid Dependence Vs Addiction
Understanding the differences between opioid addiction and dependence can help you spot warning signs and possible symptoms of developing an addiction. This knowledge also enables you to speak accurately about the conditions and their differences.
Opioid dependence is preventable, and it can be medically reversed with adequate medical detoxification. Opioid misuse such as taking more doses than prescribed, taking the drug for longer than prescribed, or taking the medication for non-medical purposes can lead to addictive behavior. Unlike dependence, addiction is viewed more as a behavioral reaction to long-term opioid use. It is primarily characterized by uncontrollable cravings and the inability to manage or discontinue drug use despite its harm.
If your loved one or you are suffering from opioid dependence or addiction, remember, there is help. There is a humane, dignified, and effective treatment available. You dont need to feel ashamed or scared, and you dont need to be locked away for months on end. Many different medical and individualized detox treatment options could be right for you.
Naloxone Can Save A Life
Naloxone is a fast-acting drug used to temporarily reverse the effects of opioid overdoses. Naloxone can restore breathing within 2 to 5 minutes.
While naloxone is only active in the body for 20 to 90 minutes, the effects of most opioids last longer. This means that the effects of naloxone are likely to wear off before the opioids are gone from the body, which causes breathing to stop again. So it is important to call for emergency medical attention. Naloxone may need to be used again, depending on the amount, type, or how the opioids were taken .
Naloxone is available without a prescription and can be picked up at most pharmacies or local health authorities. It is available in an injection or a nasal spray format.
Learn more about naloxone and where to find kits in your province or territory.
Did you know?
The Good Samaritan Drug Overdose Act protects you from simple drug possession charges if youve taken drugs or have some on you. The law applies to the person who has overdosed, the person who seeks help, and anyone at the scene when help arrives.
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Treatment For Opioid Withdrawal
While the process of withdrawal can be uncomfortable, it is rarely life-threatening. However, this doesnt keep an addict from relapsing. Treatment for opioid withdrawal includes medical detox, around-the-clock support and psychological counseling to ensure the safety and healing of the patient.
The most common methods of treatment for opioid withdrawal include medications during detox. These medications may include:
- Buprenorphine to help maintain a level of reduced withdrawal symptoms for long-term opioid users.
- Methadone to maintain withdrawal symptoms for long-term opioid users.
- Naltrexone to block the effects of opioids so that users cannot experience the high that they once sought from the drug.
- Clonidine to help reduce vomiting, diarrhea and other flu-like symptoms associated with opioid withdrawal.
- Specific medications for anxiety, diarrhea, upset stomach or other side effects of withdrawal.
If you or a loved one needs help, call and well connect you with a treatment advisor. 24 hour care is available to assist you once you make the call.
