Opioids (also known as painkillers) are a classification of drugs that are primarily used for pain relief. When prescribed by a physician, opioids can provide relief for patients with chronic or acute pain. While opioids are effective at managing pain, it can lead to dependency, particularly if used beyond prescription. Opioid dependency is a serious problem not just in Australia, but internationally as well. In 2018, opioids accounted for 3 deaths per day due to unintentional overdoses of pharmaceutical opioids such as codeine, morphine, oxycodone, and methadone.

In this article, we’ll be discussing the risk factors involved in opioid dependency as well as the signs and symptoms associated with it to promote appropriate use of these powerful medications.

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Risk factors

Prescription painkillers share a similar chemical makeup with heroin (which is a highly addictive substance), thus putting people at risk of dependency if not careful with usage. According to the Centers for Disease and Control Prevention (CDC), patients who undergo long-term opioid therapy for non-cancerous pain are at an increased risk of developing opioid dependency by up to 25%. The following are some of the risk factors that can make patients more vulnerable to developing painkiller addiction:

  • Overlapping of prescriptions from multiple physicians and pharmacies
  • History of substance abuse problems
  • History of mental illness
  • Exceedingly high daily dosages

In some states, regulations on painkillers are quite lax, leading people to obtain them more easily and further amplify the risk factors for opioid dependency. Opioid misuse can also contribute to heroin addiction, with some patients switching from prescription painkillers to heroin since it’s easier to acquire.

Signs and symptoms

Opioid dependence can develop quickly due to the body being accustomed to the dull sensation the drugs provide. Upon finishing a prescription, some patients may experience withdrawal symptoms, especially if they use painkillers in very high dosages. Without the painkillers, the patient may feel much worse and become even more sensitive to pain. They may also experience bouts of stress, anxiety, muscle cramping and aches, nausea, and vomiting.

Instead of going to the physician for medical care, some people choose to self-medicate by continuing their use of painkillers long after their prescriptions are over. The following behavioural changes are symptoms of a developing opioid dependency:

  • Taking in painkillers in greater amounts exceeding prescription
  • Combining opioids with other substances such as alcohol, illegal drugs, and other pharmaceuticals whether be over-the-counter or prescribed
  • Acquiring painkillers by visiting multiple pharmacies/physicians
  • Unexplained mood swings due to lack of opioid use

If you or your loved one is experiencing these symptoms, don’t delay and seek professional help immediately. Prolonged painkiller abuse can lead to life-threatening conditions and in worse cases, death. The signs of opioid overdose are:

  • Extremely pale face that feels clammy to the touch
  • Body suddenly goes limp
  • Fingernails and/or lips appear purplish or bluish
  • Frequent vomiting and making gurgling noises
  • Unable to speak properly
  • Difficulty being awakened
  • Breathing or heartbeat slows down or stops

Treatment options

There are a number of treatment options available for opioid dependency. These options include:

  1. Medication

Methadone (Methadose, Dolophine) is a long-acting opioid that affects the same parts of your as the drug you’re having a problem with does, but it doesn’t get you high. You can take it every day, but you have to go to a special clinic to get it. The correct dose prevents withdrawal symptoms and eases drug cravings.

Buprenorphine is a shorter acting drug than methadone. It hits the same receptors in your brain, but not as strongly. It has less risk of lethal overdose, so it is often favored for treatment. It is also available in combination with naloxone.

Naltrexone also blocks opiate receptors. Unlike methadone, it can’t ease withdrawal symptoms or cravings. But you can’t get high if you use drugs while taking it. Naltrexone works best as part of a broad recovery treatment program.

Lofexidine hydrochloride (Lucemyra) is not an opioid but it can be used to ease the symptoms when there needs to be a rapid detoxification. It has been approved for use for up to 14 days.

Any medication program has a far higher chance of success when coupled with counselling or talk therapy. 

  1. Behavioural counselling and therapy

Behavioural counselling can help patients cope with opioid dependency by developing healthier habits, assist in complying with other forms of treatment, and shift their attitude and behaviour towards opioid use. Individual counselling, cognitive behavioural therapy (CBT), and motivational enhancement therapy are some of the examples of behaviour counselling to address opioid dependency.

Group/family counselling can also prove beneficial for patients who feel more comfortable when surrounded with friends and family. A professional will recommend the best form of behavioural counselling that best suits the needs of the patient.

  1. Residential and hospital-based treatments

Residential programs combine opioid dependency treatment with residential housing services. The patient undergoes a rehabilitation program in a specialised facility where they are away from familiar triggers, temptations, or distractions to help increase their chances of success.

Hospital-based treatments on the other hand, combine opioid dependency treatment with hospital services. If the patient has other medical needs, these will be addressed as well. Hospitals may also offer outpatient treatment for patients who wish to undergo recovery but don’t want to be admitted in the hospital.

These types of treatments are very structured and are geared towards complete recovery from opioid dependence. They include different kinds of counselling and behavioural therapies to go along with scientifically-proven programs to provide the best chance of success.

Opioids are powerful medications and while these drugs can prove beneficial for pain relief, they can also bring unfavourable consequences if misused. Opioid dependency is a widespread problem for many patients and if not addressed, can encourage the use of more harmful drugs like heroin. Hopefully with this information, you’ll be able to reduce your risk of opioid dependency and use painkillers responsibly.

Remember, it is never too late to seek help. Don’t ignore the signs of opioid dependency and reach out to a professional as soon as possible. Get in touch with Calm rehab today, a leading drug and alcohol rehab center in Bali for more information.

Christmas parties, carol singers, roast turkey and Christmas cheer… most people think of Christmas and New Year as a happy and festive time, but that may not be the reality for many people in active addiction or early recovery.

There are many triggers associated with this time of year. Triggers are very personal as different things affect different people, however for many people financial fear is undoubtedly a major one. Families coming together can also cause increased stress that for some individuals, may become unbearable. 

Daily routines are commonly put on hold at this time of year leaving you vulnerable and at risk, often with much more time on your hands than you are used to. 

There are lots of factors that can lead to you being in a high risk or stressful situation while in recovery, and this is also the case if you are a functioning addict. These situations could mean an increase in using behaviours which can result in heightened tensions around the home. 

Add to that family coming to stay, excessive drinking, possible long term resentments coming to the surface and you have the potential for a crisis.

With all this in mind it is good to prepare yourself for any upcoming triggers by putting a plan of action in place to prevent reacting badly to triggers, and spiraling out of control. This could be a safe exit plan, a friend on standby or a rethink of your festive plans altogether in order to minimize risk.

Here at Calm we work closely with Dr Reshie Joseph, who has an impressive history working in the field of addiction and have put together a highly experienced & qualified team headed by Matthew Little, who holds his qualifications with the British Association for Counselling and Psychotherapy. The remainder of our team is a mix of highly experienced & qualified staff who have worked at numerous facilities across Asia & Europe, most of which are in recovery themselves & have a passion for helping people. 

We fully understand that things can soon become too much to deal with on your own. If you find yourself at your own personal rock bottom, or are concerned that things are heading in the wrong direction, please don’t hesitate to contact Calm Rehab, the leading drug and alcohol rehab center in Bali.