Themain purpose of this paper is to find out the history of opiateaddiction. First, opiate addiction has been described followed by thefour stages of addiction. On the other hand, the main characteristicsof opiate addiction that include tolerance development andwithdrawal syndrome were listed. Next, opiaid dependence diagnosiscriteria have been analyzed where the most significant signs searchedfor in patients with opioad toxicity is respiratory depression. Thispaper has also analyzed how to manage addiction as well as theconsequences of untreated opiate addiction where if left untreated,opiate addiction results in human sufferings which are incalculable.Finally, opioid withdrawal signs and recommendations to prevent risein prescription of opioid overdoses were discussed.
Opiatesare classified as drugs containing opium, heroine, codeine, morphineand synthetic opiates such as methadone. Throughout history opiatehas been used in America for therapeutic functions. Opioid drugs canbe easily obtained through medical prescription and illicit sources.Unfortunately, more medications may be accessible for diversion withincreased medical prescriptions. Opioids prescription is categorizedinto two ways one is in acute pain treatment with opioid usedbriefly and secondly, in chronic pain treatment with long-term opioidexposure. However, acute pain treatment is rarely related withaddiction or abuse, though extra medication may be a potential sourcefor other family members in the home. On the other hand, increasedaccess of opioids can lead in the upsurge of abuse. In America,access to opioids has increased due to the rising prescription. Thisis for the main reason that access to these drugs is also easily donethrough the internet thus, a new source to prescription drugs (Lambet al, 1998: 100).
Opiateabuse has been there for many years and thus the contemporaryproblems related with its use are not unique. Opiate addiction canbe described as medical illness caused by continued use of the drugregardless of related harm such as infections or overdose. Opiateprescription is common and this has resulted into more patients tobecome dependent on opiate. In their book, Lamb et al, (1998) thereare many factors such as biological, sociological, psychological andeconomic that will determine the age a person will begin to useopiates. As a matter of fact, those people addicted to these drugsusually become dependent at their early years and remain dependentfor decades. Clearly, when an individual start to use opiates thisleads to abuse and repeated use until they become dependent on thesedrugs. Excessive use of opiate may be linked sedation, overdose andaccidents with increased death risks as its long term effects.According t Lamb et al, (1998) each year approximately 100,000 peoplesuccumb to opioid overdose. Dependence symptoms include tolerance tothe drugs, compulsive drug taking and withdrawal symptom. Furtherargues that once an individual become dependent they often experiencerepeated cycles of cessation as well as relapsing extended overdecades (Lamb et al, 1998: 100).
Accordingto Courtwright (2001: 8), addiction occurs in four stages. The firststage of addiction is that of acute drug effects resulting fromneurobiologic changes and lasts from hours to days. The second stageis transformation to addiction, is associated with neuronal functionchanges that build up after repeated drug administration, and reducesafter drug use is discontinued. The third stage is that of relapseafter an individual have abstained from using the drug for days.Finally, the fourth stage is the end-stage addiction where anindividual become vulnerable to relapse which endures for years.Courtwright (2001: 9), states that the main characteristics of opiateaddiction include tolerance development and withdrawal syndrome.Tolerance is demonstrated when an individual have the need toincrease the drug dosage in order to obtain its effects.Consequently, individuals can take ever-increasing dosage as thetolerance level increase (Courtwright, 2001:9).
Opioidaddiction can be defined using a cluster of behavioral, cognitive andphysiological symptoms in individuals who continue to use the drug. Opioid dependence is characterized by an individual repeatedself-administration resulting in tolerance, withdrawal and compulsivetaking of the drug. For this matter, dependence develops over aperiod of regular use of this drug. Diagnosis of dependence on opioidis significant and has both prognostic and treatment implicationssince the patient have a serious health risk. Essentially, thediagnosis is made based on the provided patient’s history using thesigns and symptoms related with compulsive and prolonged use ofopioids for nonmedical purposes. The diagnostic criteria include astrong desire to take opioids, difficulties in controlling thisbehavior, a state of physiological withdrawal when use of the drug isreduced, and tolerance evidences. In addition, an individualdependent on opioids neglect other pleasurable interest for its usewith a most of their time spent in obtaining this drugs or recoveryfrom its use. An individual with a persistent use of opioid despiteobviously harmful consequences evident such as depression or drugassociated impairments. However, the most significant sign looked forin opioid toxicity is respiratory depression. This is exhibited in anindividual breathing less breaths per minute (Lamb et al, 1998: 100).
Treatmentcan change the history of opiate dependence by delaying illicitopiate abuse. Various treatments are used for opiate addiction andinclude managing by use of a substitution therapy with drugs likemethadone. Methadone maintenance treatment programs (MMT)substitution therapy helps to reduce its harm significantly andimprove the physical and social health of the Opiate dependentpatients. Naloxone (Narcan) treatment shloud be given to patientssuspected of overdose of this drug or those with sevre dependence onopiod. Narcan is not given orally but administered to patients eitherintravenously, intranasal or through an endotrachea tube (Lamb et al,1998: 100).
Opioidoverdose can be prevented and treatable or reversible if witnessedearly. Opioid overdose is a huge public health challenge that can beeasily prevented through use of a safe substance that is notabusable. Opioid dependence is a chronic disease that is treatablewith relapse part of its natural history. Therefore, preventingoverdose is significant and help individuals to continue withrecovery progress and allow them seek other lifesaving services (Lambet al, 1998: 100).
Consequencesof untreated opiate addiction
Ifleft untreated, opiate addiction results in human sufferings, whichare incalculable. The first consequence is mortality. In addition,untreated opiate dependence leads to high bacterial infections,tuberculosis, alcohol use and sexually transmitted disease. Peoplewith opiate dependence seek medical attention when it is too late andthis increases the health care costs. Another consequence of opiatedependence is joblessness where many users avoid steady employmentsince much of the time they are seeking drugs or taking drugs.However, fatal overdose is preventable with the effective measuresincluding reducing opioids availability and ensuring that itsavailability and use is regulated. Inappropriate opioidsprescriptions as well as other sedatives should be limited in theirsales. On the other hand, inappropriate sales by chemists andpharmacies without proper prescription should also be addressed.Finally, efficient drug prevention programs should be used to reducethe risks of opioid overdose. Secondly, fatal overdose can beprevented by making available effective treatment for thoseindividuals with opioid dependence. The proven strategy is the use ofopioid agonist maintenance treatment with drugs such as methadone orbuprenorphine. Methadone is found to increase torelance and this inturn help to reduce additional opioid effects. On the other hand,buprenorphine recues overdose risks by blocking opioid receptorspartially. This agonist treatment is regarded as the most effectivestrategy in cases of higher doses and if drug has been taken for along duration. According to lamb et al (1998), in thosecommunitieswhere drug injection is prevalent, outreach programs can be used toassist in sterilization of injection equipment, information, andhealthcare and counseling (Lamb et al, 1998: 100).
Anindividual intoxicated with opioid exhibit symptoms usually lastingfor several hours such as drooping eyelids, sedation, head nodding,constricted pupil and reduced rate of respiration. An intoxicatedindividual often feel drowsy, utter slurred speech, and have animpaired memory. On the other hand, opioid withdrawal is a clinicallycrucial behavior related with reduced use of opioid or cessationafter a prolonged use. The first symptom of withdrawal is complaintsof anxiety, achiness and restlessness. Withdrawal symptoms begin toemerge within 48-72 hours after the last opioid is used and may lastup to 7days. Furthermore, these withdrawal symptoms come with cravingof opioids and a huge sensitivity to pain. In addition, patientsdemonstrate depression, diarrhea, increased sweating, fever andinsomnia as signs for intoxiation. For acute withdrawal symptoms, ashort-term substitute such as buprenorpine is prescribed for aboutone week to reduce doses. However, the patient is required to receivegeneral health review later and also be provided with relapseprevention counseling (First and Allan, 2011: 222).
Inthe recent years, challenges related to opioid prescription haveincreased in America. Some of the risk factors associated with opiodoverdose include easy availability of the drug both prescribed andillicit. On the other hand, a reduction in heroin availability hasbeen related to decreased overdose in opioid use, thus proving thattheir close association between availability of opioid and itsoverdose. The other risk factor for overdose is the presence of acombination of opioid with other psychoactive sedating substancessuch as alcohol and benzodiazepines. Furthermore, a study measuringopioid overdose in individuals using heroin showed that use of opioidwith a combination of other alcohol and sedatives is the main factorcontributing to fatal overdose. Thirdly, lack of treatment of thisdrug dependence is a risk factor with the available substitutiontherapy known to reduce the risks of overdose significantly. On theother hand, patients who cease treatment for overdose prematurely areat a high risk (Lamb et al, 1998: 100).
Opioiddependence is a global health challenge that is accompanied byenormous personal, economic and public health effects. Approximately15.6 million opioid users are reported globally. Opiod use is relatedwith harms such as increased HIV infections as a result of unsafepractices of drug injecting. Opioid dependence is linked withsignificant reduction of human life quality as significant activitiesbecome replaced with seeking and use of opiods. Opioid dependencealso has some economic effects on the society that include increasedhealth costs and impact on other budget. It affects an individualproductivity due to absenteeism, unemployment and premature mortality(Lamb et al, 1998: 100).
Recommendationsto prevent the rise in prescription opiod overdoses
InAmerica, it is reported that death that occur as a result ofprescribed opiod overdose results in more deaths compared to thosecaused by car accidents, therefore, a major concern. People withopiate dependence seek medical attention when it’s too late andthis increases the risks associated with this drug use. opiatedependence mostly leads is joblessness where many users avoid steadyemployment since much of the time they are seeking drugs or takingdrugs. Thus inappropriate sales by chemists and pharmacies withoutproper prescription should also be addressed. It is crucial thatprescription overdose is dealt with in order to minimize opioidrisks. One recommendation is the use of a multipronged approach thatincludes distribution of naloxone. Secondly, use of real timemonitoring systems of how opioids are prescribed is crucial. Withthese systems, patients will not receive opiod prescription fromvarious doctors and this will enable the law enforcement officials tohave a track patterns concerning prescription and dispensing of thisdrug. Furthermore, it is crucial that healthcare professionals to beprovided with better education concerning the risks of prescribingthis drugs. Therefore, it is crucial that those recommendations beimplemented systematically and followed globally in order to reducethe high overdose among people with opiod dependence whetherillicitly or prescribes. Further investigation as well as action isalso required in addressing the use of opioid to alleviate chronicnon-malignant pain. This is because its use remains controversial dueto lack of clinical trials that demonstrate opiods long term benefits(First and Allan, 2011: 222).
Inconclusion, opiate addiction is a major issue in America andcontinues to worsen over the years. As mentioned earlier in thispaper if left untreated, opiate addiction is fatal. However, fataloverdose is preventable with the effective measures includingreducing opioids availability and ensuring that its availability anduse is regulated. On the other hand, when opioids are taken properlyas prescribed they can be used to manage pain effectively and safely,but when abused this can cause severe depression and even death.Individuals at risk for opiate addiction include those with a drugabuse history. This paper has analyzed the history of opiateaddiction which dates many decades ago. Alternatively the four stagesof opiate addiction has been mentioned in this paper and include theinitial stage known as the acute drug effects, the transformationstage, the relapse and end-stage addiction where an individualbecome vulnerable to relapse which endures for years. On the otherhand, the main characteristics of opiate addiction were listed.Diagnosis of dependence on opioid has been found as significant andhas both prognostic and treatment implications since the patient havea serious health risk. Essentially, the diagnosis is made based onthe provided patient’s history using the signs and symptoms relatedwith compulsive and prolonged use of opioids for nonmedical purposes. Finally, recommendations to prevent rise in prescription of opiodoverdoses was discussed. Despite, the increased adverse risks relatedto opiods use, these medications continue to be prescribed widely topatients that suffer from chronic pain. Research also shows thatopiate abuse among teenagers in America is also reported at highrate, for this reason, an urgent priority is required so as the bestpractices should be put in place for treating pain. Additionally,prevention strategies should be developed in order to minimizediversion and abuse.
Lamb,Sara J., Merwyn R. Greenlick, and Dennis McCarty. Bridgingthe Gap between Practice and Research: Forging Partnerships withCommunity-based Drug and Alcohol Treatment.Washington, D.C.: National Academy, 1998. Print. 100
First,Michael B, and Allan Tasman. ClinicalGuide to the Diagnosis and Treatment of Mental Disorders.Hoboken: John Wiley & Sons, 2011. Print.222 223
Courtwright,David T. DarkParadise: A History of Opiate Addiction in America.Cambridge, Mass: Harvard University Press, 2001. Print.