The dependence of opioids results in complicated health conditions, which often means long-term care and treatment. To improve the well-being and social functioning of the people, the absolute treatment of acute dependence on opioids is highly significant. While the main reason for rehabilitating and treating persons afflicted with this dependence is the reduction of addiction cases, an absolute stance against morbidity and mortality has recently gained precedence. The use of illicit opioids leads to complexes such as the transmission of infectious diseases; degradation of physical and psychological health; criminal behavior; gradual reintegration into the education system and workforce and an impeded social functioning. Therefore, reducing this dependence lies at the heart of ensuring its complete eradication; subsequently leading to health and holistic well-being
Thesis Statement
The use of the medication-assisted treatment in addressing opioid dependence is of utmost significance. Through employment of combinations of medications in the form of buprenorphine or methadone for substitution treatment and naltrexone for preventing relapse in combination with psychological support, modulation of opioids among addicted patients becomes a reality (Troncale, 2014). These medications assist in the elimination of withdrawal tendencies, controlling and eliminating cravings and the euphoric effects of consuming opioids. Through psychological support, patients are able to experience supportive psychosocial health and social environment, consequently addressing and augmenting the duration and overall quality of life. As such, this paper analyzes and applies critical thinking on the treatment of opioid reliance. In particular, the paper examines the psychopharmacology of opioids suggesting ways to reduce dependence using effective drug administration.
Delegate your assignment to our experts and they will do the rest.
History of the Drug
Opiates refer to alkaloid compounds naturally contained in the poppy plant of opium called Papaver somniferum. Within this drug, psychoactive compounds include codeine, morphine, and thebaine. Among the first people to have ever used this drug comprise the Mesopotamians and the Sumerians. They began cultivating the poppy plant around 3400 B.C.E. and according to them, the plant was named Hul Gil, meaning the “joy plant.” Throughout the ancient world, the plant spread to all major civilizations particularly in Europe and Asia and was used mainly in the treatment of pain and other ailments. Onwards, during the 19th century, pertinent developments changed medicinal practices, which brought about tensions between the goals of making available the medicinal benefits of opioids and the awareness of addiction and abuse developments as a devastating corollary for persons and the society. Such medical discoveries related to opioids included the 1803 extraction of the opioid analgesic morphine by Friedrich Serturner. In addition, Dr. Charles Wood, a physician of Scottish descent came up with an invention of the hypodermic needle and then used it to administer morphine to aid in the relief of pain from neuralgia.
Following these initial forms of opioid use, Dr. Eduard Livenstein, a physician of German descent came up with an initial comprehensive and accurate description of morphine addiction, inclusive of the relapse and withdrawal symptoms. Furthermore, he argued that morphine craving was a psychological response. Although he indicated early the dependent nature of prolonged heroin use, at the beginning of the 20th century, however, diacetylmorphine, a heroin brand name, was synthesized and promoted briefly as being less addictive and more effective. Consequently, this drug sold on the market in the form of a pill and was used by young Americans to induce intense euphoric experiences through crushing the pill into powder and snorting or through direct injection. As the 20th century progressed, numerous research progressions and major alterations in the use of opioids resulted in their functional employment as pain relievers and addiction eradicators. As such, the twentieth century period had the perception, especially among professionals that the use of opioids on a long-term basis brought about pain relief but at the same time resulted in increased addiction risks. During the onset of the 1990s, big alterations driven by various nonmedical and medical factors tool place. These changes brought about a spiked increase in the consistent use and abuse of opioids (Stotts, Dodrill, & Kosten, 2010). Consequently, in 1905, the United States Congress prohibited opium. The following year, they approved the Pure Food and Drug Act, which meant all drug manufacturers had to place content labeling on all prescription medicines.
Psychopharmacology of the Drug
To increase the likelihood of successful detoxifications, appropriate pharmacological agent administration is required. Clinically, two general treatment methods exist in resolving the opioid menace: detoxification and opioid maintenance treatment. Most likely, one finds that almost all opioid dependent individuals adhere to both treatment paths in multiple ways in their entire career of drug use. Moreover, partial agonist and agonist medications are normally employed for both detoxification and maintenance processes. Such medications include the alpha-2-adrenergic agonist medications used typically for the enhancement of detoxification outcomes (Schuckit, 2016). Therefore, the triumph of diverse healing methods and amalgamations are appraised through different ways, with the principal outcome of utmost concern being treatment preservation among opioid and other drug users. Secondarily, indicators such as reductions in the risk of detrimental behaviors pertaining to crime involvement and psychiatric symptoms show an indication of successful treatment. Moreover, with regard to the detoxification process, there are certain variances among individuals who withdraw from the use of illicit opioid and those from buprenorphine and methadone maintenance, especially regarding the context of occurrence.
Among efficient agonist medications for opioid dependence include methadone and levomethadyl acetate or LAAM. While LAAM is a longer acting derivative of methadone, its use is rarely advocated. Methadone, on the other hand, represents a full mu-opioid receptor primarily administered as a replacement therapy for heroin, which is the commonly abused drug and other opioids (Farrell et al., 1994). Since methadone’s onset of action is gradual, 24-36 hours when consumed orally, its use is tied to it being a detoxifying agent or administered in maintenance therapy. During maintenance, methadone acts as a substitution for heroin and other opiates, and through various mechanisms such as cross-tolerance and tolerance, there is the prevention of opioid withdrawal and intoxication. Appropriate ranges of methadone dosage are typically from 80-150 mg, normally commencing with a dosage of 20-30 mg daily and exponentially increasing the dose by 5 mg per increase until the achievement of optimal dosages (Farnum, 2017). Through treatment by methadone maintenance, patients are able to achieve retention in treatment, reduce their use of IV drugs, significantly diminish their involvement in criminal activities, and the reduced risk for HIV and other related risk behaviors. Presently, the use of methadone is the most effective treatment strategy for individuals who are highly dependent on opioids. However, in spite of treatment efficiency, the use of methadone results in substantial personal and financial costs to persons participating in the therapy (Mattick et al., 2003).
As a partial agonist medication employed in relieving opioid dependence, buprenorphine presents high efficiency. In October 2002, the Food and Drug Administration agency approved the sublingual and tablet forms of this drug in the United States. Prior to their approval, buprenorphine displayed unprecedented success in Australia and numerous European countries. In the U. S., this drug is categorized as Schedule III, meaning that it is legal for physicians who are qualified to prescribe the drug for those dependent on opioids. While LAAM and methadone are filled with agonists of an opioid nature, buprenorphine contains partial opioid agonists of the mu-opioid receptor. As such, there is the permission of using buprenorphine for day dosages since it commences slowly and stays in the system for quite a long time. Moreover, due to its attribute of being a partial agonist, the risk of unintentional overdose is highly mitigated. Outcome data from several types of research indicate that buprenorphine establishes superiority over placebo and other opiate replacement treatment approaches (Gonzalez, 2015).
Current Trends or Issues
Opiates are growing as a profound problem due to innumerable factors. Presently, this drug is among three larger categories, the other two being depressants of the central nervous system and stimulants. One factor that aggravates the problem is through the severe amplification of the amount of written and dispensed prescriptions, as mentioned earlier, and the larger social satisfactoriness of administering medications for divergent purposes, as well as the combination of drugs to produce higher euphoric effects as is well implemented by pharmaceutical companies taking full advantage of consumerism through aggressive marketing. This boost in the misuse of narcotics and other opiates has led to national “raise awareness” campaigns resolute on several topics that are related together with the hiding of prescription medications in areas that are inaccessible and the subsequent discard of prescriptions that are unused in a safe way.
Societal Concerns or Issues Related to the Topic
Since opiate drugs are prescribed over the counter, America is facing a crisis as the number of prescribed drug abuse is soaring at an alarming rate. Since 1999, various racial demographics have witnessed increases in overdoses, with heroin hitting an all-time high after 2010. In all demographic categories, Native Americans and whites have undergone the biggest increase in rates of death, predominantly, opioid-related fatalities. According to the Center for Disease and Control (CDC), by the dawn of 2014, more Native Americans and whites were succumbing to overdose than the rates of Latinos and African-Americans. Therefore, in America, among the main workings of the FDA program is to sensitize doctors on the methods of proper prescription issuance, especially those prescribing opioid analgesics. Additionally, such doctors are given information on how to properly educate patients on the appropriate application of opiates, its right disposal, and storage. These strategies are significant in the eradication of societal issues and concerns related to opioid dependence.
Significance or Relevance of the Topic to the Counselling Profession
Counseling strategies, which typically display acute efficiencies, usually address the physical and psychological aspects of opiate addiction as well as the relational, spiritual, self-esteem and health issues. Commensurately, counseling is an essential part of opiate addiction treatment and recovery. Addiction is more than a physical disease, so it requires more care than detoxification or other physical health care strategies. A fter detoxification, physical reliance to the drug is resolved. However, relapse is still a challenge to addicts. As a result, social and psychological attributes often accord influential stimuli for relapse. Thus, counseling is highly pivotal in alleviating relapse symptoms and in augmenting the treatment process.
Future Implications
Numerous researches indicate that the use of drugs in a chronic way alters the brain in highly elemental ways. In addition, these changes have been found to persist for quite a long time even after the individual abstains from taking the drug. As such, research points out that those who use opioid-based drugs have various neuropsychological impairments that are quite pronounced, particularly, in the areas of memory and executive function. Other studies support the premise that even after several years of total abstinence, impairments may continue to persist. This potentiality of permanent impairment deems it necessary for the formulation of strategies that will lead to a reduction in the abuse of opioids. Moreover, the misuse of opioids and their dependence present complicated medical issues within healthcare. Therefore, health care officials and professionals need to employ the use of treatment options such as detoxification and the opioid maintenance treatment effectively.
Conclusion
Addiction is an intrinsically chronic illness. Current comprehensions of the brain are opening up opportunities that are paving the way for more advanced treatment options for individuals addicted to heroin and other forms of opiates. With an increase in the validity of the treatment options available, proper treatment dispensation needs to focus on patient preference, holistic health status, success probability and medical history. Overall, treatment and regulation modalities need constant progress and perfection since incidences of dependence are on the rise.
References
Farnum, S. (2017). Treating Opiate Addiction with Replacement Therapy. Treatment: Which Treatment Should I Pursue,1 (1), 1st ser., 3. Retrieved August 15, 2017, from http://www.hbo.com/addiction/print/343_treating_opiate_addiction.html
Farrell, M., Ward, J., Mattick, R., Hall, W., Stimson, G. V., & Des Jarlais, D. (1994). Methadone maintenance treatment in opiate dependence: a review [Abstract]. Methadone maintenance treatment in opiate dependence: a review,309 (4), 3rd ser., 1-5. Retrieved August 14, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2541312/pdf/bmj00461-0035.pdf.
Gonzalez, J. (2015, May & June). Treating Opiate Addiction with Replacement Therapy. Retrieved August 14, 2017, from http://www.crchealth.com/find-a-treatment-center/opiate-addiction-treatment/oxycontin-articles/treating-opiate-addiction-replacement-therapy/
Mattick, R., Breen, C., Kimber, J., Davoli, M., & Breen, R. (2003, April 22). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Retrieved August 15, 2017, from http://onlinelibrary.wiley.com
Schuckit, M. A., M.D. (2016). Treatment of Opioid-Use Disorders [Abstract]. Treatment of Opioid-Use Disorders Engl J Med (1), 5th ser., 368-375. doi:10.1056/NEJMra1604339
Stotts, A., Ph.D., Dodrill, C. L., Ph.D., & Kosten, T., MD. (2010). Opioid Dependence Treatment: Options in Pharmacotherapy [Abstract]. Opioid Dependence Treatment: Options in Pharmacotherapy,1 (3), 2nd ser., 1727-1740. doi: 10.1517/14656560903037168
Troncale, J. (2014, May 10). Buprenorphine, Methadone, and Opiate Replacement Therapy. Retrieved August 14, 2017, from https://www.psychologytoday.com/blog/where-addiction-meets-your-brain/201405/buprenorphine-methadone-and-opiate-replacement-therapy
