Opioid Addiction: Causes, Symptoms, and Treatment

Description of the Issue 

Opioid addiction is a chronic condition that has significant impact on an involved individual's health, socioeconomic, and sociocultural aspects of their life. Opioids are generally a set of drugs which act on the nervous system to prompt pain relief and release of feelings of pleasure. Most opioids are legally availed for public consumption under specific prescription by a qualified physician. Legally prescribed opioids are administered for the purposes of chronic pain management in patients due to severe physical injuries or internal pain from health conditions (Center for Substance Abuse Treatment, 2004). Healthcare providers mostly prescribe fentanyl, methadone, oxycodone, hydrocodone, morphine, buprenorphine, and codeine. However, other forms of opioids such as heroin are illegal as much they have an element of assistance to relieve pain. 

Opioid addiction can be described as a compulsive feeling to use the opioid drugs outside the treatment window, that is, when they are not medically required. Opioids are well known for their high influence on compulsive consumption among people with a history of using the drug. The effects of opioids are non-discriminative of whether the prescription was done a medical professional and taken as per the directions, or abused. A common challenge over the years is that most opioid prescriptions around the world are abused or transferred to other people for the purpose of getting high on drugs. Addicted individuals end up prioritizing consumption of the opioid drugs before other primary aspects of their life such as family other personal relationship (Center for Substance Abuse Treatment, 2004). Conducted research has significant evidence on this impact of opioid drugs but still not much has been done to understand why the addiction effects are intense on some people and mild on others. Most common effects of opioid addiction are perilous to life, especially when overdosed. Opioid overdosing which might as well be a result of addiction causes slow or difficulties on breathing, unconsciousness, and death in extreme cases where medical attention is not sought in good time. Regardless of whether the opioid drug is legally prescribed or not, nor the amount consumed, all cases of opioid drug consumption have a risk of overdose if instructions are not adhered to. 

The causes for opioid addiction are intertwined: they can be environmental, genetic, lifestyle, or a combination of all of them. From a genetic perspective, the genes associated with opioid addiction are located in the endogenous opioid area, which is the part of the body for pain regulation, pleasure, and addictive behavior. The endogenous opioid system encompasses naturally produced opioid substances alongside their respective receptors onto which opioids fit. External ingestion of opioids into the body, that is, exogenous opioids act on the same receptors which then affects how the body responds to it, whether pain reliefor pleasure. Ultimately these effects cause addiction. 

Based on conducted research, opioid addiction is a disorder that can also be caused by non-genetic factors such as substance abuse history, psychiatric and mental disorders, stress and depression, history of trauma, childhood neglect and abuse, a history of violence, and specific personality profiles such as impulsivity. Environmental factors such as easy access to opioid drugs on illegal basis also lose a great risk for opioid addiction among exposed individuals. An interaction of all these factors make the situation more complex. 

Behavioral Addictions and Social Norms 

Behavioral Addictions 

Addiction occurs in many forms whereby in most cases the physical dependence on something is assessed by the person's inability to do without it. Therefore, withdrawal symptoms have always been used as primary indicators of addiction. Behavioral addiction is the compulsive nature of a behavior that gives hint on evidence of withdrawal symptoms (Karim & Chaudhry, 2012). The individual in question is always empowered by a compulsion to engage in a behavior or action without giving otherwise thoughts despite their knowledge about the negative consequences of the object on their mental wellness and general physical health. In most situations, the victims derives psychological pleasure from the action but later experiences remorse and guilt after overwhelming consequences of the same action. Behavioral addiction is persistent of not treated over a lengthy period. 

Common behavioral addiction types include sex addiction, gaming addiction, shopping addiction, gambling addiction, food addiction, and exercise addiction. All these types of behavioral addictions have a common profile that defines each one of them which creates a distinct line between the addicts and every other person who also engages in these activities but not addicted to them. 

A behaviorally addicted person often experiences mental health or physical health challenges as a result of the certain behavior. Opioid addiction is parallel to this experience in the sense that opioid drug addicts usually experience chronic constipation, reduction of the size of the pupils, low libido, slurred speech, sweating, hyperalgesia, and nauseatic effects (Karim & Chaudhry, 2012). These symptoms are related to both the physical health and mental health of the victim hence not only categorizes opioid addiction as a substance addiction type but also a behavioral addiction. 

Additionally, behavior addictions are associated with withdrawn and broken social relationships with family, friends, colleagues, or other members of the society. Euphoria and discontent are key symptoms of opioid addiction and such effects are likely to obstruct how an individual relates with their friends and other significant relationships. Lastly, a behaviorally addicted person is prone to other negative implications that directly emanate from the behavior in question. For instance, an opioid drug addict will continually spend their money to buy legal opioid drugs or illegal drugs such as heroin which are costly. Ultimately, these people might start selling off their household items such as furniture on black markets to get money to maintain their addiction habits. 

Social Norms 

Social norms refer to societal ideals about different aspects of life. In the case of addiction, especially for substances, there exists different societal ideals that make it appear stylish or normal to abuse the substance. Victims of opioid addiction are prone to these norms which shape their addiction and scale it even further. For instance, binge-drinking is a common norm among the modern youth which has attributed to alcoholism and its abuse. Innocent youth are subjected to a force that deprives them a sense of belonging; hence naturally forcing them to indulge in binge-drinking (Karim & Chaudhry, 2012). In the same context, given the exciting and pleasurable effects of opioid drugs such as codeine, shared experiences within peers makes the innocent youth to pick up the behavior. Based on conducted research, many young people tend to think that engaging in substance use is part of fashion and 'cool'. Therefore, they are easily caught up in the web of addiction of substances such as opioid drugs. 

Another common social norm about substance use and addiction is the mythical view that alcohol has certain medical benefits. Also, marijuana has been subject to this type of discussion. Therefore, based on such notions, the society feels that such substances should not be shunned and instead be appraised for their benefits on different aspects of human life. In the same vein, opioid drugs such as codeine are associated with medical properties and may easily be thought as more beneficial with more consumption. Therefore, ultimately the addiction develops with continued consumption of the drug. 

Explaining the Impact 

Opioid addiction has different effects on the physical and socioeconomic aspects of an addict and other people around them. Physical health problems such as mental disorders are among major impacts of opioid addiction. According to the Incentove Salience model, opioids among other substances are known to cause neurological excitement and cravings in the long-term. This model provides the link between opioid use and the mental health of an individual. Therefore, continuous use of the drug alters different parts of the neuron system; hence mental health problems. Additionally, opioids such as heroin are extremely costly. Therefore, abusers are likely to suffer from financial instability in the long run, which might also directly affect both the people depending on them or those they depend on. The stimulus response learning model stipulates that the behavior to take the opioid drug is triggered by an external stimulus which leaves a high chance of the exact stimulation in future. Therefore, based on this theory, continuous financial exploitation due to addiction is clear. 

Treatment Options 

Medication 

There are several treatment options applied for both substance and behavioral addictions. These options include behavioral counseling, use of medical treatments for withdrawal symptoms, and follow-up programs to check on relapse. Use of medication to treat withdrawal symptoms associated with a certain addiction has been used for several years to help drug addicts to recover. Additional, medication can also help prevent relapsing among victims taken through the treatment program. 

For the case of withdrawal, medications suppress the associated withdrawal symptoms during detoxification. Detoxification is the first step of the treatment process. Detoxification simply aids in the draining of the addictive substance from the body system so that the affected individual does not feel the compulsion to seek for the substance, or the severity of the withdrawals are reduced significantly. Detoxification drugs are used while at the same time the individual is requested to put in effort in making choices regarding substance use that do not trigger the need to abuse (Center for Substance Abuse Treatment, 2005). The Food and Drug Administration has made significant milestones within detoxification by use of electronic devices. The device is put behind the ear where it can send electrical impulses that stimulate the nerves of the brain regarding withdrawal symptoms. 

Medications can all be use to prevent relapsing among addicts who have already undergone treatment. The purpose of the medicine used under relapse prevention treatment programs help in rebuilding of the normal brain functioning. Opioid addiction can also be treated using these approaches, that is, prevention of relapses and withdrawal symptoms. Opioid addiction is normally treated using other opioid drugs (Center for Substance Abuse Treatment, 2005). For instance addiction to codeine or heroin can be treated by administering a treatment procedure that uses Methadone. Since methadone affects the same part of the brain as heroin and codeine, it naturally suppresses the cravings for opioid drugs and withdrawal symptoms. Already detoxified patients can be induced with Naltrexone which blocks the effects of opioid drugs in the receptor cells in the brain to ensure that the individual does not relapse into addiction (CSAT, 2004). After a significant period of treatment, the patients gradually become open to adopting behavioral remedies for addiction; hence ending up transforming the individual into an important member of the society. However, according to a study by NIDA, full detoxification using a combination of methadone and naltrexone has proved to b more effective for opioid addicts than using the two remedies separately (CSAT, 2005). 

Behavioral Therapy 

Behavioral therapies are significant in the alteration of the attitude and behavior of a victim of addiction. The main purposes of behavioral therapy include supplementing other forms of treatment for addiction such as medication, instill life skill knowledge, and perfom a full behavioral change. Behavioral therapies can either be done on outpatient basis or inpatient basis whereby in outpatient basis, the patient is allowed to visit the counselling session from home following a strict timetable. On the other hand, inpatient therapy involves admission of the patient into a housing facility for a temporary period whereby necessary counseling sessions will be channeled. 

Outpatient therapies can further be divided into four groups or approaches which have different prescriptions in handling addiction. The multidimensional family therapy majorly works well for adolescents battling drug abuse within their families and has an ultimate goal of refixing the general functioning of the family. Opioid addiction has been linked to genetic factors which might result from family members. For instance, an opioid drug addict pregnant mother is likely to pass down the addiction to the new infant. In these circumstances, this form of therapy is viable and most effective. Cognitive therapy on the other hand is essential in helping patients identify situations which are likey to trigger their drug use habits and advised accordingly (Center for Substance Abuse Treatment, 2005). For instance, most opioid drug abusers take the drug for pleasure and pain relief from depression effects: therefore, identification of such triggers will help the therapist to counsel the patient effectively. Lastly, motivational interiewing and incentive therapies all use positive reinforcements to convince the addict to avoid abuse of opioids. Therefore, when the treatment is intense, inpatient measures can be undertaken and gradually adjusted to transition into outpatient therapy after the symptoms get mild. 

Analysis of Approaches 

Peer-based Approaches 

Peer based approaches to treatment of addiction are majorly objective on treating the addiction completely. These approaches are as discussed above in the treatment options: behavioral therapies, and medications. The Minnesota Model for instance sums up all these approaches as treatment for addiction. Opioid addiction is both a behavioral and substance addiction as already discussed above, hence the Minnesota model of addiction suffices in treatment of this form of addiction. The model is made up of five major steps: admission about powerlessness, finding hope, surrendering, taking inventory, and sharing inventory (Winster et al., 2000). The admission stage allows the victim to reflect on the consequences of the drug addiction disorder. Thereafter, it is important to identify a higher power which in this case is medication or therapy specific for opioid addiction treatment. Surrendering in the Minnesota model implies a change in decision making such as less consumption of substance or complete abstinence. The last step steps are majorly recovery processes. Contrary to this model is the harm reduction approach. 

Peer-based approaches for treatment of opioid addiction might be the most effective in solving the problem of addiction but has negative effects too. Since the main objective of these approaches is the complete recovery of the victim, relapsing is demonized to the extent that individuals who relapse fall into depression for the negative stigma. Also, this model focuses only on opioid addicts who have developed physical dependence on the opioid drugs such as heroin while ignoring the cohort with minimal levels of consumption (Winster et al., 2000). However, the effect of opioid drugs on the brain are the same whether in large or small amounts. Also, continuous consumption of small amounts definitely causes opioid addiction in the long run. 

Harm Reduction Approach 

The harm reduction approach is binary in terms of methodologies used: reduction of the health, social, and economic consequences associated with opioid addiction without necessarily reducing the real abuse of opioids, and actual reduction of use of opioids. The harm reduction model is quite unpopular in the fight against opioid addiction for several reasons (Rhodes, 2009). Harm reduction approach enrolls the victims on a program whereby they consume less of opioids compared to their usual abuse. This action can be seen as an excuse for relapse. Moderation on the opioid drugs is an excuse to continually take the opioids. Additionally, harm reduction approaches do not work effectively with illegal substances such as illegal opioids. Intake of less heroin for example is not an opioid addiction treatment since a drug like heroin only needs to be taken in small amounts to cause addiction and abuse in the long run (Winster et al., 2000). Lastly, harm reduction approaches do not offer opioid addicts of other safe remedies to help them relieve their pain or offer pleasure. 

Assessment of Utility of Traditional and current Treatment Approaches 

Traditional approaches of treating drug addiction, including opioids majorly revolved around abstinence. Abstinence referred to complete avoidance of the opioids in this case. However, as much as abstinence proved to be effective in the early years, it reported many instances of relapses among victims. Substance addiction or abuse, such as opioid addiction not only affects the physical health of the person but also their other aspects of life. Therefore, dealing with the aspect of the drug alone does not solve the entire problem. This gap prompted the formulation of new approaches which are currently used. Current approaches to addiction treatment focus on several aspects suchbas the drug itself, the physical health of the indit, mematl health, and socioeconomic aspects of their life (Winster et al., 2000). Prominent current approaches include psycho education in form if counselling and behavioral therapy sessions, and medical treatment through drugs which eliminate withdrawal symptoms from the body system if the victim. Current methods are a broad spectrum since they cover diverse aspects both directly and indirectly related to opioid abuse. 

Recommendations 

A human being feels appreciated when they are included or rather when they feel a sense of belonging. Current programs do not have this aspect, hence the result of continual challenges in solving opioid addictions in the United States and other parts of the world. Giving these people the right to choose what they feel is applicable for them is an essential first step; the victim becomes deeply connected with the program because it was all out of their choice. Therefore, the recommendation are based on entirely self-selection and freedom to choose. The addicts should be divided into different groups depending on a commonly shared aspect: mentally unstable, heavily abusing, among others. After that, these groups should be subjected to make decisions or choices regarding what they would want first: for instance, priority on substance abuse treatment or counselling. Based on their preferences, further subdivisions should be done. Based on the new groups formed, two significant platforms should be created: treatment shelters, and recovery centers. 

Treatment centers or community facilities are meant for individuals who are extreme abusers. Most opioid substance abusers might find it hard to avoid opioid drugs; thus, such a factor is critical in helping such individuals. Therefore, based on selected choices, these individuals will be put in these centers where treatment will be offered, among other services such as food, water, and different basic needs. Recovery centers, on the other hand, are specific for moderate opioid substance abusers who are ready to be treated and put on therapy, and the cohort from the treatment centers who need recovery to avoid relapse. These individuals are exposed to treatment options, after which they are discharged and helped to secure normal lifestyles. 

References 

Center for Substance Abuse Treatment. (2004). Clinical guidelines for the use of buprenorphine in the treatment of opioid addiction. 

Center for Substance Abuse Treatment. (2005). Medication-assisted treatment for opioid addiction in opioid treatment programs. 

Karim, R., & Chaudhri, P. (2012). Behavioral addictions: An overview. Journal of Psychoactive Drugs, 44(1), 5-17. 

Winters, K. C., Stinchfield, R. D., Opland, E., Weller, C., & Latimer, W. W. (2000). The effectiveness of the Minnesota Model approach in the treatment of adolescent drug abusers. Addiction, 95(4), 601-612. 

Rhodes, T. (2009). Risk environments and drug harms: a social science for harm reduction approach.