Using Buprenorphine for Pain Relief

Buprenorphine for Pain Relief | Recovery By The Sea

Using Buprenorphine for Pain Relief– Buprenorphine is most commonly used in medication-assisted treatment (MAT) to help people reduce or stop the use of heroin or other opiates. However, current research has also found that buprenorphine-naloxone (Suboxone) may also provide relief for opioid-dependent patients suffering from chronic pain.

How Buprenorphene Works

Buprenorphine works by mitigating withdrawal symptoms when a person dependent on opioids discontinues use. Buprenorphine has a specific mechanism of action that makes it desirable for treating opioid dependence and possibly chronic pain.

Buprenorphine has a high attraction to specific opioid receptors that are responsible for pain relief. It remains attached to these receptors for a longer time than other drugs, and as a result, has a prolonged effect.

However, despite this affinity, it acts only as a partial agonist. This means that it prevents opioid withdrawal symptoms, but its effects are less potent than other opioids. Also, and perhaps most critically, buprenorphine does not act on opioid receptors that cause feelings of euphoria.

Moreover, the drug does not induce a “high,” meaning that it has a much lower potential for addiction than other opioids.

Administration

As noted, buprenorphine is often combined with naloxone in the form of a drug called Suboxone. Naloxone is a short-acting, opioid antagonist. When combined with buprenorphine, naloxone can neutralize the potentially dangerous effects of other opioids, including sedation and respiratory depression, without preventing pain relief.

Side Effects

Although not nearly as severe as other opioids, both buprenorphine and Suboxone can have adverse side effects, including the following:

  • Stomach and back pain
  • Blurred vision
  • Constipation
  • Difficulty with sleep
  • Mouth numbness
  • Headache

More severe side effects, including difficulty breathing or swelling of the mouth or tongue, require prompt medical attention. Importantly, combining buprenorphine with the use of other drugs like benzodiazepines can be fatal.

Buprenorphine for Pain: Research

In a 2017 review, researchers examined the efficacy of buprenorphine for the management of chronic pain. They analyzed more than two dozen randomized controlled trials involving five buprenorphine formulations.

Overall, the researchers found that 14 studies suggested that buprenorphine in any formulation was useful for the treatment of chronic pain. More specifically, 10 of 15 studies revealed that transdermal buprenorphine (skin patches) were effective, and two of three studies showed that buccal film (film placed between gum and cheek) was also effective.

However, only one study indicated that either sublingual (under the tongue) or intravenous buprenorphine was useful for the treatment of chronic pain. Importantly, no serious adverse effects were reported in any of the studies, indicating that the use of buprenorphine is safe.

In 2014, researchers published a review that examined the effectiveness of sublingual buprenorphine for the treatment of chronic pain. They found that sublingual buprenorphine was, indeed, efficacious.

Researchers suggested some potential benefits of buprenorphine, including the following:

  • Increased effectiveness in treating nerve pain
  • Ease of use among the elderly and in renal impairment
  • Less immunosuppression compared with morphine and fentanyl
  • Ceiling effect for respiratory depression when administered without other depressants
  • Less development of tolerance
  • Antihyperalgesic effect

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Treatment for Hyperalgesia

Due to buprenorphine’s binding properties, it’s believed that it may be able to help those who suffer from opioid-induced hyperalgesia. Opioid-induced hyperalgesia is defined as sensitization caused by exposure to opioids. The condition is hallmarked by a paradoxical response in which a patient using opioids for pain relief could become more sensitive to painful stimuli.

Prescribing Buprenorphine for Pain
In the U.S., buprenorphine is being used to treat chronic pain, and Suboxone is sometimes prescribed off-label for this purpose. Also, the transdermal buprenorphine patch is available for the treatment of severe chronic pain.

Suboxone Abuse and Addiction

Suboxone, when used as directed and under the supervision of a physician or addiction specialist, can be an effective tool for helping a person discontinue opioid use. In some cases, it may also help manage pain.

Suboxone, however, like any opioid-based drug, has some potential for abuse. It can be purchased illicitly, and those with legitimate prescriptions can still become dependent. While the drug does not induce the same euphoric high as other opiates, if used in large quantities, it can have psychoactive effects.

If the drug is tampered with, this can result in a condition known as precipitated withdrawal. This condition may occur if a person crushes the drug and snorts it or liquifies it for injection. Naloxone is an opioid overdose-reversal drug that is used in Suboxone as a deterrent against abuse.

When used orally, naloxone is inactive. However, if the drug is tampered with, the naloxone would become active and, in theory, cause the person to go into instant withdrawal from opioids. Also, one could surmise that it would be likely to neutralize buprenorphine’s already minimal rewarding effects.

That said, instances of abuse still do occur. People that abuse Suboxone or buprenorphine alone say they will swallow, snort, or inject the drug in an attempt to intensify the effects. Suboxone is more apt to be abused by those addicted to relatively small doses of other opioids.

So, although the naloxone should make abuse less likely, it does appear that Suboxone could potentially cause a high when snorted. A rewarding high would be more likely in those who are “opioid-naive,” meaning individuals who don’t regularly use opioids and are not currently on a buprenorphine treatment program.

Signs of Suboxone Dependence

When someone is dependent on Suboxone, they may not exhibit significant symptoms, unless he or she is going through withdrawals. This may be the first sign there is a problem.

Several common behaviors may be associated with a drug dependency, and the following signs may indicate that someone you know has a problem:

  • Doctor-shopping for drugs
  • Isolation from family and friends
  • Drowsiness or insomnia
  • Deception/manipulation of others
  • Obsessiveness over obtaining and using the drug
  • Stealing or frequently borrowing money
  • Lack of interest in activities once considered enjoyable
  • Neglect of essential responsibilities, such as work, school, or family

Abuse and dependence do not necessarily equal addiction. Addiction is a condition also characterized by compulsive drug-seeking in spite of adverse consequences that result. In fact, it is possible for a person to become emotionally addicted to a substance even without a particularly strong chemical dependence.

Suboxone Addiction Side Effects

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Suboxone addiction can lead to several side effects, including the following:

  • Nausea
  • Vomiting
  • Diarrhea
  • Slurred speech
  • Impaired coordination
  • Insomnia
  • Sweating
  • Depression
  • Drowsiness
  • Small pupils
  • Impaired memory
  • Erratic moods and behavior

Also, the abuse of Suboxone can result in significant risks to one’s health, such as central nervous system (CNS) depression and overdose. Due to the presence of naloxone, Suboxone overdose is uncommon. Most cases of overdose and respiratory distress tend to manifest when the drug is used in combination with other depressants or psychoactive substances, such as alcohol or benzodiazepines.

Treatment for Opioid Addiction

Buprenorphine is a drug used primarily for the treatment of opioid addiction. It is often found as the combined medication, Suboxone, which also consists of naloxone. However, doctors sometimes prescribe Suboxone or stand-alone buprenorphine for pain.

Buprenorphine alone has a relatively low potential for abuse and addiction compared to other opioids. Suboxone may be even more abuse-deterrent. That said, abuse still does occur, and when an opioid is involved, there is always the possibility that a person will become dependent and psychologically addicted.

Recovery By The Sea offers comprehensive programs comprised of services beneficial to the recovery process. These services include, but are not limited to, the following:

If you or someone you love is addicted to opioids, contact us today! Discover how we help people break free from the shackles of addiction for good!

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The Three Stages of Opiate Withdrawal

Stages of Opiate Withdrawal | Recovery By The Sea

Opiates are highly addictive painkillers commonly abused through both prescription and illicit use. Opiates are naturally-occurring compounds found in the opium poppy and include morphine, codeine, and thebaine.

“Opioids” is the more common term now used for all natural and semi-synthetic (e.g., Oxycontin and heroin) and fully-synthetic (e.g., Fentanyl) drugs that work on opioid receptors in the brain. For the purposes of this article, the terms “opiate” and “opioid” may be used interchangeably.

Due to the addictive quality of opiates, the use of these drugs may lead to tolerance, dependence, and withdrawal. Tolerance develops as a result of the brain’s propensity to reduce the effects of certain substances in response to repeated exposure. Increased tolerance often compels people to use a substance more frequently and in higher amounts, an action that can rapidly lead to dependence.

Dependence is a condition that occurs over time as the brain adjusts to the presence of a substance and eventually becomes unable to function without it. When a person then tries to discontinue use, they encounter highly unpleasant withdrawal symptoms while the brain and body attempt to re-establish equilibrium.

Opiate withdrawal occurs in three stages. A person who has developed a dependence on opiates may start to encounter withdrawal symptoms within 6-12 hours after their last dose.

How Long Does Opiate Withdrawal Last?

Some symptoms of opiate withdrawal may onset within hours after the last dose, and others may occur later in the withdrawal process and continue for a week or more. Psychological symptoms, such as anxiety, depression, and cravings, may persist for weeks or even months after discontinuing use.

Medical detox generally lasts between 5-6 days, depending on the severity of withdrawal symptoms. During this time, a person detoxing from opiates will encounter three different stages of withdrawal. These stages are distinguishable based on the types of symptoms experienced, their severity and how long they are expected to persist.

Timeline for Stages of Opiate Withdrawal

The exact timeline for opiate withdrawal varies between individuals depending on the drug used, method of administration (e.g., oral ingestion, injecting, snorting, or smoking), how long the drug was used and how much of it. Other factors, such as a history of trauma, co-occurring mental health disorders, biological and environmental factors, and whether or not a person receives medical care during detox, can also influence the length and intensity of symptoms a person experiences during opiate withdrawal.

The general timeline for opiate withdrawal can be divided up into three stages: early, peak period, and late withdrawal.

Three Stages of Opiate Withdrawal

Stage 1: Early Withdrawal (6-30 hours)

 

Stages of Opiate Withdrawal | Recovery By The Sea

The first stage of withdrawal typically begins within 6-12 hours after cessation of use for short-acting opiates such as heroin, and within 30 hours for long-acting prescription opiates such as oxycodone.

Those who are undergoing the early stage of withdrawal will begin to encounter a set of uncomfortable physical and psychological symptoms. Symptoms that manifest during this time can generally be expected to worsen over the next 24-48 hours.

Early withdrawal symptoms may include the following:

  • Bone and muscle pain
  • Insomnia
  • Sweats
  • Loss of appetite
  • Rapid heart rate
  • Runny nose
  • Watery eyes
  • Increased blood pressure
  • Anxiety
  • Fever

Stage 2: Peak Period (72 hours)

Peak withdrawal symptoms may be expected to onset about 72 hours after the last use of the drug. It is within this stage that symptoms are at their most severe, reach their peak, and can persist for up to five days after they begin.

Many of the symptoms experienced during this period are flu-like and can result in dehydration and a loss of appetite. For a person to keep their strength during this time, it is essential to maintain satisfactory levels of hydration and nutrition. Solid foods and some fluids may be difficult to consume, and therefore those undergoing withdrawal should drink plenty of water and eat softer foods or take liquid nutritional supplements.

Late withdrawal symptoms may include the following:

  • Stomach cramps
  • Diarrhea
  • Nausea
  • Vomiting
  • Depression
  • Goosebumps
  • Chills
  • Intense drug cravings

Stage 3: Late Withdrawal (72+ Hours)

It is in this final stage of opiate withdrawal that physical symptoms and some of the more severe psychological symptoms will begin to subside. But instead of being in the clear, the person undergoing withdrawal and those supporting him or her will need to be cautious and watch for persisting symptoms. The first few days following the general cessation of symptoms still require monitoring and gentle and patient care.

Opiate abuse and addiction can be complicated and may be associated with psychological or emotional needs that make maintaining addiction recovery more challenging beyond the intense initial stages of withdrawal. While the flu-like symptoms, aches and pains, and other physical effects of withdrawal will have likely subsided by this point, drug cravings and persisting feelings of restlessness, anxiety, depression, and insomnia may still linger.

The length of time a person experiences these persisting symptoms can vary between individuals. While detox is the first step need to overcome opiate addiction, additional care is usually required to help the person sustain abstinence from drug use.

There are multiple treatment options that may be beneficial following detox, including psychotherapy, counseling, medication-assisted therapy (MAT), and group support as recommended based on the unique needs of the individual. If you are investigating which treatment options may be most appropriate or necessary following detox, coordination with a trained addiction treatment specialist may be indispensable to determine what course of treatment will be best for you or your loved one.

Medications for Opiate Withdrawal

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Many people are suspicious of the idea of using other prescription drugs to help treat the symptoms of opiate withdrawal. However, experts have found that medication-assisted therapy (MAT) can prove beneficial for many people undergoing opiate detox.

In fact, rather than serving as a total replacement for an opiate or opioid drug, certain FDA-approved medications, such as buprenorphine, naltrexone, and Suboxone, can be used to ease psychological cravings and withdrawal symptoms commonly encountered by those with a dependence on opioids.

Health providers may prescribe medications as necessary to provide a safer and more beneficial experience that will support a person as they endure the stages of detox. Additional treatment may also be needed to address the emotional aspects of the addiction, including co-occurring disorders such as anxiety or depression.

Getting Help for Opiate Withdrawal And Addiction

Willingness and motivation to take the first steps toward quitting opiates is one of the most significant points of progress in recovery, and, fortunately, it is not an endeavor that has to be undertaken alone. Withdrawing from addictive substances such as opiates can be a stressful and even potentially dangerous process.

Whether you or a loved one are struggling with opiate addiction, there is help available Recovery by the Sea employs trained and compassionate staff who offer resources and tools vital to recovery. We are dedicated to helping people in desperate need of treatment to achieve abstinence and develop skills that will help them maintain long-term sobriety and wellness.

Contact our specialists today to discuss opiate addiction treatment options. Discover how we help people free themselves from the clutches of addiction and learn how to foster healthy and fulfilling lives!

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Opiate Drugs and Addiction

Opiate Drugs and Addiction | Recovery By The Sea

Opiate Drugs and Addiction – Opiates are intoxicating, potentially addictive substances that occur naturally and have painkilling and depressant properties. All opiates are classified as controlled substances in the United States.

Opiates Defined

Opiates are compounds procured from the opium poppy, Papaver somniferum. They have potent medicinal properties and are used for pain relief, cough suppression, antidiarrheals, and sedation. The three main alkaloids derived from opium include the following:

Morphine

Morphine is the most abundant compound in opium and has also been the most commonly used for medical purposes. Morphine is used primarily to manage pain and has also been essential for deriving many semisynthetic medications, such as hydromorphone.

Heroin is also derived from morphine and is chemically similar. Heroin is technically classified as a semi-synthetic opiate, as there are synthetic processes involved in producing the heroin that is sold on the streets.

Codeine

Codeine is an alkaloid found in lesser concentrations than morphine, but it is also an important compound used to derive other semi-synthetic pharmaceuticals. In addition to analgesia, codeine is used as a prescription cough suppressant.

Thebaine

Thebaine is considered to be the most toxic of the opium compounds, but it is used to produce important semi-synthetic medications, such as oxycodone and hydrocodone.

Opioids Defined

The term “opioid” refers to any compound, natural or synthetic, that binds to opioid receptors in the brain and body. These receptors are proteins in the brain, spinal cord, and digestive tract that interact with compounds produced naturally in the body (endogenous opioids). Opioids not created in the body that may be consumed, injected, snorted, or inhaled act on the same receptors and induce similar effects, albeit much more intense.

What Are Semi-Synthetic and Synthetic Opioids?

As noted, in addition to natural opiates, there are semi-synthetic and synthetic opioids. If a substance is entirely synthetic, it is technically an opioid and not an opiate.

Semi-synthetic opioids are partially derived from opium alkaloids. Synthetic opioids, though, are completely human-made. Still, these drugs all act on the brain and body in the same way as opiates, and also all have a high potential for physical dependence and addiction.

Semi-synthetic opioids include the following:

  • Hydrocodone
  • Oxycodone
  • Hydromorphone
  • Oxymorphone
  • Buprenorphine

Fully synthetic opioids include tramadol, fentanyl, and methadone.

It’s important to point out that there is no distinction in the many of risks associated with these drugs. Morphine, heroin, and synthesized opioids all pose similar risks for users. The most significant risks involve extremely potent opioids such as fentanyl, which even in tiny amounts can result in rapid, life-threatening overdose.

Addiction to Opiate Drugs

Risks of using opiates or opioids include physical dependence and addiction due to the way in which they interact with opioid receptors in the central nervous system. All forms of opioids and opiates, whether natural or synthetic, attach to opioid receptors, induce pain relief and sedation, and create a sense of intense well-being or euphoria.

Opiate Drugs and Addiction | Recovery By The Sea

Effects of Opioid Abuse and Addiction

Common side effects of opioid use include the following:

  • Fatigue
  • Constipation
  • Breathlessness
  • A sense of elation
  • Bronchospasms
  • Chemical dependence
  • Nausea
  • Vomiting
  • Confusion
  • Slurred speech
  • Chest pain
  • Depressed respiration
  • Loss of consciousness
  • Coma
  • Death

Dependence occurs as the body becomes accustomed to the presence of certain substances, and can no longer function normally without them. As a result, people who could previously control their use begin to engage in compulsive drug-seeking behavior in an attempt to forestall highly unpleasant withdrawal symptoms that manifest as a result of drug discontinuation.

Withdrawal Symptoms

Some of the common withdrawal symptoms associated with discontinuing the use of opioids include the following:

  • Intense cravings
  • Nausea
  • Vomiting
  • Stomach pain
  • Cold sweats and chills
  • Diarrhea
  • Anxiety and agitation
  • Muscle tension
  • Shaking or quivering
  • Sleep disturbances
  • Enlarged pupils
  • Body aches and pains

Overdose

The following are signs of an opioid overdose and should be considered a medical emergency. If someone you know is experiencing these signs/symptoms, call 911 immediately.

  • Awake, but unable to communicate
  • Very slow, shallow, labored, or stopped breathing
  • Pulse (heartbeat) is slow, erratic, or not there at all
  • Cyanosis (bluish skin tone, especially lips or fingernails in lighter skinned people, grayish or ashen skin tone in darker skinned people)
  • Choking sounds or gurgling noise (sometimes referred to as the “death rattle”)
  • Vomiting
  • Body is very limp
  • Face is very pale or clammy
  • Unresponsiveness to outside stimulus
  • Loss of consciousness or coma

Treatment for Addiction to Opiate Drugs

Opioid addiction is a very serious disease, and those suffering are urged to seek professional help as soon as possible. Recovery By The Sea specializes in the treatment of addictions related to opiate drugs and other substances using a comprehensive approach to mental and physical wellness.

Our evidence-based services include those vital to the recovery process, such as behavioral therapy, individual, family, and group counseling, support groups, aftercare planning, and more.

If you or someone you love is struggling with an addiction to opiate drugs, please contact us today to discuss treatment options. Discover how we help people free themselves from the chains of addiction and live long, healthy, and satisfying lives!

Identifying Opioid Use Disorder

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Identifying Opioid Use Disorder – Due to the ongoing opioid epidemic in the U.S., identifying or diagnosing opioid use disorder in individuals has become more critical than ever.

Discovering whether a loved one is engaging in opioid misuse, abuse, or is suffering from an active addiction may be challenging initially. A solid determination can involve many factors that rely on the close observation of signs, symptoms, and behavioral changes.

Opioids Defined

Opioids are prescription or illicit drugs that include hydrocodone, oxycodone, heroin, and fentanyl among many, many others. Doctors often prescribe them legally for treating acute moderate to severe pain. But, due to their highly addictive nature, patients may begin misusing them.

Others commence their opioid abuse with legitimately or illicitly obtained pharmaceuticals, but switch to heroin or other illegal drugs when they can no longer afford or obtain their original drug(s) of choice. And, tragically, many people experiment with heroin, which is more powerful than most prescription opioids and can prove addictive with remarkably little use.

Opioids act on the limbic system, the spinal cord, and brain, where they bind to receptors. These receptors release an excessive amount of neurotransmitters, such as dopamine, that are responsible for feelings of reward and well-being. It doesn’t matter whether we’re talking about prescription medications or illegal street drugs; the principal effect is the same.

The main difference between these kinds of drugs is their potentials for abuse or addiction. The more potent the drug, the higher its addiction potential. Furthermore, the method of administration makes a difference, as well. Swallowing a pill is less likely to rapidly result in tolerance and dependence versus snorting or injecting a powder, which reaches the brain faster and more intensely.

Opioid Use Disorder: Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), an opioid use disorder is defined as problematic opioid use that leads to serious impairment or distress.

Opioid Use Disorder Diagnostic Criteria
To qualify for a diagnosis of opioid use disorder, a person must experience two or more of the following symptoms within a 12-month time period:

1. The substance is used in larger amounts or for a longer time than intended.
2. There is persistent desire or unsuccessful attempts to cut down or control the use of a substance.
3. A considerable amount of time is spent attaining, using, or recovering from substance use.
4. The person is experiencing cravings to use opioids.
5. There is continued opioid use that results in failure to fulfill important obligations at work, school, or home.
6. There is continued opioid use despite recurrent social or interpersonal problems that result from this use.
7. Important social or recreational activities are undervalued in favor of opioid use.
8. There is repeated opioid use in dangerous situations.
9. Opioid use is continued despite physical or psychological problems that develop as a result of use.
10. Tolerance occurs, which is characterized by the need to take higher doses of a drug to experience the desired effects, or a diminished effect from the same amount).
11. Uncomfortable and painful withdrawal symptoms occur upon cessation of drug use.

An opioid use disorder may be considered as mild (2-3 symptoms), moderate (4-5 symptoms), or severe (6 or more symptoms) in nature. A mild disorder may be more indicative of misuse or abuse, whereas a severe disorder would likely be considered full-blown addiction. These disorders exist of a spectrum, however, and like any chronic disease, the severity of symptoms may wax and wane over time.

The terms “abuse” and “addiction” may be thought of as archaic when used alongside the more contemporary concept of “opioid use disorder.” These older terms are simply ways of expressing different levels of problems controlling drug use and the effects they have on one’s health and life.

Signs and Symptoms of Opioid Use Disorder

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In addition to diagnostic criteria, there are other common signs and symptoms of opioid misuse, abuse, or addiction, that may include the following:

  • Impaired vision
  • Gastrointestinal problems
  • Dry mouth and nose
  • Financial and legal problems
  • Track marks (sores near injection sites)
  • Emotional distress caused by strained relationships
  • Anoxia or hypoxia (oxygen deficiency in tissues)
  • Increased risk for suicidal thoughts or attempts

In addition to the aforementioned effects, users also tend to struggle with mental health problems, including depression, anxiety, bipolar disorder, post-traumatic stress disorder, and more.

Dependence and Withdrawal

Substance addiction alters the way in which a person’s brain functions, particularly the reward behavior circuits in your brain. For long-term users, drug use impacts the entire body. Over time, chronic use leads to dependence or a condition characterized by the body’s inability to function normally without exposure to the drug.

When a dependent person tries to cut back or stops using abruptly, they will experience unpleasant withdrawal symptoms, such as the following:

  • Chills
  • Depression
  • Agitation
  • Anxiety
  • Drug cravings
  • Diarrhea and abdominal pain
  • Nausea and vomiting
  • Body aches and pain

The intensity and duration of withdrawal symptoms vary between individuals and largely depends on the length and severity of use, in addition to other factors. The withdrawal process can be very harrowing to endure and can last for several days.

The Treatment Process

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Most addiction treatment centers, such as Recovery By The Sea, customized their treatment plans to meet each patient’s unique needs and consider the history of drug abuse as well as mental and physical health. If you or a medical/mental health professional has identified problematic opioid use by a loved one, it is probably time to look into treatment options.

Treatments take different forms, can last for varying periods, and can take place in a variety of settings. However, comprehensive medical care that takes place over a prolonged period has been clinically shown to be related to better outcomes for persons in recovery.

For many, willpower is not enough to sustain long-term sobriety, and thanks to modern medicine, it doesn’t have to be. There is medication available, such as Suboxone, that treats opioid use disorder by reducing withdrawal symptoms and cravings. Drugs such as these have been shown to be extremely helpful for preventing relapse and improving the overall well-being of the person in recovery.

With the addition of psychotherapy and professional counseling, the chances of succeeding have vastly improved over the last few decades. Following medical treatment, thousands of people continue to be helped by traditional approaches to recovery maintenance such as 12-step programs and holistic mind-body connection strategies like mindfulness.

Get Help Today

An opioid use disorder is not a sign of moral decay or weakness – it is a chronic and serious medical condition characterized by changes in the brain due to extended drug use. Breaking free of addiction is a long and sometimes arduous process that requires patience, focus, and tremendous support from medical and mental health professionals and loved ones.

Recovery by the Sea employs highly-skilled addiction specialists who deliver comprehensive, evidence-based services to clients with care and expertise. We are dedicated to providing clients with the tools, resources, and support they so urgently need to achieve abstinence and begin their journey to long-lasting wellness and sobriety.

If you or a loved one is struggling with an opioid use disorder, please contact us today to discuss treatment options and find out how we can help!

What are Narcotic Drugs?

Narcotic Drugs | Recovery by the Sea

Narcotic drugs, also known as narcotic analgesics, opioids, or painkillers are used primarily for the treatment of moderate-severe acute (short-term) pain, such as that experienced following an injury or surgery. They are also sometimes used to relieve chronic pain, such as in the case of cancer or palliative care, and can also treat diarrhea and coughing.

Some narcotic drugs such as oxycodone and codeine are legal if they are obtained through a prescription. However, these drugs are commonly diverted for their pain-relieving, feel-good effects. They are also found in completely illicit versions on the black market (e.g. heroin and fentanyl.)

Regardless of their origin, all narcotics have a high potential for abuse, addiction, and overdose. For this reason, they are considered very dangerous when not administered as prescribed under the care of a physician. In a nutshell, narcotics are depressant drugs that dull pain but can also impair cognition and senses, cause sedation, and slow autonomic functions of the central nervous system to a life-threatening extent.

Although the word narcotic tends to have a negative connotation regarding the illegal drugs associated with it, it is also a standard term used in health care. From one to another, narcotic analgesics vary in their ingredients, strengths, dosages, and cost. Many are taken orally as tablets, capsules, or liquids, while others can be injected or administered as a transdermal patch.

List of Narcotic Drugs

The following is an extensive list of both prescription and legal narcotic drugs.

Opium

Opium is the raw, natural foundation for all narcotics. It is derived from the somniferum papaver poppy plant and contains several opiate alkaloids including morphine, codeine, and thebaine. These chemicals have pain-relieving properties and are also the basis for many modern drugs, including oxycodone (thebaine) and heroin (morphine.)

Opium is not as commonly abused in the United States as derived opiates and opioids due to its limited availability as a natural substance, although it is classified as a Schedule I drug per the Drug Enforcement Administration (DEA.) However, when it is encountered, it is usually found as a brownish powder and can be smoked, drank as a tea, taken in pill form, or injected.

Morphine (MS Contin, Kadian, and Arymo ER)

Morphine, as noted above, is an opiate derived directly from the opium poppy that is used as an analgesic for the treatment of both acute and chronic pain, and is also used as a sedative before surgical procedures. Morphine is considered to be one of the most effective pain relievers on the market and is available in oral solutions, tablets, suppositories, and injection preparations.

Is the U.S, morphine is not misused nearly as often as heroin and prescription opioids, but still has a high potential for addiction and is most often abused via injection by those dependent on opioids.

Codeine

Codeine is used as an analgesic and cough suppressant, but for pain, is widely considered to be less effective than morphine. In the U.S., codeine is only available in generic form or in combination products, such as Tylenol with codeine.

Codeine is generally thought to be less addictive than many more potent narcotics – that said, however, it still has the potential for abuse, dependence, addiction, and overdose.

Heroin

is heroin a stimulant

Heroin is an illicit, semi-synthetic opiate, and like opium is heroin is classified as a Schedule I controlled substance in the U.S., as it has no accepted medical use and a high potential for abuse and addiction.

It is commonly distributed as a brown-to-white powder or a less pure version known as “black tar heroin” which resembles a dark sticky tar-like substance.

Heroin can be snorted, smoked, or injected. Heroin creates a very intense and rapid rush of euphoria, but can also cause extreme sedation. Therefore, users often cycle between an awake and unconscious state, also known as being “on the nod.”

Overdose deaths due to heroin and its far more potent cousin fentanyl (see below) have increased dramatically since the turn of the century, and are involved in tens of thousands of deaths each year.

A heroin overdose is a medical emergency and is characterized by labored/difficult breathing, stupor, lethargy, confusion, clammy/cold skin, slow heart rate and blood pressure, a bluish tinge (cyanosis) to the nails and lips, and potentially, a complete loss of consciousness.

Oxycodone (OxyContin, Percocet)

Oxycodone is an effective painkiller for moderate to severe pain, but if used for longer than a few days or abused, however, can quickly result in drug tolerance and dependence. Oxycodone is generally dispensed in tablet form and may be combined with an over-the-counter analgesic, such as acetaminophen.

Oxycodone is a Schedule II controlled substance, meaning that it does have an approved medical use. However, it is also commonly abused – in fact, OxyContin (and other oxycodone products) contain a black-box warning concerning their high diversion (theft), abuse, dependence, addiction, and overdose potential.

Oxycodone pills/tablets can be crushed and the powder can be snorted, smoked, or injected. These methods increase the effects of oxycodone, but also increase the risk of addiction and overdose.

Hydrocodone (Vicodin, Norco, Lortab)

Prescription Drugs | Recovery By The Sea Addiction Treatment

Hydrocodone is an effective painkiller and the #1 prescribed and most often diverted and abused opioid drug. Prescribed in tablets, capsules, and syrups, hydrocodone medications can be swallowed, snorted, smoked, or injected.

The DEA has warned that hydrocodone is one of the top drugs found to be involved with prescription opioid overdose deaths, and it is considered to have a high potential for addiction. It is also frequently found in combination formulations with acetaminophen (Norco, Vicodin) which increases the risk of health complications when abused.

Hydromorphone (Dilaudid and Exalgo)

Another Schedule II narcotic derived from morphine, hydromorphone is dispensed in tablets, vials, suppositories, and injectables. The drug is frequently diverted via “doctor shopping” – e.g., forged prescriptions and sketchy prescribers – and through pharmacy and nursing home theft.

When abused, hydromorphone can be smoked, snorted, swallowed, and injected. It is very potent, highly addictive, and has a carries a significant potential for overdose when abused.

Meperidine (Demerol)

Demerol is a pain medication marketed as a table or syrup, and abuse often begins with a legitimate prescription for pain. A patient using Demerol for severe pain may become tolerant to prescribed doses and begin to escalate use (and evolve into abuse.)

Even when Demerol is used as directed with a prescription, a patient can become dependent on the drug and experience withdrawal symptoms when they attempt to quit – therefore, it can be challenging to stop using Demerol, resulting in misuse/abuse and addiction.

Methadone (Dolophine, Methadose)

Methadone is an opioid analgesic, although it is frequently prescribed for opioid dependence and detox as a replacement for faster-acting, more potent opioids such as heroin. It can be dispensed as a pill, wafer, or in liquid form, often administered through federally-regulated clinics.

Methadone is one of the longer-acting opioid agonists, as it remains active in the bloodstream for close to a full day. This means that it can be prescribed in lower doses and less often than other narcotics for the management of opioid withdrawal symptoms.

Buprenorphine (Subutex, Buprenex, Butrans, Probuphine and Suboxone, Zubsolv, and Bunavail)

Buprenorphine is a long-acting, partial opioid agonist drug approved by the Food and Drug Administration to treat opioid dependence, both on its own and included in buprenorphine/naloxone formulations such as Suboxone. However, it can still be abused and has a potential for dependence.

The inclusion of naloxone in combination with buprenorphine products acts as an abuse-deterrent. Moreover, naloxone is an antagonist drug – if buprenorphine combination products are altered for abuse, effects of the opioid agonist are blocked.

Tramadol (ConZip, Ultram, and Ryzolt)

Narcotic Drugs | Recovery by the Sea

Tramadol is a different kind of narcotic analgesic. It not only has opioid agonist effects but also blocks the reabsorption of norepinephrine and serotonin for additional painkilling properties.

Although Tramadol is considered to have a relatively low potential for abuse and addiction, it is still a controlled substance and those who are already dependent on opioids and chronic pain sufferers may be more likely to abuse it.

Fentanyl (Actiq, Fentora, Duragesic, Subsys, Abstral) and Carfentanil

Fentanyl is a very potent narcotic (up to 50 times more potent than heroin) prescribed for the treatment of chronic and severe pain in those who are tolerant to other opioids. As a prescription, is it often administered as a transdermal patch. In a hospital setting, it is also used for general anesthesia.

On the black market, fentanyl is not usually a product of drug diversion, however. Rather, it is illicitly made in Chinese labs and frequently cut into other drugs such as heroin to increase the potency of the product and maximize profits. It the last few years, it has been involved in an escalating number of overdose deaths, now numbering in the thousands each year.

Carfentanil is similar to fentanyl but 100 times more potent. It is not indicated for any medical use in humans, and in the U.S. is only used by large animal handlers for sedation. The drug can be lethal to adults in tiny doses of two milligrams or less and is extremely dangerous to even handle it, less alone consume it.

Treatment for Addiction to Narcotic Drugs

After detox, narcotic drug addiction is most effectively using a comprehensive, evidence-based approach that includes behavioral therapy, counseling, and group support. Our center offers these therapeutic services in inpatient, partial hospitalization, and outpatient formats.

Our professional medical and mental health staff specialize in addiction and can provide clients with the knowledge and tools they need to recover and enjoy long lasting sobriety and wellness. Recovery from addiction is a lifelong endeavor, but you don’t have to do it alone.

Addiction to Opiates

Addiction to Opiates | Recovery by the Sea

Addiction to Opiates – Opiates are alkaloid compounds that occur naturally in the opium poppy (Papaver somniferum.) For medicinal purposes, three psychoactive chemicals are isolated – morphine, codeine, and thebaine.

Due to their analgesic (pain relieving) properties and interactions on the brain’s reward system, opiates have a high potential for abuse and addiction. According to the National Institute on Drug Abuse (NIDA), more than two million people in the U.S. and between 26.4-36 million globally abuse opioids.

For this reason, the Drug Enforcement Agency has placed them on the list of controlled substances as Schedule II drugs, meaning that despite dangers associated with their use they do serve a legitimate medical purpose.

Opioids are partially or wholly synthetic, human-made versions of opiates. They include illicit street drugs such as heroin, as well as prescription painkillers such as oxycodone and hydrocodone. Opiates and opioids, as technically defined, are different in that they are natural versus synthetic. However, the two are often referred to interchangeably because they bind to the same brain receptors and result in strikingly similar effects.

Prescription opioids, such as Valium, are indicated for the treatment of acute moderate-severe pain, such as following an injury or surgery. These drugs have often been used to treat chronic pain, despite the threat of addiction that tends to develop with long-term use.

Addiction to Opioids: How They Work

Addiction to Opiates | Recovery by the Sea

Opioids are chemicals that provide pain relief by connecting to corresponding receptors in the brains of living beings. Once attached, these cells transmit signals that mitigate feelings of pain and increase feelings of general well-being.

Moreover, opioids modify one’s perception of pain more than they truly numb or block it,. Over time, however, this effect can result in a condition known as hyperalgesia, which is characterized by increased sensitivity to pain.

In addition to desirable effects, opiates and opioids can also result in adverse side effects, such as constipation, drowsiness, and nausea and vomiting. Long-term use also greatly increases the risk of dependency, tolerance, and abuse.

Addiction to Opiates: Why They are so Dangerous

When used long-term opioids can become addictive. Addiction is fueled by dependence (withdrawal symptoms that manifest upon cessation) and tolerance (increasing amounts of the drugs are needed to produce the same effect.)

The former (dependence) decreases one’s desire to quit or cut back, due primarily to cravings and unpleasant side effects upon suspension of use. Withdrawal symptoms may include the following:

  • Low energy
  • Irritability and agitation
  • Anxiety
  • Depression
  • Insomnia
  • Runny nose, Teary eyes
  • Hot and cold sweats,
  • Goosebumps and chills
  • Yawning
  • Muscle aches and pains
  • Abdominal cramping
  • Nausea and Vomiting
  • Diarrhea
  • General malaise

The latter (tolerance) compels users to take higher doses, which has the potential to result in life-threatening central nervous system (CNS) depression, a condition characterized by a slowed or impaired respiratory rate and heartbeat.

Also, when used in conjunction with alcohol, benzodiazepines, or other CNS depressants, the sedative effect of opioids is exponentially greater than when used alone. The impact of the other substances is also intensified, as well – meaning the risk of overdose and death is significantly higher.

Finally, the overuse of opioids, especially when combined with alcohol or other drugs, raises the risk of overdose or injury to oneself and others when operating a vehicle or equipment.

Addiction to Opiates: Symptoms of an Opioid Overdose

  • Vomiting, dry heaving, and gurgling noises
  • Delirium and confusion
  • Limpness, weakness, impaired or incapacitated motor functions
  • Cyanosis – purple or bluish skin, fingernails and lips
  • Labored or profoundly slow breathing
  • Unconsciousness and unresponsiveness
  • Coma
  • Respiratory arrest
  • Death

An opioid overdose is a medical emergency and requires an immediate dose of naloxone. If you or someone you know is experiencing the above symptoms related to opioid use, please call 911 immediately.

Treatment for Addiction to Opiates

Addiction to Opiates | Recovery by the Sea

Opiate addiction is a serious and life-threatening condition that is best treated by a long-term substance abuse recovery program. Before intensive treatment begins, patients should undergo a medical detox, a process in which the person is supervised around-the-clock by medical staff and monitored/medicated for severe symptoms of withdrawal.

After detox, persons are urged to participate in residential (inpatient) rehab for at least 30 days. During this treatment program, patients receive medical care, therapy, and counseling while meeting with physicians, addiction specialists and peer support groups.

After discharge from rehab, many opt for intensive outpatient treatment, which offers many of the same supportive recovery services as inpatient treatment but offers the person more flexibility to attend to critical responsibilities such as work and school while they transition back to the outside world.

Toward the end of treatment, we provide aftercare planning services to patients to help them locate medical and mental health resources outside of the center. We also host alumni activities which foster ongoing peer interaction and support.

Through participation in a comprehensive, long-term evidence-based treatment program, you can learn the skills you need to maintain sobriety and ultimately regain the happy, fulfilling life you deserve.

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