Opiates come in a variety of types and with a variety of demons associated with abuse. If you suspect a loved one is suffering from opiate abuse, we recommend becoming informed on the treatment options available to them.

How Opiate Addiction Destroys Families and Lives

Addicts don’t wake up one day and decide to get themselves hooked on a substance that could potentially destroy every good thing they’ve ever had in their lives. For some, the addiction happens by accident, the unhappy side effect of needing to take prescribed opiate painkillers for a long-term injury. For others, the addiction happens when the addict uses opiates as a method to numb emotional pain, trauma, and depression.

Whatever the reasons for the addiction, the results are devastating—both for the addict and for his or her family members and loved ones. As the drugs physically change the brain, the addict no longer feels euphoric and simply requires more and more of the drug just to feel normal. Non-addicts cannot comprehend the horror that opiate addicts go through when they do not have the drug in their system. The lengths that an addict will go to in order to feed the addiction and find some semblance of normality produces a laundry list of bad decisions, deceitful and manipulative behaviors, mood swings, and more. Friends and family watch the addict discard his or her responsibilities, reject loved ones in favor of drug-using friends, and even spiral into mental illness and homelessness despite the love, concern, and help that loved ones try to offer.

If you love and care for an opiate addict, there is definitely hope; many addicts have been able to overcome their addiction, address the emotional and physical issues that helped create the addiction, and lead happy, healthy lives once again. But the road to healing can be very difficult for both you and your loved one. Understanding what causes the addiction, the side effects your loved one suffers, and how your loved one can recover and lead a normal, drug-free life will help you as you continue to give support and aid during this terrible time.

The Different Types of Opiates

An opiate is defined as a narcotic analgesic that acts on the central nervous system. Used as painkillers, opioids attach to specific proteins called opioid receptors. These receptors are located throughout the body, including in the brain, the spinal cord, the gastrointestinal tract, and in other bodily organs. As it attaches to these receptors, the opioid reduces the sensation or perception of pain.

Opiate painkillers created by pharmaceutical companies are all based on the original drug of choice, opium, which was originally derived from the opium poppy thousands of years ago. Heroin, created in 1874 by chemists looking for a painkiller that was less addictive than morphine, is actually twice as addictive as morphine, and is still labeled as an illegal drug in the United States. Opiate addicts who start out by abusing prescription opiate painkillers often turn to heroin when they can no longer get their drug of choice.

Legal, prescription opiates (narcotics) include:

• Methadone. Developed by the Germans during WWII, methadone was later used by American doctors in the 1950s to treat opiate addiction. In the 1960s, Dr. Vincent Dole discovered that a single daily dose of methadone prevented heroin addicts from obsessing about and trying to obtain heroin. Methadone is still used today as a treatment for heroin addiction, but methadone has also been increasingly abused because its effects are similar to morphine, and it is highly addictive.
• Fentanyl. Fentanyl is a synthetic opiate most often used in anesthetic to prevent pain after surgery. As one of the strongest opiate painkillers, it is available both as a short-lasting treatment for breakthrough pain (pain felt between doses of another opiate painkiller, such as is experienced after surgery), and a long-term time-release painkiller in the form of a lollipop or patch. Fentanyl also comes in a film that can be placed under the tongue to dissolve, or a pill that dissolves in the cheek. Fentanyl creates a very quick tolerance to even high doses of opiate painkillers, and addiction is swift.
• Oxycodone. Sold under the brand names OxyContin, OxyIR, OxyFast, Percodan, and Percocet, oxycodone is another semi-synthetic opiate painkiller created by pre-WWII German scientists in an effort to reduce addictive effects while still relieving pain. OxyContin was originally marketed in the 1990s by Purdue Pharma, its U.S. patent holder, as the safe, non-addictive alternative to morphine and other strong opiate painkillers. Those claims were untrue, and oxycodone abuse has skyrocketed.
• Hydrocodone. Hydrocodone is prescribed when pain cannot be managed by NSAIDs or other non-narcotic analgesic painkillers. Like the medications listed above, it also has a high potential for dependency and addiction. Hydrocodone is also used in cough syrups to calm coughs and relieve the pain that persistent coughing creates.
• Codeine. Codeine was isolated from the opium poppy in 1830 by French doctor Jean-Pierre Roubiquet. It is a natural opiate and is less powerful than many of the other opiate painkillers, most often used in cough syrups to suppress coughing. Even if it is less powerful, codeine still produces the euphoric effect of an opiate, and many addicts use it in conjunction with alcohol and/or benzodiazepines (anti-anxiety medicines) for the calming sense of wellbeing the combinations produce. Others mix codeine with stimulants like cocaine or methamphetamine to reduce the negative side effects of the cocaine or meth. Codeine is highly addictive.
• Morphine. A natural opiate painkiller, morphine was isolated from pure opium at the beginning of the 19th century in response to the huge level of opium addiction that were happening in America at the time. Morphine kills pain ten times better than raw opium and is highly addictive, as was demonstrated during the Civil War, when it was widely used in military hospitals. Morphine is available in pill or liquid form.
• Vicodin. Vicodin is a brand name for the combination of hydrocodone and acetaminophen. Lortab is another. Vicodin is used to treat moderate to moderate-severe pain, and when abused, it can cause dependency and addiction.

Why Are Opiates So Addictive?

Opiates produce a sense of euphoria and wellbeing that is simply not available through any other natural means. There are many reasons why a person might become addicted to opiates, including long-term use for chronic pain, self-medication because of emotional or psychological distress such as PTSD, peer pressure, or a misunderstanding of the supposed safety of an FDA-approved prescription drug. Many people who consider themselves good citizens with no interest in committing crimes like taking illegal drugs have a difficult time admitting they have an addiction problem and seeking help in the first stages of dependency or addiction. The results of addiction are devastating, however.

At first, the user enjoys the cessation of pain along with the sense of euphoria and wellbeing the opiate provides, but in short time, higher and higher doses are needed to provide the same feeling. Then the user must keep upping the dose just to feel normal, while crashes produce serious withdrawal symptoms along with deeper and deeper feelings of despair and depression. Eventually, the user must take the opiate simply to reduce the depression and withdrawal symptoms, because feeling normal is no longer possible.

You may wonder why someone feeling so terrible would continue to take the drug, but non-addicts cannot comprehend how serious withdrawal symptoms can be—thousands of patients describe it as “the flu times 100.” The incredibly uncomfortable withdrawal symptoms, along with crushing despair and depression, force many to seek relief with more of the drug, even when they have tried very hard to give it up on their own.

Opioid Side Effects

Many people dislike using narcotic (opiate) painkillers because undesirable side effects drown out any feelings of wellbeing or euphoria. Others only begin really feeling the negative side effects when going through withdrawal. Some of the negative side effects of opioids include:

• Nausea
• Constipation
• Liver damage
• Drowsiness
• Physical dependence
• Lung disease
• Withdrawals: magnified flu-like symptoms

Treatment Options for an Opiate Addiction

While it is horrifying to watch someone you love and care for spiral into an opiate addiction, there is hope. The most effective treatment plans help the addict deal with the physical effects of withdrawal while also helping him or her confront the psychological reasons for the addiction in the first place.

Options include:

12-Step Programs

Based on the 12-Step Program for alcoholics, a narcotics 12-step program helps participants accept responsibility for their actions, confront the reasons why they choose to use opiates, and give and receive support among others in the group.

Medication Management

Medication is sometimes needed in order to help an addict more easily cope with physical and psychological withdrawal or to ease the pressure of co-occurring disorders (substance abuse occurring along with mental disorders). A skilled doctor or team of doctors assesses the patient’s specific needs in order to determine which medications are needed, and the medication protocol is then closely managed for therapeutic effectiveness.

Detoxification Period

Entering a detoxification program helps an addict deal with withdrawal symptoms in a safe, closely monitored environment. For opiate addicts, this is important, as trying to quit cold turkey with no medical oversight can be overwhelming (leading to relapse) or even fatal. A detox program is overseen by experienced medical doctors and other trained personnel who closely monitor the physical and psychological effects of withdrawal on the addict.

Detox programs prepare and assist the patient through several stages of ridding the body of the drugs and then working to help the patient heal on an emotional, spiritual, and psychological level. These programs are available as outpatient and inpatient programs. Opiate addiction often calls for an inpatient program due to the severity of physical withdrawal symptoms and the need for close management of medications that can ease those symptoms.

An Inpatient Program

A patient in an inpatient program lives at the facility for the duration of the program. This allows the facility to closely monitor how the patient is doing from hour to hour and make sure each patient is getting proper medication and nourishment while attending medical and therapy appointments. Close observations also helps eliminate other negative influences.

Opiate addicts are usually encouraged to enter an inpatient program because of the severity of opiate withdrawal symptoms and because there are medications that can be used to reduce and alleviate some of those symptoms. These medications, which can themselves be addictive if abused, must be carefully administered.

The length of inpatient programs depends on the severity of the addict’s addiction and the patient’s response to the medications and therapies he or she will receive there. Thousands of opiate addicts in inpatient programs have been able to address the root causes of their addiction as well as overcome the physical dependency and addiction to the opiate. Addressing the root emotional causes of addiction greatly reduces the chances that a former addict will relapse after leaving the program.

An Outpatient Program

People enrolled in outpatient programs live outside the facility while spending part of the day attending medical and therapy appointments within the facility. Outpatient programs allow patients more freedom of movement so that they can meet with family members and friends, work at a job, or attend school during the program’s duration. For former drug and alcohol abusers, this freedom requires a great degree of diligence and personal responsibility on the patient’s part while still providing a strong network of support for the patient. One advantage to an outpatient program is that the lessons learned in the program can be immediately applied as the patient interacts with the outside world.

Self-Help Support Group

Self-help groups such as Alcoholics Anonymous and Narconon (for narcotics abusers) offer people struggling with addiction the ability to find support from others who are going through the same trials and who are willing to share their experiences and encouragement.

Meetings for self-help groups are usually run by a volunteer leader, who might be a former addict or someone trained in addiction psychology. Members of the group are asked to share their stories and insights, and there is a great degree of accountability for individuals as they relate their struggles, relapses, and successes. Many of these groups pair an established member (sponsor) with a new member, with sponsors spending additional time and effort to get to know and help the new member and keep him or her accountable for their actions. Information shared in the group setting is considered completely confidential.

Family and Individual Therapy

Addiction programs almost always include family and individual therapy as part of a successful healing process.

Family therapy helps family members to accept and understand the addict’s behaviors, needs, strengths, and weaknesses while rebuilding bonds that may have been deeply strained by the addiction. Supportive family members can be among the greatest assets for recovering addicts, and this therapy can help begin the healing process needed for that support to be available.

Individual therapy is conducted in a confidential setting between the patient and a qualified clinician or licensed therapist. The individual and the therapist explore the emotional and mental reasons behind the addiction, along with other concerns. Talking with a non-judgmental person who is educated in the psychology of addiction, and recovery in an environment that is safe and confidential, is hugely beneficial for recovering addicts.

Aftercare Treatment

The successful completion of a drug rehabilitation program is something that should be celebrated and acknowledged. But once the program is over, former addicts still need support and help as they continue on their path to better life decisions and achieving their goals and dreams. Aftercare treatment programs are sometimes available as an extension of inpatient programs; other times, participants are required to remain clean and sober for a specified amount of time before being admitted. Either way, the aftercare treatment helps solidify lessons learned in a detox program while providing a network of support for the recovering addict.

Conclusion

Opiates (narcotics) are some of the most addictive substances. Used as painkillers, opioids in opiate drugs attach to opioid receptors located throughout the body. The protein suppresses the perception of pain, and in some people, produces a sense of extreme euphoria and wellbeing. The combination of pain suppression and euphoric sensations makes the drugs highly desirable, and the body quickly becomes addicted, requiring more and more of the drug to produce the euphoria, a sense of normalcy, and, eventually, just to relieve the crushing depression and despair of withdrawal.

Opiates are plentiful in our society, and many people become addicted to legal prescription painkillers by accident after a surgery, serious injury, or when dealing with chronic pain. Others turn to opiates as a source of relief to create a sense of wellbeing.

Opium, heroine, and codeine are the three natural drugs derived directly from the opium poppy. The most common natural, partially synthesized, and fully synthesized legal opiate painkillers include (in order of strength, from least to greatest):

• Codeine
• Hydrocodone (Vicodin, Lortab)
• Morphine
• Methadone
• Oxycodone (OxyContin, Percoset)
• Fentanyl (Duragesic)

Any and all of these opiates can cause dependency and addiction when not used in the correct way—and occasionally, even when used correctly over long periods of time. Addiction to prescription opiate painkillers is often a gateway to heroine abuse and addiction.

San Antonio Behavioral Healthcare Hospital provides substance abuse and addiction programs for adolescents and adults ages 12 and over. Our facility operates both inpatient and outpatient programs to help teens and adults overcome the physical effects of addiction and withdrawal, as well as assist patients in identifying the psychological causes of their addiction. If you or a loved one is addicted and needs help, please call us for more information or for a private and confidential assessment at (210) 541-5350. We offer this information and assessment at no charge 24 hours a day, seven days a week. Together, we can help you thrive.