Opioid Addiction

It should come to no surprise the country is amid an opioid epidemic. But COVID has cast a shadow over the problem. Prior to the virus, news of opioid addiction and its devastating impacts were making headlines. Who can forget the harrowing picture of a four-year-old boy found in the back seat of a car, while his parents – overdosed on heroine – were unconscious in the front seats? It’s a graphic image that circulated the media and broke so many hearts. So while COVID is still very much a national threat, so is the misuse of opioids.

What are Opioids?

According to the National Institute on Drug Abuse, opioids are a class of drugs derived from the opium poppy plant. They are either made directly from the plant or by scientists in a lab, using the same chemical structure. Used primarily as medicines to treat moderate to severe pain, opioids are referred to as “opioid painkillers.” They’re sometimes used to treat diarrhea and sometimes found in cough medicines. And, generally speaking, when prescribed by a doctor and used in a short amount of time, opioids are safe.

But too many people are misusing them.

Whether they’re taking more than the prescribed dose or taking someone else’s prescription, individuals all over the country are developing substance use disorders (SUDs).

Classified as a medical illness, SUDs are caused by the continued misuse of drugs. The disorder alters the brain, it causes health problems and interferes with life’s responsibilities. And yet opioid addiction continues to affects more than 2 million Americans. In 2018, nearly 50,000 people died from an opioid-related overdose, according to the Centers for Disease Control and Prevention (CDC).

It’s the calming effect opioids produce, really, that is appealing. Opioids, like a siren’s song, lures the individual into a relaxed state, promising a false sense of reality. This is especially dangerous because opioids are highly addictive, and overdoses and deaths are common.

How do Opioids Affect the Brain and Body?

Like gum on a shoe, opioids stick to opioid receptors in the body, specifically in many areas of the brain, spinal cord and other organs. When attached and activated, the opioids blocks pain signals sent from the brain to the body by releasing large amounts of dopamine.

As the chemical responsible for pleasure, dopamine makes us feel good, and that release makes it easier to take the drug again and again.  

Normally, the brain makes its own versions of opioids, called endogenous opioids, which helps the body control pain. But when opioids bind to the receptors in the brain and nervous system, a forceful surge of relief, pleasure and relaxation are achieved.

According to the NIH, opioids act on many places including:

• The limbic system, which controls emotions.
• The brainstem, which controls things your body does automatically, like breathing. Opioids slow breathing, stop coughing and minimize feelings of pain in this part of the brain.
• The spinal cord, which receives sensations from the body before sending them to the brain.

How Does Someone Become Addicted to Opioids?

When people use opioids for a long period of time to treat pain, the drugs begin to change the way the nerves cells work in the brain. Eventually, the nerve cells become used to the opioids being around, so people feel the need to use more. When the individual suddenly stops, flu-like symptoms develop. Known as withdrawal, it’s a highly unpleasant feeling that includes body aching, fever, sweating, vomiting or chills. This, along with the overwhelming urge to continue to consume the drug despite the negative toll it can take on someone’s life and health, makes it very hard for a person to stop.

Common Types of Opioids:

• Heroin
• Synthetic opioids, such as fentanyl
• Pain relievers, such as oxydocone (OxyContin ® Percocet®) hyrdrocodone (Vicodin®), codeine, morphine and many others.

What are Some of the Side Effects?

While opioids – when taken in a short period and as prescribed – can reduce pain, they do cause harmful effects:

• Drowsiness
• Confusion
• Nausea
• Constipation
• Euphoria
• Slowed Breathing – this can cause a condition known as hypoxia, which happens when too little oxygen reaches the brain. Hypoxia can produce short-and-long-term psychological and neurological effects, including coma, permanent brain damage or death.

Older individuals are at greater risk of misuse. Typically, they have multiple prescriptions increasing their risk of adverse drug interactions and/or drug-disease interactions. And because of their age, their metabolism is slower thus affecting the breakdown of drugs.

How to Treat an Opioid Overdose?

An opioid overdose occurs when a person uses enough of the drug to produce life-threatening symptoms or death. Breathing slows down or stops, decreasing the amount of oxygen to the brain, which can result in coma, brain damage or death.

So if you suspect someone has overdosed, first and foremost, call 911. Once the medical team arrives, they will administer a medicine called “naloxone.” It works by rapidly binding to opioid receptors and blocking the effects of opioid drugs. Naxolone is administered with a needle, a hand-held auto-injector or a nasal spray.

In some states, pharmacists can dispense naloxone without a personal prescription.

How long do Opioids Stay in Your System?

While it is difficult to narrow down an exact time frame when the drugs will be out of the body’s system due to variables, such as weight, age, gender, preexisting conditions, etc. This can serve as a guideline:

Information pulled from Addiction Center

Morphine

Urine Test	Up to 3 days
Hair Test	Up to 90 days
Blood Test	Up to 3 days
Saliva Test	Up to 3 days

Codeine

Urine Test	Up to 3 days
Hair Test	Up to 90 days
Blood Test	Up to 24 hours
Saliva Test	Up to 4 days

Fentanyl

Urine Test	Up to 3 days
Hair Test	Up to 90 days
Blood Test	Up to 2 days

Heroin

Urine Test	Up to 3 days
Hair Test	Up to 90 days
Blood Test	Up to 6 hours
Saliva Test	Up to 1 hour

Oxycodone

Urine Test	Up to 4 days
Hair Test	Up to 90 days
Blood Test	Up to 24 hours
Saliva Test	Up to 4 days

Hydrocodone

Urine Test	Up to 4 days
Hair Test	Up to 90 days
Blood Test	Up to 24 hours
Saliva Test	Up to 36 hours

Methadone

Urine Test	Up to 12 days
Hair Test	Up to 90 days
Blood Test	Up to 24 hours
Saliva Test	Up to 10 days

Propoxyphene

Urine test	Up to 10 days
Hair test	Up to 90 days

Tramadol

Urine test	Up to 72 hours
Hair test	Up to 90 days
Blood test	Up to 48 hours
Saliva test	Up to 48 hours

Treatment

With medicines like buprenorphine and methadone, which work by binding to the same opioid receptors in the brain as the opioid medicines, reducing cravings and withdrawal symptoms; and naltrexone, which blocks opioid receptors and prevents opioid drugs from having an effect, SUDs can be medically treated.

Behavioral therapies, such as cognitive behavioral therapy, also helps overcome addiction. It offers ways to change attitudes associated with drug use, helps manage stress that might trigger relapse, and teaches healthy life skills.

So even though overcoming opioid addiction might seem daunting and hopeless, please know without a doubt it is not.