Long-lasting implications of opiates
Opioids, a class of medications used to treat persistent or severe pain, include morphine, oxycodone, hydrocodone, fentanyl, and methadone, among others. These drugs work by binding to opioid receptors in the brain, spinal cord, and other organs, blocking pain messages and triggering dopamine release, which can lead to addiction.
Long-term opioid use, defined as use extending beyond 70 to 120 days or more, is a concern due to its association with increased risks of misuse, addiction, and overdose. The Food and Drug Administration (FDA) defines long-term use for studies as having prescriptions covering at least a 70-day supply over three months. In clinical contexts, long-term opioid use is often described as lasting longer than 90 days, with at least 10 prescriptions or a 120-day supply dispensed.
Long-term use may result in a range of adverse effects. Common short-term effects include drowsiness, euphoria, nausea or vomiting, constipation, slowed breathing, altered mental status or periods of confusion, addiction, and overdose. Long-term effects may differ, with potential risks including chronic nasal infections, tissue perforations, nasal collapse, and being unable to smell (from snorting opioids) or abscesses, skin infections, and heart infections (from injections). Long-term use may also lead to adrenal insufficiency, respiratory depression or sleep-disordered breathing, sex hormone disruption, osteoporosis, immunosuppression, cardiovascular complications, bowel dysfunction, and a higher risk of cancer development or promotion.
In the event of an opioid overdose, seek emergency medical attention immediately. Naloxone, an injection or nasal spray that can be administered without a prescription in some places, can be used to reverse the effects. However, it's important to note that naloxone is not a substitute for medical attention.
Opioid use disorder, involving persistently taking opioids despite experiencing harmful consequences and being physically dependent on opioids, affects millions worldwide. Experts attribute 120,000 deaths to opioids every year globally. Seeking help for addiction can be daunting, but several organisations can provide support, such as the Substance Abuse and Mental Health Services Administration (SAMHSA) and the 988 Suicide & Crisis Lifeline.
Many opioids are Schedule II, including codeine, fentanyl (Actiq, Duragesic, Sublimaze), hydrocodone (Vicodin, Hysingla ER), oxycodone (OxyContin, Percocet), oxymorphone (Opana), and morphine (Kadian, Avinza). Schedule I substances have no currently accepted medical use and a high potential for misuse; heroin is an illegal opioid.
[1] FDA. (2016). FDA strengthens warning about opioid risks. Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/fda-strengthens-warning-about-opioid-risks
[2] National Institute on Drug Abuse. (2021). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
[3] Centers for Disease Control and Prevention. (2016). CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
[4] World Health Organization. (2019). Guidelines for the pharmacological treatment of chronic pain among adults. Retrieved from https://www.who.int/publications/i/item/9789240015719
- The misuse and long-term use of opioids, including morphine, oxycodone, hydrocodone, fentanyl, and methadone, can lead to chronic diseases, mental health issues, and health-and-wellness concerns due to their association with addiction and overdose.
- Pursuing science-based therapies-and-treatments for substance use disorders, such as cognitive-behavioral therapy and counseling, may be beneficial for individuals struggling with opioid use disorder.
- In conjunction with medical-conditions management and pain management strategies, proper nutrition and the use of natural supplements like CBD could play a role in maintaining overall health and wellness, particularly for those with chronic pain.
- Long-term opioid use can result in a range of adverse effects, including chronic nasal infections, tissue perforations, nasal collapse, inability to smell, heart infections, adrenal insufficiency, respiratory depression, sex hormone disruption, osteoporosis, immunosuppression, cardiovascular complications, bowel dysfunction, and a higher risk of cancer development or promotion.
- Healthcare professionals and organizations, such as the Food and Drug Administration, National Institute on Drug Abuse, Centers for Disease Control and Prevention, and World Health Organization, provide helpful resources for understanding the risks and consequences of opioid use, as well as treatment options for addiction.
- In the event of an opioid overdose, seeking immediate medical attention is crucial. Naloxone, a readily available antidote, can help reverse the effects of an overdose, but it should not be considered a substitute for proper medical care.
