Opioid addiction is the continued use of substances that negatively affect the body’s systems, even though he is harmed by them. When he stops using the substance, withdrawal symptoms occur. Over time, he increases both the duration and dosage of substance use. This use leads to serious problems. Worldwide, there are more than 20 chemically diverse opioids suitable for clinical use.
What Is an Opioid?
It is a group of drugs derived from opium. Over time, these drugs can lead to addiction. Opioid addiction is a treatable form of addiction. More than 20 chemically distinct opioids are in clinical use worldwide. In developed countries, opioids are the substance most frequently associated with misuse and addiction
. Opioid addiction—excluding heroin—is most commonly observed among individuals who became dependent during medical treatment, among healthcare professionals who have easy access to these types of medications, and among those who obtain their medications from healthcare providers and treatment programs.
Today, it is viewed as a biopsychosocial disorder in which multiple factors interact regarding the initiation of use, continued use, and relapse following periods of abstinence.
According to the DSM-IV-TR, 10% of the U.S. population has tried cocaine at least once, with 2% having misused it in the past year, 0.8% in the past month, and 2% having misused it or been dependent on opioids at some point in their lives.
The highest rates of use have been observed in the 18–25 (1.3%) and 26–34 (1.2%) age groups.
Public awareness of the risks associated with cocaine use, coupled with intensive anti-drug campaigns highlighting its effects, has led to a decline in cocaine use in recent years. Opioid addiction in the U.S. experienced a resurgence in the 1990s. Between 1990 and 1995, there was a twofold increase in emergency department visits due to heroin abuse.
In the late 1990s, there was an increase in opioid dependence among people aged 18–25, as well as a brief rise in the use of pharmaceutical sources of oxycodone (OxyContin). Non-injection methods of use, such as smoking and snorting, have grown in popularity.
Results from a national assessment conducted in 2000 (Treatment Episode Data Set) showed that 243,723 users sought treatment for heroin use and 25,723 users sought treatment for other opioid dependence.
Opioid dependence is currently viewed as a biopsychosocial disorder in which multiple factors interact—from the initiation of use, through continued use, to relapse following periods of abstinence.
These factors include pharmacological, social, environmental, personality, psychopathological, genetic, and familial factors.
What Are the Symptoms of Opioid Addiction?
There are certain withdrawal symptoms associated with opioid use. These symptoms can be listed as follows:
- Intense craving for an opioid medication
- Runny nose or sneezing
- Watery eyes
- Muscle pain or cramps
- Abdominal pain
- Nausea or vomiting
- Diarrhea
- Dilated pupils
How Is Opioid Addiction Treated?
Following the patient’s evaluation at the psychiatry outpatient clinic, neuropsychiatric and psychological tests are conducted to confirm this diagnosis.
Once the diagnosis is confirmed, the individual undergoes a psychosocial evaluation, and a family consultation is conducted. If, based on these evaluations, an outpatient treatment plan is decided upon, the patient is enrolled in the program.
The clinician’s approach is crucial when working with patients with opioid addiction, who may be hesitant or reluctant to disclose their substance use and related problems.
Patients undergoing treatment may find it difficult to discuss their potential addiction due to fear of losing access to treatment. An effective opioid addiction treatment plan can be outlined as follows:
- Establishing a diagnosis of opioid dependence
- Determining eligibility for treatment
- Developing initial treatment recommendations and a treatment plan
- Planning for psychosocial treatment
- Ensuring there are no contraindications for the recommended treatments
- Identifying other medical comorbidities and conditions
- Consulting with other relevant departments
- A complete medical history
- Physical examination
- Psychiatric evaluation
- Relevant laboratory tests
- Formal psychiatric evaluation
In addition to the characteristics listed above, we can list the treatment methods for opioid dependence as follows:
Treatment of poisoning due to overdose: Opioid poisoning is one of the most serious psychiatric emergencies. The most prominent finding in patients with opioid dependence is constricted pupils. An opioid overdose suppresses the respiratory center in the central nervous system and can lead to death.
The success of treatment for this addiction depends on how quickly antagonist medications, such as naloxone, are administered. In addition, it is essential to maintain an open airway and intravenous access for patients with opioid dependence, provide necessary intravenous fluid replacement, and ensure advanced cardiac life support. Treatment must be conducted in a fully equipped hospital that includes an intensive care unit.
The patient’s vital signs—such as blood pressure, pulse, temperature, and respiration—must be monitored very closely until the opioids are completely eliminated from the body.
Medication-assisted treatment: Medication-assisted treatment plays a very important role in opioid addiction. Medications such as naltrexone, methadone, and buprenorphine are used for this purpose.
Psychotherapy: As with the treatment of other addictive substances, one of the most important treatment approaches for opioid addiction is cognitive-behavioral therapy, particularly relapse prevention therapy. Group therapy, couples therapy, and family therapy are also integral parts of the treatment program. It is also beneficial to provide therapies aimed at cognitive rehabilitation for patients with impaired cognitive function.
