Opioid Dependence
Many people throughout the UK are living with opioid addiction. This has far-ranging effects. From the physical and psychological deterioration to the external consequences, opioid addiction can take over a person’s life. Sadly, for many this can end up with a devastatingly fatal outcome.
Since 1994 opiate-related deaths have been steadily increasing in England and Wales.(1) There are, however, many ways to treat opioid addiction and dependency throughout the UK. When a person is able to access high-quality treatment and a team of highly experienced professionals, a life of recovery is achievable.
What are opiates and opioids?
Opiates and opioids are derived from a part of the poppy plant. Some are made from a part of the plant, whereas others imitate the chemical compounds from this specific part of the poppy plant and are man-made (or synthetic).
Examples of natural opiates are codeine and morphine. Synthetic opioids include methadone and fentanyl.
One of the effects of these drugs is that they are psychoactive. This means they can alter a person’s state of mind. The psychoactive drugs are grouped as depressants, stimulants, hallucinogens, and narcotics. Opiates and opioids are depressants that are also sometimes classified as narcotics.
In general, the majority of people use the terms “opiates” and “opioids” interchangeably. Both legal and illegal substances are in use in the UK. Heroin is illegal, whereas many of the other opioids are prescribed (prescribed drugs can, however, be used both illegally and legally).
Examples of opiates and opioids include:
- Codeine
- Tramadol
- Heroin
- Fentanyl
- Oxycodone
- Morphine
What are opioids used for?
Opioids are usually prescribed by doctors within pain management for patients. When prescribed and taken in the advised way, opioids are very efficient at treating moderate to severe pain.
Medical staff might administer opioids after surgery and where injuries have occurred. Opioids are also often used to treat pain where it is caused by cancer.
It’s interesting to note that in the UK between 2006-2017, there was an increase in opioid prescriptions by doctors for non-cancer patients. In terms of oxycodone, there was a 30-fold increase in prescriptions.(2)
How an opioid addiction develops
To understand how an opioid addiction occurs, it’s necessary to understand a little about how the brain works.
Dopamine is a neurotransmitter, which is a chemical that is released in the brain. Dopamine creates the experience of pleasure and happiness. It’s a chemical that helps to regulate moods and motivation. For those without addictions, it can be released during pleasurable activities such as when a person exercises, listens or dances to enjoyable music, and by spending time in the sun.
When a person takes opioids, the drug binds to certain brain receptors. One of the effects is the release of dopamine. People become addicted due to the cravings for more pleasure than the opioid-induced. (3)
Endorphins are polypeptides, which is another brain chemical that eases a person’s experience of pain and can increase feelings of happiness. Opioids release endorphins along with dopamine in much higher doses than the brain ever naturally will. This can cause a feeling of euphoria (especially when the person first takes the drug – the euphoric feeling reduces with continued use).
Addiction begins when the person taking the opioid feels they need it every day. This is due to the drug leaving the body and the chemicals “running out”. In the long term. The depletion of the drug in the body creates physical and mental withdrawal symptoms.
What are the signs of addiction?
Addiction comes with physical, mental, and behavioural symptoms. This can be very difficult for people who care for those who are living with addictions.
Symptoms include:
- Mood swings and irritability.
- Sleep disruption.
- Taking medication in a way that wasn’t advised by a doctor.
- Drowsiness and slurred speech.
- Low motivation or interest in doing things.
- Money problems.
It’s important to note that addiction is a brain disease that leads to increasingly poor physical and psychological health and increasingly difficult social, and financial situations.
What is an opioid dependency?
When a person has used an opioid for a period of time it will affect how the bodily systems function. This creates an environment where the brain and body require the drug in order for it to function “normally”.
The World Health Organisation (WHO) describes dependence as altering the brain’s structure and function. This influences behaviour.(4)
A person can be both tolerant and dependent on a substance without addiction is present.
Addiction and mental health: dual diagnosis
It’s commonly accepted within the addiction field that there is a link between addiction and mental health conditions such as depression and anxiety.(5)
Many people who have an opioid addiction will also suffer from mental health problems. It’s not always easy to identify which illness came first. Some people will use opioids to ease the symptoms of their mental health and some people will develop mental health issues due to ongoing opioid use. The two often exacerbate and prolong the symptoms of each other.
With this in mind, it’s essential that when a person experiences opioid addiction that they also receive treatment for any mental health issues.
Treatment for opioid addiction
Opioid addiction is a brain disease with both physical and mental effects. Fortunately, it can be treated and people can heal and lead a life of recovery. For this vast majority, a life of abstinence is the goal as being the safest and most effective way to manage the addiction.
Outpatient and inpatient treatment options
Throughout the UK there are various types of treatment available. These are divided into two categories: outpatient and inpatient services.
Outpatient services are provided for people within their local community. This is a government-funded treatment clinic. A team of drug and alcohol workers support people through various one-to-one and group sessions. There is usually a timetable of therapeutic groups that a person can go to as and when fits their schedule.
This can be a very useful treatment option for people who need to remain living at home. Where mild substance use exists, outpatient services can be very effective.
For those with moderate to severe addictions, inpatient services tend to be a more effective environment to begin treatment.
Inpatient services are rehab clinics where people stay overnight for a particular length of time. The approach provides an immersive treatment programme.
There are staff to treat all areas of a person’s addiction from doctors to prescribe medications, therapists to provide psychological treatments and drug and alcohol workers to hold one-to-ones and facilitate group work.
Physical detox
Where a physical dependence exists, which is common in opioid addiction, a physical detox is essential. A detox removes the opioid from the body. This requires a residential stay overseen by medical staff. Doctors and clinical nurses ensure the individual is safe throughout the detox and is provided with the most comfortable experience under the circumstances.
Medications such as methadone, buprenorphine, and naltrexone can be prescribed to ease withdrawal symptoms.
Psychological therapy
For many who live with an opioid addiction mental health problems exist. Underlying causes and factors influencing the addictive behaviours to continue need to be treated. Evidence-based therapies provide the most efficient way of doing this.
Cognitive Behavioural Therapy, Dialectical Behavioural Therapy and Mindfulness-Based Stress Reduction provide solid frameworks for psychological healing. These types of therapies allow people to face and begin to understand what makes them think and feel the way they do. This is also space where strategies are provided to enable the individual to face triggers and cravings more effectively.
Aftercare
In order for the effectiveness of opioid addiction treatments to last into the future, a programme of aftercare is put in place.
Aftercare programmes support people to stay focused on their recovery goals. This will usually mean a person will be linked to outpatient or inpatient services for continuing and regular support.
Group work, casual one-to-one sessions and support linked to outside organisations to develop future prospects all make up a solid recovery package.
What you can do if you think you might have an opioid addiction
If you’re concerned that you have an opioid addiction you can contact OK Rehab. You’ll speak with one of our friendly and compassionate team members who are highly experienced in working in the field of addiction.
Our team can discuss your symptoms with you and hold a pre-assessment to get the full picture. With your consent, we can refer you to the most suitable treatment services in your local area to suit your individual needs.
Final thoughts
Opioid addiction is rife within the UK. It’s a brain disease with far-reaching and devastating effects. With the increase of opioid prescriptions in the country, opioid addiction could be set to increase.
Whether a person uses an illegal or legal opioid the symptoms and experience are very similar. Treatment is necessary and the safest way to recover. Throughout local areas around the country, there are highly efficient services available to treat a person’s addiction.
Treatment and recovery are possible. For more information contact UK Rehab.
References
- https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2018registrations#two-thirds-of-drug-poisonings-are-because-of-drug-misuse
- https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003270
- https://www.meduniwien.ac.at/web/en/about-us/news/detailsite/2016/news-from-august-2016/dopamine-far-more-than-just-the-happy-hormone/
- https://www.who.int/substance_abuse/about/en/dependence_myths&facts.pdf
- https://journals.sagepub.com/doi/abs/10.1177/070674371105600808
