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WHAT ARE OPIATES?
Opiates are potent analgesic (pain relieving) drugs. They are often prescribed to relieve acute or chronic pain and pain from serious illnesses. They can also be used to suppress chronic cough and diarrhea. Opiates, or opioids as they are known in general, can be broken down into several categories.
- fully synthetic
- endogenous opioid peptides.
OPIATES VS. OPIOIDS
Although the two terms do have distinctions, they are often used interchangeably. Opium, found in poppy plants, is used to make natural opiates. Morphine, codeine, and opium are a few examples of natural opiates.
Opiates can also be found naturally in the human body in the form of endogenous opiod peptites. These include endorphins and dynorphins.
Opioids are synthetic or partly synthetic. They are manufactured through chemical synthesis rather than derived from the poppy plant. Semi-synthetic opioids include buprenorphine, hydrocodone, oxycodone, hydromorphone and oxymorphone. Fully synthetic opioids include Fentanyl, Tramadol and Methadone.
Both natural opiates and their synthetic counterparts act similarly in the human body by binding to certain opioid receptors in the central nervous system and in other tissues.
Opiates have been used to treat many different types of pain. However,
they are prized for their important role in treating long-term, chronic pain in those who are terminally ill with conditions such as cancer.
In recent years, prescriptions for opiate painkillers have increased, especially for non-malignant, chronic pain. Prescriptions for strong opiates have been reportedly written for conditions such as headaches and menstrual cramps. In the U.S., opiates are indicated for the following uses:
- Analgesic (to combat pain)
- Terminal illness
- Diabetic neuropathy
- Serious trauma or injury
- Cough suppressant
- Drug detoxification (methadone and buprenorphine)
OPIATE SIDE EFFECTS
As with any medication taking an opiate medication can cause any number of side effects to develop. To avoid serious side effects, they should be taken exactly as prescribed Altering the dose in any way can be dangerous or even fatal.
Common side-effects include:
- Severe constipation
- Trouble sleeping
- Loss of appetite
- Tingling or redness of the skin
- Blurred vision.
Signs of an allergic reaction include:
- Difficult breathing
- Closing of the throat
- Hives or swelling of the lips, face, tongue or throat.
- Any of these serious side effects should prompt a visit to the emergency room.
OPIATE WARNINGS AND RISKS
Opiates can be used as part of a successful pain management plan but certain risks are involved. These can include addiction, withdrawal upon cessation of use and overdose. Opioids are a controlled substance in the United States that includes heroin and some prescription painkillers such as Actiq, Dilaudid, Vicodin, OxyContin and Percocet.
Opiates can affect response and reaction times so it’s advised that people avoid operating heavy machinery or driving until they know how they’ll respond to the medication. Women who become pregnant may be advised to avoid prescription painkillers because of possible complications.
Dangerous side effects can develop for patients who combine opiates with alcohol, other narcotics, tranquilizers, or some sleeping medications. It’s important for patients to check their food and beverage labels to make sure alcohol is not an ingredient. Opiates are central nervous system depressants. Taking them with other substances can cause serious, even fatal effects.
Opiates also act directly on the respiratory center in the brainstem, where they cause a slowdown in activity. This results in a decrease in breathing rate. Excessive amounts of opiates, like heroin, can cause the respiratory centers to shut down breathing altogether. When someone overdoses on heroin, it is the action of heroin in the brainstem respiratory centers that can cause the person to stop breathing and die.
HOW OPIATES PROVIDE PAIN RELIEF
Feelings of pain are produced when specialized nerves are activated by trauma to some part of the body, either through injury or illness. These specialized nerves, which are located throughout the body, carry the pain message to the spinal cord. The message is then relayed to other neurons, which carry it to the brain.
Opiates help to relieve pain by acting in both the spinal cord and brain. At the spinal cord, opiates interfere with the transmission of the pain messages between neurons and prevent them from reaching the brain. This is known as analgesia.
Opiates also act in the brain to help relieve pain. There are several areas in the brain that are involved in interpreting and responding to pain messages. They allow a person to know he or she is experiencing pain and that it is unpleasant. Opiates working in these regions don’t block the pain messages themselves. Rather, they change the subjective experience of the pain. This is why a person receiving morphine for pain may say that they still feel the pain but that it doesn’t bother them anymore.
A person who takes opiates for a long enough period will likely develop opioid (opiate) tolerance. This is when the body adapts to the presence of the resulting in a decrease in the drug’s effectiveness over time.
Tolerance can be caused by a desensitization of the opioid receptors leading to an increase of pain and a need for a higher dose. Another cause of tolerance is that the opioid receptors have been internalized by the cell itself. This is called endocytosis and is marked by a decrease in opioid binding sites that are available to provide pain relief.
Long-term opiate use can be dangerous because it can lead to dependence, addiction and overdose. Opiate-induced tolerance can underlie all of these issues because as a tolerance develops, patients need increasingly higher doses of the drug to achieve analgesia. A person who is suffering from chronic pain just wants relief. They may not think about the effects of long-term opioid use and potential risks.
There is another condition that may overlap with opioid tolerance. This is opioid-induced hyperalgesia. This occurs when prolonged use of opioids leads to a paradoxic increase in pain. This can occur despite increases in drug dosage.
An increased sensitivity to pain can happen to anyone taking any dosage of an opioid. It’s important that patients not increase their dosage without talking to a doctor.
RISKS OF DEPENDENCE, ADDICTION AND OVERDOSE
Opioids are unrivaled when it comes to pain management, but there are many risks that accompany them. These narcotic drugs can be habit-forming and may lead to physical and/or psychological dependence. These medications are indicated for moderate to moderately severe pain and some are designed for pain that persists around the clock.
The compulsive use of opiates or any use outside the label’s instructions can constitute abuse. Most people don’t set out to become addicted to their medication. In fact, most people become “accidental addicts” after taking prescription medication for a legitimate condition.
OxyContin , Percocet, Codeine, Fentanyl and Vicodin are among the most prescribed drugs on the market. They are also among the most abused. Once regular use has caused a tolerance, the medication becomes ineffective at producing intended effects. At this point, many people decide to escalate their use.
Other forms of abuse include breaking, crushing or otherwise disturbing the medication to cause rapid release of the medicine. Abuse can damage your health, ability to function normally in everyday life, and ruin careers and relationships
Opiate addiction is recognized as a central nervous system disorder, caused by continuous opiate intake. Opiates elicit their powerful effects by activating opiate receptors that are widely distributed throughout the brain and body. Two important effects produced by opiates are pleasure (or reward) and pain relief. The rush of pleasure and/or relief from pain is so strong and powerful; it can lead to opiate abuse and addiction.
The brain itself produces substances known as endorphins (the body’s natural painkiller) that activate the opiate receptors. They are involved in respiration, nausea, vomiting, pain modulation, and hormonal regulation. After prolonged opiate use, the nerve cells in the brain, which would otherwise produce these endogenous opiates, cease to function normally. The body stops producing endorphins because it is receiving opiates instead. The degeneration of these nerve cells causes a physical dependency to an external supply of opiates. Abrupt or sudden abstinence from opiates induces yet another traumatic disorder – withdrawal syndrome.
OPIATE REWARD SYSTEM
Findings from animal research indicate that, like cocaine and other abused drugs, opiates can also activate the brain’s reward system. When a person injects, sniffs, or orally ingests heroin (or morphine), the drug travels quickly to the brain through the bloodstream.
Because of its chemical structure, heroin penetrates the brain more quickly than other opiates on the list, which is probably why many addicts prefer heroin.
Once in the brain, the heroin is rapidly converted to morphine, which then activates opiate receptors located in the VTA, nucleus accumbens, and cerebral cortex(refer to the Introduction for information on the reward system). Once the pleasure circuit is activated, great amounts of dopamine are released within the nucleus accumbens. This causes an intense euphoria, or rush, that lasts only briefly and is followed by a few hours of a relaxed, contented state. This excessive release of dopamine and stimulation of the reward system can lead to opiate abuse and addiction.
OPIATE ADDICTION VS. OPIATE DEPENDENCE
Although sometimes used interchangeably, the terms “addiction” and “dependency” are clinically thought of as two separate things. Opiate dependence does not always entail opiate addiction.
Compiling the research from The National Institute of Health, The American Academy of Pain Medicine, the American Pain Society and the American Society of Addiction Medicine one can create a general definition for each:
Addiction: Addiction is a primary, chronic, neurobiological disease. Genetic, psychosocial, and environmental factors influence its development and manifestations. Opiate addiction is characterized by behaviors that include: impaired control over drug use, compulsive use, craving, and continued use despite negative and dangerous consequences.
Physical dependence: Physical dependence is a state of adaptation that is manifested by withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing the blood level of the drug, and/or the administration of an antagonist. A physical drug dependence means a person needs the substance to function and can have intense cravings.
Opiate addiction is commonly described as a disorder caused by untreated opiate dependence, with a strong potential for relapse. This means opiate users who are trying to get well, may fall back into old patterns of drug use and abuse. Because opiates are so potent, they have a particularly high relapse rate. Strong cravings and other opiate withdrawal symptoms can trigger relapse if not well managed, even after a period of abstinence.
Caution should always be taken when using prescription medications. Warnings and precautions are listed on the label. They spell out risks, including overdose, and give guidelines for avoiding it. Opiate overdose can be fatal so it’s important to take these medications exactly as prescribed. Patients who overdose on opiates almost always do so accidentally after one escalates use due to a tolerance to the medication.
However, overdose can also be intentional for those using it recreationally to achieve a state of euphoria. The risk of fatal overdose is high among this group, especially those people who combine opioids with other substances to heighten effects.
Opioids are central nervous system depressants. They slow respiration, which can lead to serious health complications including cardiac arrest, coma and death. All users must be aware of overdose symptoms so emergency medical attention can be sought if they develop
Symptoms of overdose can include:
- clammy skin
- slowed heart rate
- difficult breathing
If the overdose is recent, doctors may induce vomiting, pump the stomach or use activated charcoal so the body doesn’t absorb the drug. An antidote may also be given to counteract the effects of an opioid overdose.
OPIATE WITHDRAWAL SYMPTOMS
One of the most challenging aspects of recovery from opiate addiction is the withdrawal process. Many of our patients want to know what to expect from the opiate withdrawal process. However, no two people have the same withdrawal experience. The timeline for opiate withdrawal depends on a variety of factors and differs between individuals. That is why effective treatments for opiate addiction cannot take a “one size fits all” approach. Understanding the common symptoms of opiate withdrawal can help you make informed decisions about your treatment.
Opiate addiction does not develop overnight, and the same is true for recovery from the drug. Opiates — whether heroin or prescription painkillers — exert their effects by crossing the blood-brain barrier and acting on specific brain areas. The opiate molecules bind to particular receptors in the limbic system of the brain, which is responsible for processing rewards and emotional information. When these receptors are activated, the trigger the “rush” or euphoric sensations experienced by opiate users.
Over time, however, the brain becomes numbed to the effects of opiates and a tolerance is built. It takes more and more of the drug to achieve the same effect. When the drug is no longer taken, and the body does not get its expected dose, the result is a collection of physical and psychological symptoms.
WHAT TO EXPECT FROM OPIATE WITHDRAWAL
Opiate withdrawal symptoms typically start within a few hours of the drug leaving the blood stream. They peak between 5 and 10 days. The severity and duration of the opiate withdrawal symptoms can depend on the length of opiate dependence, dosage, metabolism, the drug of abuse, the manner in which drugs are taken, and other factors.
Most people have no residual symptoms after a few weeks, although some people have reported experiencing a post-acute withdrawal syndrome (PAWS) that lasts up to a few months. Many individuals in the recovery community have commonly described PAWS. However, the Diagnostic and Statistical Manual of Mental Health Disorders, or any other significant medical association, do not not recognize it.
RISKS OF OPIATE WITHDRAWAL
Going “cold turkey” can be dangerous for some opiate users. Patients run the risk of severe dehydration or elevated blood pressure. Furthermore, opiate withdrawal can cause heart irregularities that may be dangerous for patients with certain chronic medical conditions. Professional medical attention is suggested, to keep one safe during the opiate withdrawal process. For example, medical detox protocols help remove opiates from your system and safely manage withdrawal symptoms.
Perhaps one of the most prominent disadvantages of going “cold turkey”, is the high likelihood of relapse or due to the extreme discomfort, some might not even complete the withdrawal process. A professional medical detox is more likely to result in a positive, safe, and effective manner to obtain an opiate-free life. The Waismann Method ® located exclusively in Southern California has successfully treated thousands of patients and medically assisted them in overcoming opiate withdrawal symptoms.
A person who has developed a physical and/or psychological dependence to an opiate (narcotic) medication will need professional detox to recover safely. Examples of these opioids include OxyContin , Demerol, Vicodin, Percocet, Dilaudid, morphine and heroin.
Opioid addiction has become a staggering problem in the U.S. due to several factors including the high number of prescriptions being written. Opioids have become increasingly easier to obtain, both among patients seeking pain relief, as well as recreational users. Detox is the first step in any responsible recovery program. It can be an intense process but one that can be medically managed by professionals. This helps to ensure safety and maximize your chance of long-term recovery
SAFE, MEDICAL OPIATE DETOX CAN TAKE LESS THAN TWO HOURS
Opiate abuse can lead to addiction, which calls for specialized medical detox to ensure safety and success. The Waismann Method offers a renowned rapid detox and a medical opiate detoxification program based on the idea that all patients should be treated with the utmost respect, professionalism and compassion. Our safe, humane treatment for opioid detox can help patients overcome their physical dependence to opioids within days.
Performed in a private accredited hospital, the rapid detox procedure is performed in less than two hours and uses intravenous medicine to cleanse the opiates from patients’ receptor sites. Our opiate detox helps to medically manage and overcome the withdrawal symptoms without the use of other opiates. Patients also take advantage of our exclusive recovery center, Domus Retreat for a few days. The Waismann treatment is unique and thorough. Is design for those who seeks the best and most advance form of medical opiate detox available. Patients have options of 5, 7, 10 and 14 days all inclusive around the clock superior care. From an extensive pre- treatment assessment, through detoxification with our multi-board certified anesthesiologist and with a conclusion of treatment at our private post-detox care center.
Opiate Drug List
Click on a drug from the list below for more information