By Callie Wight
Nothing in this article is meant to be medical advice. Please consult your own healthcare provider.
Some info below taken from: www.emedicinehealth.com/narcotic_abuse/article_em.htm
https://drugfree.org/resources/
http://emedicine.medscape.com/article/287790-overview
I am sure you’ve heard the buzz going around about opioid addiction or opioid use disorder.
First, sharing helping resources on the Hill, Mary Morse, executive director of Spirit Mountain Retreat, informs me our community offers 12-step help for opioid addiction through the “… Narcotics Anonymous program on Thursday evenings at 7:30 p.m. at the Spiritual Oneness Center on Cedar Street…. But anyone would be welcome at any of the 15+ Alcoholics Anonymous meetings on the Hill.” (Also, see above websites). Many local psychotherapists also help.
Opioids are powerful and effective pain-killing medications. They are also highly addictive. (The statistics on opioid use or abuse in the U.S. are readily available elsewhere.)
The Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition defines opioid use disorder as a “…problematic pattern of opioid use leading to clinically significant impairment or distress…” noted by behaviors leading to negative, life-changing outcomes. These usually include losing control over one’s use of the drug and preoccupation with obtaining the drug. People become unable to live up to major obligations at home and at work. Some studies report a strong likelihood of a hereditary susceptibility to opioid dependence.
In most U.S. cases, the drug is a recurring prescription from a single physician (not obtained from drug dealers) to treat pain. Recently, it is especially given to treat chronic pain. Apparently, prescribers believe these drugs to somehow not be addictive when used for chronic pain. Prescribing practices became liberal. Many people get the drug free from a friend or relative.
On the other hand, illicit use often begins in the early teen years, along with cigarettes, alcohol and other drug experimentation.
Recently, the Centers for Disease Control released prescribing recommendations particularly for relief of chronic pain and stated that opioids should not be the first line of treatment. They encourage nonopioid pain relievers and nonpharmacological options.
Opioids mimic our own naturally occurring endorphins and, like them, effect a variety of body systems including:
• Pain
• Mood (decreased anxiety, euphoria)
• Motivation
• Stress
• Temperature
• Respiration
• Endocrine activity
• Gastrointestinal activity
Overcoming opioid addiction is possible, but no easy task. Chronic pain still needs to be treated while managing addiction. Under-treating the pain is not an option.
Prescribers are turning to a combination of key medications, psychosocial therapy and 12-step programs. The medications include old, standby methadone plus newer buprenorphine.
Why treat with another drug that also causes dependence/tolerance? Methadone is legally used once per day. Once tolerance to it has developed, this drug has little effect on mood or judgment. The idea is that maintenance therapy manages addiction while improving destructive behaviors associated with out-of-control use.
Prognosis factors include access to medical care, whether employed, legal situation, education level, family status and other psychological difficulties. The above sites recommend straightforwardly informing the individual: that they’re unable to use the opioid judiciously; that treatment must be accompanied by rehabilitation; to expect mood to suffer until stabilized; and to emphasize 12-step programs.
Callie Wight is a California state-licensed registered nurse with a Master of Arts in psychology.
