Opioid Abuse

2008 Nucleus Medical Art, Inc. Risk Factors The following factors increase your chances of developing opioid abuse. If you have any of these risk factors, tell your doctor: Age: 20-29 Symptoms The symptoms below are associated with opioid abuse. If you experience any one of them, see your physician. Toleranceneed to sequentially increase dosage to have the same drug effect Withdrawal (see below)adverse symptoms occur when the drug is not taken Increasing amounts of time spent drug-seeking Interference of drug or drug-seeking behavior with social, occupational, or school functioning Continued use of drugs despite obvious social, legal, occupational, or interpersonal problems stemming from drug use Desire or efforts made to decrease or stop drug use Opioid withdrawal symptoms: Aching Fever Sweating Chills Craving Diarrhea, nausea, vomiting Sleeplessness Pain, muscle aches Goose pimples Uncontrollable shivering, tremors Restlessness Tearing eyes, runny nose Yawning Diagnosis Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will ask you specific questions about your opioid use, such as how long you have been using opioids and how often you use them. Urine drug screens or serum drug tests may be performed to verify the presence of opioid drugs in your system.

Treatment Talk with your doctor about the best treatment plan for you. Treatment options include the following: Rehabilitation Programs In rehabilitation programs, people with opioid abuse stay in a controlled environment for 6-12 months, during which they learn to become reintegrated into society. It may be necessary to be in a medical detoxification center initially, where the side effects of drug withdrawal can be safely managed. Support Groups Similar in format to Alcoholics Anonymous, Narcotics Anonymous is a twelve-step type program that has a good record for supporting individuals who are recovering from addiction to opioid drugs. Behavioral Therapy Behavioral therapies to help people quit are designed to modify peoples attitudes and behaviors related to opioid abuse, and learn how to avoid and cope with situations in which they are most likely to use drugs. Medications The medications methadone, Subutex (buprenorphine hydrochloride), and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) have been shown to be effective in the treatment of opioid addiction by interfering with some of the symptoms of withdrawal. They cannot cure opioid addiction by themselves, but are useful adjuncts to other forms of treatment (such as psychotherapy, group therapy, and/or behavioral therapy), They are also useful because in some instances they allow an individual to undergo withdrawal from opioids as an outpatient, rather than requiring inpatient treatment.

Prevention The best way to prevent opioid abuse is to never use opioids, since they can be highly addictive. More practically speaking, closely following the medical directions given when opioids (narcotic) drugs are prescribed to treat pain can prevent the onset of opioid abuse. RESOURCES: American Council for Drug Education http://www.acde.org National Institute on Drug Abuse http://www.nida.nih.gov Partnership for a Drug-Free America http://www.drugfree.org CANADIAN RESOURCES: Canadian Centre on Substance Abuse http://www.ccsa.ca The Council on Drug Abuse http://drugabuse.ca References: Meehan, WJ, Adelman SA. Opioid abuse. Emedicine website. Available at: http://www.emedicine.com/med/topic1673.htm . Accessed November 6, 2006. Mind over matter: opiates. National Institute on Drug Abuse website. Available at: http://teens.drugabuse.gov/mom/mom_opi1.asp . Accessed October 3, 2006. Nature, causes, and health consequences of illicit opioid use. National Center for Biotechnology Information website. Available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=dcp2.section.7003 . Accessed October 4, 2006. NIDA InfoFacts: treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/Infofacts/treatmeth.html. Accessed October 3, 2006.

Purcell TB. Factitious disorders and malingering. Rosens Emergency Medicine: Concepts and Clinical Practice . 6th edition. Philadelphia, PA: Mosby; 2006. Last reviewed February 2008 by Rosalyn Carson-Dewitt, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.