What often begins with legal prescriptions to relieve chronic pain, opioid misuse by two million people in the United States is now an alarming crisis. For example, studies reveal about 90 people a day die from an opioid overdose. Unknowingly, the legal prescription of an opioid medication can be the initial starting point of the opioid abuse stages of misuse, abuse, tolerance, and dependence on the drugs. Consequently, how the problems with misuse or abuse begin is unclear, but certain risk factors generate a higher probability of developing a substance use disorder with opioid medication.
Common opioid pain relievers are hydrocodone or oxycodone are legal prescriptions. In addition, illegal opioid drugs such as heroin, prescription pills, illicit fentanyl, and other substances are illegal and for sale on the streets. Opioid pain relievers may have annoying side effects for some people, which cause them to reject their use. Unfortunately, the results of opioids are pleasurable for some, which leads them to take more and build tolerance and dependence.
Types of Opioids
Opioids interact directly with nerve cells in the brain, spinal cord, digestive tract, and other places once they enter the body. However, activating the release of endorphins, which reduce pain and create pleasurable feelings, remains an effective pain treatment. When understanding the opioid abuse stages, it is essential to link the effect of pleasant feelings with the temptation to take a higher dosage. Furthermore, investigating the types of opioids and how their production methods are valuable knowledge.
Medical professionals, pharmacologists, and chemists classify opioids in several ways. The manufacturing process is a simple way to distinguish differences. Other elements, such as frequency or medication dosage, can be considered, such as short- and long-term effectiveness. Healthcare providers determine the type of opioid to prescribe when treating short-term pain control and chronic pain issues.
The following determinants help to classify opioids through their production:
- Natural opioids come from the opium poppy plant. Morphine, opium, and heroin fall into this category. Morphine is used to treat medium to severe short-term pain, and Morphine extended-release (MS Contin) for chronic pain.
- Synthetic opioids are created in a lab through chemical processes. Fentanyl and methadone are examples of synthetic opioids. Methadone (Methadone HCl Intensol) is often a prescription for long-term chronic pain. Fentanyl is 50 to 100 times more powerful than morphine. Pharmaceutical fentanyl was originally a treatment to manage pain in cancer patients.
- Semi-synthetic opioids are made from opium plants going through a chemical modification. Oxycodone and hydrocodone are the treatment for short-term acute pain. Their extended-release forms are for the treatment of chronic pain. Hydromorphone (Dilaudid) is for moderate to acute short-term pain treatment.
Stage 1: An Opioid Tolerance
Repeated usage of opioids over a while begins to change the delicate balance of brain chemistry. Tolerance describes the process involving the brain getting used to opioids and adjusting the levels of endorphins it has to produce. To maintain the level of pleasure and pain relief one desires, larger dosages of the drugs are needed. Increasing potency and frequency of opioid usage involves misuse and the next level in the opioid abuse stages.
Stage 2: An Opioid Dependence
In the additional opioid abuse stages, dependence occurs after tolerance is present, indicating misuse has taken a turn to abuse. Abuse refers to using medications other than how a doctor prescribes them.
Once the body and mind depend on opioids to function, the addiction stage is next. Once dependence is apparent, withdrawal symptoms will occur if opioid dosages do not maintain or increase. If dosages lessen, unpleasant physical and mental withdrawal symptoms can push users to a higher level of intensity.
Common opioid withdrawal symptoms can include any of the following:
- Muscle pain or severe cramps
- Chills
- Nausea, vomiting, and diarrhea
- Anxiety and restlessness
- Insomnia
- Cravings and urges
- Dilated pupils
Stage 3: Opioid Abuse Stages and Addiction
Opioid use disorders involve addiction, which is an illness that requires treatment. Therefore, moving through the opioid abuse stages of tolerance and dependence to the addiction stage brings new challenges. Addiction indicates the loss of the ability to control decision-making skills for self-control. Finally, the loss of judgment or impulse control is a criterion healthcare providers use to diagnose addiction or a substance use disorder.
Healthcare providers look for the following signs, symptoms, and behaviors when assessing opioid use disorders. Almost 20% of people using prescription opioid medications for chronic pain develop an opioid use disorder.
Signs and symptoms of opioid use disorder include any of the following:
- A slow increase in frequency and dosage of a legal opioid prescription
- An inability to decrease dosages or stop using opioids
- Increased drug-seeking behaviors
- Increasing intensity of cravings for opioid drugs
- Opioid medications begin to interfere with lifestyle responsibilities
- Denial of a problem if family or friends bring up the changes they see
- Practice risky behaviors without clear judgments for safety
- Acknowledgment that mental or physical symptoms are beginning from opioid misuse or abuse, but cannot stop using
- Developing tolerance for opioids
- Experience withdrawal symptoms when trying to stop or decrease usage
Final Stage: Opioid Withdrawal
Once an opioid use disorder is present, it is dangerous to try to quit taking opioids cold turkey alone without a good detox program. The opioid abuse stages of misuse, abuse, tolerance, and dependence take time. Once the drugs affect the brain’s chemistry, medically monitored detox is strongly recommended. Tapering is recommended for most people developing opioid abuse, but detox is a wise choice once a substance use disorder develops.
The following signs and symptoms are opioid withdrawal symptoms to watch for:
- Runny nose, sniffling, watery eyes, and continual yawning
- Feeling restless or anxious
- Feeling irritable and moody
- Experiencing an increase in chronic pain
- Sweating, goosebumps, and chills
- Stomach cramps and digestive issues
- Muscle pain and cramping
- Tremors
- Rapid heart rate and blood pressure fluctuations
- Difficulty sleeping
- Suicidal thoughts
Get the Treatment You Deserve for An Opioid Use Disorder at Freeman Recovery
What begins as a treatment regimen for chronic pain can end in an opioid use disorder without intention. Freeman Recovery Center in Tennessee recognizes and understands accidental opioid addiction. Our compassionate treatment professionals realize fear of experiencing chronic pain again without the help of opioids is frightening.
Contact us for answers to your questions about detox and begin to feel hope for a healthier future.
