Opiate Addiction
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Opiate Addiction
- Introduction
Addiction is a brain disease that arises from substance abuse’s continued use despite psychological and physical harm to the body. However, an opiate is a drug extracted from opium naturally found in the opium poppy plant, which has morphine, codeine, and thebaine components. In the United States of America, opioid addiction has been a significant issue for several years, starting from the 1990s. This has caused overdose deaths and crisis in the health care system. Therefore, there is a need to examine the opiate crisis issue to enhance any efforts in combating it. Exploring the opioid crisis’s history, psychopharmacology, current issues and trends, societal concerns, its significance to the counseling profession, and its future implications could provide a good starting point for addressing the opiate crisis.
- Brief History of Opioid Addiction
In 1775 opioid was available in the United States of America which was then used to treat soldiers in the 1860s, during a war and many soldiers became addicted. This was when the United States government issued a directive on importing opium drugs specifically for medicinal purposes. Moreover, communities worldwide and the US used psychoactive drugs for numerous reasons, and no laws were guiding the use of such medications for centuries.
Before 1800, the US healthcare community extensively used cocaine and opiates for pain management, characterized by massive marketing and prescription. Due to adverse effects on the health care system, opiates were first regulated in 1914 following the enactment of the Harrison Narcotic Control Act in 1914 which was a response to the rapid rise in street heroin abuse and also influenced patients’ and physicians’ perspectives on the use of opiates due to its addictive nature (Jones et al., 2018). Between 1920 through to 1950s, patients with prolonged pain were considered addicts, while cancer patients were encouraged to increasingly wean themselves off opioids until they could measure their lives in weeks.
In 1924 the drug was declared illicit with the Anti-Heroin Act, whereby the US government banned the trading and even use of heroin for medicinal purposes. Reaching the second half of the twentieth century, a generally negative view of opioids persisted, which often resulted in under-treatment of chronic pain and under-reliance on opioid analgesics. However, in the early years of the 1990s, research would show that opiates were safe for pain management and other conditions leading to a surge in prescription rates among the healthcare community and public (Jones et al., 2019).
Throughout the 1990s to early 2000s, opioid prescription rose rapidly further, resulting in non -prescription use accompanied by a rise in overdose deaths and addiction, leading to the opioid crisis facing the country today (Kolodny et al., 2015).
- Psychopharmacology of Opiates
- Short-Term Effects of Opioid Use:
People who use opioids experience short-term effects, whereby it affects the brain and the nervous system. Interaction with brain receptors results in dopamine release that causes euphoria and relieves pain significantly more than naturally. Opioids can enhance drug behavior by changing activity in the limbic system, which controls feelings.
Over time, continuous use of opioids generates elevated levels of dopamine, which translates to tolerance, which requires that individuals consume a higher amount of opioids to experience the same effect.
The increased tolerance and increasingly higher amounts of opioid use lead to addiction where individuals become drug-dependent and opioid use develops into an involuntary phenomenon.
- Long-Term Effects
The brain is the most affected part of long-term opioid use. It is the medial temporal lobe and prefrontal cortex responsible for regulating and controlling social behaviors, thought processes, decision-making, and long-term memory; continuous use of opioids results in the following long- term effects.
- It causes physical dependence and addiction, whereby the user adapts to the drug’s presence in the body in large amounts to get the intended effects that were initially experienced.
- It results in uncomfortable symptoms, usually known as withdrawal symptoms since the body cannot function normally without using the drug. These involve the inability to sleep, vomiting, restlessness, diarrhea, and muscle and bone pain.
- It predominantly affects the respiratory system, endocrine, gastrointestinal, cardiovascular, and central nervous system.
- Current Trends or Issues
Many people are dying from opioid overdose across diverse populations, races, and ages in the world. The number of individuals using nonmedical opioids has increased, especially for adults between 18 and 25 years, while prescription opioid use has also increased across different ages (Phillips et al., 2017).In response to this, several federal, state, and local interventions have been put in place to manage drug use. Opioid availability has increased, especially in the black market, which is also associated with a rise in prescription and nonmedical use.
- Societal Concerns or Issues Related to Opioid Abuse
Drug addiction is a social concern that results in regular use of substance abuse despite posing harmful effects on the body, affecting the person physically and psychologically.
The critical societal concern regarding opioid use in the country is the rising number of deaths resulting from opioid abuse and overdose (Phillips et al., 2017) since drug dependence has risen in the United States.
Regardless of the adverse effects of opioid use on the brain and body, the healthcare community has also not found a more reliable substitute for opioids, making it hard to combat addiction among users (National Institute on Drug Abuse, 2020).
The government has attempted to implement numerous interventions to control nonmedical use worldwide; most interventions have not resulted in substantial outcomes (Dasgupt et al., 2018).
For patients with conditions characterized by severe pain, finding the most effective treatment for such pain without the risk of addiction and other disorders remains to be a significant concern.
- Significance of Opioid Abuse to the Counseling Profession
Treatment of opioid addiction and its related symptoms remains to be a significant challenge to the counseling profession, especially for patients who have to deal with chronic pain in the long term (Jones et al., 2018). Counselors can help in curbing the issue of opioid addiction and abuse since it has become a significant concern in the country thus, counselors gets the opportunity in preventing and offering interventions
The counseling profession is also needed at this time, especially from the establishment of prescription opioids, to ensure that patients do not develop tolerance and subsequent addiction associated with long-term opioid use (SAMHSA, 2017).
Due to high addiction rates, the counseling profession is more stretched than before, which creates a shortage in the field and necessitates an increase in trained counselors to address the problem. Developing awareness at an early age is encouraged so that counselors can enlighten the young on the adverse effects of opioids.
Rehab centers have been established due to the high risk of addiction among patients receiving opioid prescriptions to help clients overcome addiction and other physical conditions. There is a need for addiction treatment counselors to increasingly partner with other healthcare professionals, especially those focusing on conditions characterized by chronic pain (SAMHSA, 2017; Salmond & Allread, 2019).
Based on the complex nature of opioid addiction, the counseling profession needs to develop more innovative addiction treatment approaches. Such as behavioral counseling, use of medication, treatment of mental disorders such as depression and anxiety, and detoxification
- Future Implication
Combating the opioid addiction crisis will require a multidisciplinary approach consisting of professionals across the healthcare and public policy.If the government, its agencies, and the healthcare community fails to combat the opioid problem today, the crisis might reach unmanageable levels and present a significant challenge to the healthcare community (Phillips et al., 2017).
Irrespective of the government’s efforts to combat opioid addiction and overdose deaths, an addiction-free future is dependent on whether the healthcare community develops a more effective pain treatment drug.
Considering the current effects and prevalence of the opioid abuse problem, there is a possibility its legal status might be reconsidered in the future.
- Conclusion
The opioid crisis is a significant difficulty for the country and requires a unique approach to combat it. After the legalization of medical use in the 1990s opioid crisis emerged, and today, it is a significant calamity affecting millions around the country. It remains to be a primary challenge to the government and the healthcare community. However, the counseling profession has stretched its workforce and posed a critical challenge to its operations. Drug addiction is a disease that should be dealt with. Failure to do so will have negative future implications in the country.
References
Dasgupta, N., Beletsky, L., & Ciccarone, D. (2018). Opioid crisis: No easy fix to its social and economic determinants. American Journal of Public Health, 108(2), 182-186. https://doi.org/10.2105/ajph.2017.304187
Jones, G. H., Bruera, E., Abdi, S., & Kantarjian, H. M. (2019). The opioid epidemic in the United States—Overview, origins, and potential solutions. Obstetrical & Gynecological Survey, 74(5), 278-279. https://doi.org/10.1097/ogx.0000000000000677
Jones, M. R., Viswanath, O., Peck, J., Kaye, A. D., Gill, J. S., & Simopoulos, T. T. (2018). A brief history of the opioid epidemic and strategies for pain medicine. Pain and Therapy, 7(1), 13-21. https://doi.org/10.1007/s40122-018-0097-6
Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36(1), 559-574. https://doi.org/10.1146/annurev-publhealth-031914-122957
National Institute on Drug Abuse. (2020, June 10). Opioid overdose crisis. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis
Phillips, J. K., Ford, M. A., & Bonnie, R. J. (2017). Pain management and the opioid epidemic: balancing societal and individual benefits and risks of prescription opioid use. National Academies Press.
Salmond, S., & Allread, V. (2019). A population health approach to Americaʼs opioid epidemic. Orthopaedic Nursing, 38(2), 95-108. https://doi.org/10.1097/nor.0000000000000521
SAMHSA. (, 2017). Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health. Createspace Independent Publishing Platform.