Opioids are endogenous, natural and synthetic substances that act on the opioid receptors. It is a morphine-like effect that can quickly lead to addiction. Opioid abuse is therefore to be understood as meaning the use of such substances that leads to addiction or supports addiction. For prevention, any doctor should exercise caution when prescribing opioids. The treatment and therapy must be carried out by withdrawing from the opioids.
What is opioid abuse?
There are many different opioids on the market. Most of these are prescribed for severe pain. Only occasionally are opioids used as an emetic or to combat diarrhea. One group of patients who can benefit from the good analgesic effect of the administered opioids are cancer patients with chronic pain associated with the disease. See usvsukenglish for What does the abbreviation DS stand for.
When a doctor handles the prescribed opioids properly, there are no dangerous side effects or even deaths from opioid abuse. We speak of opioid abuse when the dosage of these drugs no longer corresponds to the actual needs of the patient. This can then lead to serious health problems. In the worst case, those affected can die.
Causes
The causes of opioid abuse can be different. Since most opioids are prescription drugs due to the dangers they pose, it is often only the lack of caution on the part of the treating physicians that causes many patients to abuse opioids in the first place. However, there are also some lighter-acting opioids that are freely available in pharmacies.
In these cases, it is very difficult to prevent abuse because addicted patients can switch to another pharmacy at any time to buy their addictive substances there. In addition to opioids, which are often negligently prescribed by doctors, there is also a black market for them, which contributes to the fact that opioid abuse can repeatedly lead to serious damage to health and even to the death of many people.
Symptoms, Ailments & Signs
The pain-relieving effect of opioids is perceived less and less as you get used to it, and the dose keeps increasing. Under certain circumstances, the cause of the pain that originally existed is no longer there. However, because of the addictive nature of opioids, the abusers feel the pain is still there and need more and more of the addictive substance.
Overdosing can lead to life-threatening complications. If the drug is injected, scarring and inflammation of the puncture sites occurs. Urinary retention, severe constipation, respiratory depression to the point of suffocation, extreme itching, slow pulse and severe drop in blood pressure.
Life -threatening lack of oxygen, colicky pain in the biliary system, stiffening of the muscles or constant vomiting are just a few of the possible side effects of opioid abuse.
Diagnosis & course of disease
A good way for the treating physician to detect opioid abuse is to closely observe the patient’s pupils. Usually in this case the pupils are sharply narrowed. However, this does not necessarily have to be the case.
If the opioid abuse has already caused a very severe lack of oxygen in the patient’s body, the pupils can also be very dilated for this reason, since opioid poisoning has already occurred. If the doctor suspects opioid abuse and the patient is willing to provide information, it is first important to find out how this patient can obtain the opioids.
If he is prescribed it by another doctor, this must be clarified. Otherwise, it must be clarified whether he is acquiring over-the-counter opioids or whether they can acquire them illegally. The course of the disease then also depends on the extent to which the doctor treating the patient can persuade the patient to look at his incipient addictive behavior.
Complications
Chronic opioid abuse often leads to psychological and physical dependence. Due to the ever-increasing need for opioids, regular intake of excessive amounts increases the risk of complications occurring, which can range from constant tiredness and sleep disorders to a slow heartbeat and drop in blood pressure. Other possible consequential damage is impotence, constipation, severe weight loss, tooth decay and hair loss, and speech and movement disorders also occur.
If the opiate is improperly administered intravenously, there is a risk of disease transmission through contaminated syringes: bacteria can enter the puncture site and cause local inflammation. Repeated use of the injection equipment often leads to infection with HIV or hepatitis C. During pregnancy, this can occur Miscarriage caused by opioid abuse: If the child is carried to term, there is a risk of deformities or developmental delays.
If there is already a dependency, stopping the opioids makes itself felt through tormenting withdrawal symptoms such as sweating, cramps, diarrhea, nausea, vomiting, anxiety and restlessness, and thoughts of suicide can also arise. An acute, life-threatening complication is an overdose: a reduced breathing rate and depth of breathing can lead to fatal oxygen deficiency.
In the psychosocial area, opioid abuse often leads to neglecting one’s own needs apart from opiate consumption and interpersonal relationships. The depletion of financial reserves can ultimately result in drug-related crime.
When should you go to the doctor?
In the case of an existing opioid abuse, it is generally recommended to consult a doctor at short notice, even if there are no acute symptoms. The reasons for the abuse should be discussed in a trusting conversation with the doctor. A visit to a doctor is particularly advisable if the abuse of opioids is not a one-off event and the patient has had problems with opioids before. This applies not only to illegal substances, but also to prescription drugs containing opioids.
The practitioner can then take steps to prevent opioid abuse from developing into a difficult-to-control addiction. In addition, it may be necessary to adapt an existing medication with prescription drugs.
However, if acute symptoms occur, in the case of opioid abuse, a doctor should be consulted immediately to avoid complications. Warning signs are, for example, abscesses or inflammation of the skin. If you suspect that you have hepatitis, you should consult a doctor as soon as possible, since hepatitis can significantly increase the adverse effects of opioid abuse.
Treatment & Therapy
Once it has been clarified how the said opioid abuse came about in a patient and this patient is also willing to be treated, the further course of action can be discussed. If there is already a strong addiction, it will not be possible to help the patient without treatment in an addiction clinic.
The doctor must then help to find a place in such a clinic. Frequently, a more or less long waiting time is possible, which has to be bridged. Here the doctor is asked to ensure that the patient’s motivation to seek treatment is maintained until admission to the addiction clinic. In mild cases and also to bridge such waiting times, it is possible to seek accompanying outpatient therapy.
If possible, it is advisable to motivate the patient to stop taking these drugs immediately before being admitted to the addiction clinic. Even if that is done, the therapy should be done so that the causes of this behavior can be worked up in an in-depth analysis. This will help prevent a relapse later.
Outlook & Forecast
Few sufferers are able to stop using opioids after a single harmful abuse. As a rule, these are medically informed patients with a stable life perspective and without previous mental illnesses. In very many cases, the abuse of opioids leads to a life-threatening addiction. Whether and how quickly dependence develops depends on the patient’s general mental state, family environment and history, but also on the primary disease present.
The prognosis of those affected improves if they receive medical care. In the case of dependence on opioids, the most promising is inpatient withdrawal therapy or substitution therapy. Which form of therapy can achieve the most favorable prognosis depends on the respective situation of the patient. Without consulting a doctor, the prospects for those affected are very poor.
An untreated opioid addiction also leads to a worsening of the underlying primary disease and thus to severe pain again. The affected patients therefore resort to opioids even more frequently. With regular consumption, coping with everyday tasks or exercising a job is usually hardly possible. Repeated abuse of opioids often leads to the death of the person affected by overdosing.
Prevention
In general, the best prevention of opioid abuse is for primary care physicians to be aware of their responsibility when prescribing opioids to their patients to manage pain. This should always be carefully considered and only done when absolutely necessary, and even then not without forgetting to thoroughly educate patients about the addictive effects of these drugs.
Aftercare
Prolonged abuse of substances regularly leads to habituation. If the body then no longer receives its intoxicating substances, it shows clear withdrawal symptoms. A patient can only face these with a strong will and a supportive environment. This is why opioid abuse is usually followed by longer follow-up care.
A stay of several weeks in an addiction clinic is advisable. In many cases, it is about experiencing everyday life without painkillers. Patients must perceive their feelings and actions as pleasant when no opioid is used. Possible complications can occur in particular when the patient is no longer continuously monitored.
Many then fall back into old patterns, for example by fighting stress with painkillers. Selective aftercare in the form of discussions with a psychotherapist or a general practitioner can pave the way to a healthy life.
Sport and relaxation techniques strengthen willpower and experience has shown that many patients can manage without painkillers. Contact with like-minded people can also help to strengthen your will. Basically, it must be stated that the success of aftercare mainly depends on the decisions of the patient. This results in the sometimes high number of relapses.
You can do that yourself
Opioid abusers are often more difficult to persuade to seek treatment than alcoholics. The relatives should show the affected person the consequences of the addiction as well as ways out of the addiction in order to increase the chance of withdrawal. However, the patient himself must have the will to stop the opioid abuse.
If this will is present, inpatient or outpatient withdrawal is an option. The first step is to discontinue the drug or replace it with a less harmful drug. The opioids should be gradually reduced under medical guidance to minimize psychological and physical withdrawal symptoms. After withdrawal, the sufferer must learn to naturally relieve stress and tension. This is achieved through physical activity, yoga, autosuggestive methods and many other measures.
In order to achieve long-term success, withdrawal and subsequent therapy must be professionally guided. In addition, any psychological comorbidities such as depression or anxiety disorders must be treated. In the context of psychotherapy, the addict learns coping mechanisms and can also get in touch with other affected people. Individual and group therapies are important support after overcoming opioid abuse.