“Opiates” are drugs in the opioid class – a family of legal and illicit drugs that all interact with the brain’s natural opioid receptors with strong pain-relieving, pleasure-inducing, and addictive effects.
Opiates and opioids both derive their names from the opium poppy plant – the first natural source of a substance that was discovered to produce these effects. Modern descendants of opium that use processed ingredients from the original organic source are called “opiates” – separate from similar drugs developed from artificial and inorganic components.
A lineup of the most common opiates includes:
- Heroin
- Morphine
- Codeine
Recognizing the Signs of Opiate Addiction
Opiates are all addictive, but they also have many non-recreational purposes that can complicate our ability to recognize when use has grown into addiction. Look out for the following symptoms of abuse, or signs that someone is taking doses that are too high:
- Pinpoint pupils
- Nausea
- Slowed heart rate
- Slowed breathing
- Low temperature (hypothermia)
- Dry mucous membranes: nose, mouth, or eyes
- Slowed speech
- Loss of coordination
- Loss of appetite
- “Nodding off,” drowsiness, or fatigue
- In injecting users, bruises or “track marks”
Opiates act on the nervous system’s naturally existing opioid receptors. These are pathways that our endogenous opioids enkephalin and endorphin use to communicate nervous system messages about pain and contentment, as well as regulate many basic bodily functions. When high doses of synthetic opiates flood the system for a long period, the brain shuts down its production of our endogenous opioids in an effort to regulate the amount of messaging going on at the receptors.
Opiate Dependence
When a person has developed a dependence on opiates, their body has become so used to the presence of the drug that when it is removed, they experience withdrawal symptoms. When synthetic opiates are removed from the system, such as when the drug of abuse is not available or when the user is attempting to quit “cold turkey” – the nervous system doesn’t have adequate stocks of its neurotransmitters to regulate itself properly anymore. This sends the system into an unmoderated overdrive, with symptoms that in many ways mirror the effects of an opiate high:
- Dilated pupils
- Tearing up/excessive production of saliva
- Runny nose
- Restlessness
- Fever
- Extreme sweating, even in cool environments
- Diarrhea
- Abdominal pain
- Depression or joylessness
- Agitation, irritability, or anxiety
- Bone ache
- Muscle pain
- Cramping
- Uncontrolled muscle spasm
Symptoms of Opiate Abuse
Periods of consistent opiate abuse can wear down an individual’s emotional, mental, and interpersonal health, producing changes that may be visible to the people closest to them. Heavy use of opiates can result in:
- Depression
- Memory loss
- Cognitive decline
- Brain fog
- Loss of interest in hobbies
- Loss of pleasure
Opiate addiction has some common signs:
- Poor focus
- Frequent emotional or physical absence from events related to personal, relationship, or work life
- Using in secret
- Becoming guarded or defensive when asked about unexplained spending
- Developing skin abscesses, cardiovascular infections, and blood-borne illnesses.
In the long term, opiate users face many forms of tissue damage and harm to the nervous system and internal organs. Respiratory and cardiac depression can set in rapidly and requires an immediate response with naloxone and emergency treatment.
Diagnosing Opiate Addiction
Addiction is a disease, and requires a medical professional to provide a diagnosis. Getting this diagnosis first relies on the person with an addiction or people close to them acknowledging and wanting to address the problem.
To receive a diagnosis of a moderate Substance Use Disorder (SUD), you must demonstrate two of the following criteria within a 12-month period. If you answer positively to six or more of them, it indicates a severe SUD:
- Regularly consuming larger amounts of opiates than intended by a doctor or consuming opiates for a longer amount of time than planned
- Attempting to, or expressing intent to reduce the consumption of opiates without doing so
- Spending long periods of time attempting to get hold of opiates, ingesting opiates, or recovering from use
- Craving opiates
- Failing to fulfill professional, educational, and family obligations as a result of opiate use
- Regularly using opiates in spite of the social, emotional, or personal issues they are causing or exasperating
- No longer engaging in hobbies, passions, or social activities due to opiate use
- Consuming opiates despite risk of danger or injury
- Continuing to consume opiates despite knowing the physical or psychological harm they are likely to be causing
- Increased tolerance to opiates, meaning that you need to consume more to feel the effects
- Experiencing withdrawal symptoms (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.
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Treating the Symptoms of Opiate Abuse and Addiction
The first step of substance abuse treatment is detoxification, which means allowing all traces of opiates to leave your system. Safely managed detoxification from opiate abuse involves a process called “opiate replacement therapy” (ORT). ORT involves assessing the level of tolerance in a user, and prescribing a long-acting medication that shares some characteristics in common with the drug of abuse.
FDA-approved medications for ORT are:
- Methadone
- Buprenorphine
- Naltrexone
Opiate addiction is as profoundly psychological as it is physiological. Medications cannot treat the vast majority of these devastating conditions on their own. The treatment program needs to address the root causes and driving factors in the individual’s addiction. At this stage psychosocial and behavioral counseling can be valuable, as well as a wide variety of mainstream and alternative therapies.
Medical detox, psychosocial counseling, peer support, specialist CBT, and dual diagnosis are all equal pillars of an approach to opiate addiction sustainably. Dual diagnosis is when you are assessed for the opiate use disorder, and for other complicating addictions and co-occurring mental health conditions that may affect both your substance abuse and your recovery process. Opiate addiction is often accompanied with mental health conditions such as depression or anxiety. You may abuse opiates to self-medicate and numb emotional or psychological suffering and pain.
Residential care provides a safe, comfortable setting for you to address the underlying causes of your substance abuse issues with clinical support and confidentiality.
