How to Recognize and Treat Opioid Abuse Before It’s Too Late

Opioids are medications that are used for pain relief, typically for moderate to severe pain. They work by binding to the opioid receptors in the brain, which decreases pain. Prescription opioids can include:

• Codeine
• Fentanyl
• Morphine
• Oxycodone (by self or in combinations such as oxycodone/acetaminophen with brand name Percocet)
• Hydrocodone (often in combination formulas such as hydrocodone/acetaminophen, with brand names of Vicodin, Lortab, Norco)

Opioids may also consist of street drugs, such as heroin or synthetic fentanyl.

When opioids are misused, and taken in doses or frequencies higher than they are prescribed for, there is a potential for opioid abuse and addiction.

Opioid abuse is also called opioid use disorder. It is a disorder in which someone is misusing opioids to the point where it is becoming difficult for them to be able to stop using them or decrease their use. The abuse can interfere with the person's ability to perform everyday tasks, like go to work or school.

This article will review the signs of opioid abuse, the effects and dangers it can cause, as well as how it can be treated and prevented. 

Abuse of Prescribed Opioids

When pharmaceutical companies in the 1990s told prescribers that their opioid pain medications were not addictive, more prescribers began using them for their patients.

As time went on, it became clear that these medications were causing opioid abuse and putting patients at risk. This then led to people looking for stronger doses of medication, with an increase in opioid overdoses.

The opioid crisis in the United States places a significant burden on the physical and financial health of the country. It is estimated that almost $80 billion is associated with this epidemic each year due to lost wages, healthcare expenses, and involvement in the criminal justice system.

Signs of Opioid Abuse

Some of the signs of opioid abuse can include:

• Cravings for using drugs
• Feeling drowsy 
• Changes in sleeping patterns
• Flu-like symptoms
• Weight loss
• Change in eating habits
• Isolating from friends or family
• Stealing from friends or family
• Poor hygiene
• Frequent mood changes
  

Effects

The abuse of opioids can have long-lasting effects on someone’s health, possibly even resulting in death. Someone living with opioid abuse may be in overall poor health.

Often, symptoms or problems are neglected, and regular health maintenance, such as checkups, colonoscopies, mammograms, etc., are not done. Opioids can also cause problems to the organs in the body, including the brain, bowels, heart, lungs, and bones. 

Brain 

Opioid abuse can cause the brain and body to become overly sensitive to pain. This often happens when someone is trying to cut back or quit using these medications.

The use of opioids can cause amnesia or forgetfulness. They can become drowsy and sleepy, or may also experience the opposite in losing the ability to sleep well. Depression and anxiety are often experienced by people who abuse opioids. 

Bowels

Frequent use of opioids can lead to severe constipation, which could potentially result in an obstruction, or blockage, in the intestines. Opioid use can also cause nausea, vomiting, and abdominal pain.

Heart

Regular use of opioids has been associated with the development of heart problems including heart failure (the heart is unable to pump enough blood for the body's needs) or heart attack (blocked blood flow results in damage to the heart muscle).

Lungs

Opioids can slow the respiratory system, potentially leading to respiratory failure. It can also cause problems such as sleep apnea (periods of low oxygen during sleep).

Bones

An increased risk for bone fractures has been found to occur in people with opioid abuse. This could be due to some weakening of the bones or also because people who abuse opioids may be at an increased risk of falling.

Dangers

Opioid abuse can lead to overdose. If too much of an opioid is taken, a person's respiratory drive becomes severely diminished. This can lead to very shallow breathing or may even cause someone to stop breathing altogether.

An overdose of opioids is a medical emergency. Signs of an overdose may include:

• Skin feels clammy
• Pale skin
• Loss of consciousness or not being able to be woken up
• Vomiting
• Change in breathing rate
• Fingernails that look blue in color

Treatment

The first step in treating opioid abuse is someone recognizing that they have a problem and wants to quit using drugs. Sometimes this occurs as a result of a medical emergency from drug use. Other times this can come from discussions with concerned family and friends.

Sometimes people need to be admitted for withdrawal symptoms as they stop using opioids. Other times people attend therapy as an outpatient, which can be led by their physician or at a center that deals with addiction and rehabilitation.

Medications may be effective at treating opioid abuse. The medications methadone and buprenorphine can be used to help reduce the cravings for opioids and prevent withdrawals. They must be given in combination with talk therapy and their dose is decreased over time.

Another medication, naltrexone, blocks the effects of opioids so that they don’t provide any type of high or pleasurable feeling. This medication is usually taken once a day.

The medication Narcan (naloxone) is used in an emergency when someone has overdosed on opioids. Narcan quickly stops the action of opioids in the body, which can help revive someone who has overdosed. In March 2023, the Food and Drug Administration (FDA) approved Narcan Nasal Spray as an over-the-counter (OTC) emergency treatment for opioid overdose. 

In addition to medical therapy, there are multiple behavior-focused therapies that may be used along with or following medications. These therapies can include:

• Cognitive behavioral therapy: Recognize and change patterns of thinking and behaviors leading to opioid abuse
• Motivational improvement: Education on how to stay motivated when quitting opioids
• Group counseling: Can be with family members or others who have abused opioids
• Residential programs: Inpatient therapy which takes place in a facility that can provide both emotional and medical support while in recovery

Prevention

There are things that can be done if there is concern about someone abusing opioids. If someone is prescribed opioids, the tips below are some of the ways to stay safe and prevent abuse.

• Never take more than the prescribed amount of opioid medication.
• Do not take opioids along with alcohol or any other recreational drugs.
• Do not sell the prescription medication.
• Keep the prescription out of reach of anyone else in the home.
• Dispose of any unused opioid medications if no longer needed.
• Do not share prescription opioids with anyone else.

The Opioid Overdose Crisis

Unfortunately the number of people experiencing an overdose of opioids is significant. In 2017, opioid abuse was officially named a public health crisis. The number who died of an overdose of opioids in the 12 months ending in April 2021 was estimated to be over 75,000.

There is an increased number of people misusing prescription pain medications and moving on to other drugs such as fentanyl or heroin.

Many private and government agencies have been working to end the overdose crisis through public education, increasing access to treatment centers, supporting research for drug abuse and treatment, and encouraging non-opioid pain relief by healthcare providers.

Summary 

Opioid abuse in the United States is a significant problem. The overprescribing of prescription pain medications can lead to misuse and abuse of these medications. Opioid abuse can lead to many long-term health problems and even death.

Prevention of opioid abuse is important so this doesn’t become an issue. Treatment options such as medications, therapy, and rehabilitation are available for those who are looking to quit. 

A Word From Verywell 

If you have been prescribed opioid medications for pain control, it is very important to take them only as directed and not share them with anyone else. If you’re no longer experiencing pain, contact your local pharmacy for the safest way to dispose of your medication.

Having an opioid addiction or loving someone who does can be scary and stressful. Treatment options are available to help quit abusing drugs, but it requires wanting to quit and having a good support system.