Should I Be Taking Prescription Opioids?

Should I Be Taking Prescription Opioids?

What are the long term consequences of prescription Opioids?

There is a class of drug substances known as opioids or opiates.  Included in this class are heroine and prescription painkillers like, codeine, fentanyl, hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), and morphine.  Opiates originally derive from the opium poppy plant.  They affect the human brain by acting on the opiate receptors and interacting with the natural chemicals called endorphins.  They affect the emotional center of the brain (the limbic system) and produce pleasurable and relaxing feelings.  Opiates also affect the part which produces automatic bodily responses (the brainstem) and the sensation center of the brain (the spinal cord), leading to slowed breathing and reduced pain.  This explains why they are used in many painkilling medications.  They can have other effects on the body as well including drowsiness, confusion, and nausea.

There are several negative consequences of opiate abuse and addiction.  Opiate abuse and addiction can adversely affect one’s health and behavior (e.g., brain changes, compulsive drug-seeking behaviors), social life, and psychological well-being.  Regarding their health impact, opiate drugs can result in a surge or “rush” of euphoric feelings and sensations.  In the short term, opiate abuse can also lead to other effects like slowed breathing, slowed heart rate, nausea, constipation, and unclear thinking.  

Data from the Drug Abuse Warning Network (DAWN) shows that approximately 343,000 U.S. emergency room visits made in 2015 were related to prescription opioids.  Furthermore, those who overdose are at serious risk for death.  In fact, the number of unintentional deaths due to drug overdose in the U.S. have proven to be higher for opioid analgesic medications than for cocaine and heroin combined.  The below figure displays these figures for recent years.  There were nearly 14,000 opioid-related deaths reported in 2008.

In the long term, opiate abuse can have dire consequences on one’s health.  One of the most obvious, perhaps, is the effect of physical addiction to the drug.  Once addiction develops, the structure and functioning of the brain of an opiate addict is altered and the brain becomes accustomed to functioning with the opiates present.  The brain then develops a tolerance to the drug, meaning the higher amounts will be needed to produce the same effects as before.  Other negative health effects of prolonged opiate abuse include increased risk of contracting communicable diseases (e.g., HIV, hepatitis) for those who inject opiate drugs and permanent organ damage that may result from prolonged opiate use.   

Over time, long term use of opiates, whether legal (e.g., OxyContin) or illegal (e.g., heroin), causes the human brain to become accustomed to them.  This type of use changes cell functioning so much so that sudden cessation can lead to withdrawal.  

Withdrawal is another consequence of long term opiate abuse and is defined as the experience of “symptoms that occur after chronic use of a drug is reduced abruptly or stopped”.  Opiate withdrawal symptoms may include:

  • Restlessness
  • Muscle and bone pain
  • Insomnia 
  • Diarrhea
  • Vomiting
  • Cold flashes with goose bumps (“cold turkey”)
  • Involuntary leg movements

 

Not only does long term abuse of opiates have negative consequences on one’s physical health, but it can also negatively affect one’s behavioral and mental health.  At the point at which a person becomes physically addicted to these drugs, addicts are likely to display compulsive and out of control drug-seeking behaviors in order to continue use of the drug.  For example, one study of adolescent OxyContin® abusers found that many engaged in risky behaviors such as stealing from family members and healthcare professionals, involvement in other crimes (e.g., to obtain money to purchase the drug), and ignoring their own health needs.