Understanding Opioid Use Disorder
This is a medical condition, not a character flaw. Here is what that actually means, and the signs that it may be time to ask for help.
Substance use disorders (SUDs) are chronic, relapsing disorders that typically demonstrate a strong compulsive drive to take a drug despite adverse consequences, a loss of control over intake, and the development of a negative emotional state during abstinence or withdrawal.
Societal and cultural views are often still attached to a belief that the stereotypical behaviors associated with addiction reflect a character or moral flaw, or are a matter of choice. Evidence shows these behavioral trends can be explained by specific changes in the brain, triggered by the frequent use of addictive substances.
The emergence of a substance use disorder involves complex interactions between sociologic and biological factors, often including a genetic vulnerability. Because of that nature, SUDs are best treated with a multi-modal approach, often combining complementary pharmacological and behavioral interventions.
Opiates and opioids
Opiates refer specifically to naturally occurring compounds derived from the poppy plant, such as morphine. Opioids is a broader term, encompassing both naturally occurring and laboratory-derived substances, including synthetic and semi-synthetic agents.
These all share a dangerously high potential for addiction or misuse. Data shows they are sometimes mixed with additional agents to enhance their effects, such as xylazine, which also heightens the potential risks and side effects. We have additionally seen the impact of atypical agents such as tianeptine, designer benzodiazepines, cathinones, hallucinogens, and kratom.
How it often begins
Though some patients begin use recreationally, it is not uncommon for initial exposure to follow a legitimate prescription for pain relief after an illness, an injury, or a surgical procedure, including orthopedic or dental interventions. A tendency toward misuse can develop as more frequent use is needed and tolerance increases.
People living with opiate use disorder typically demonstrate predictable behavioral and physical signs of misuse, so those close to them should be aware of these as a signal that help may be needed.
Signs that help may be needed
Every person is different, and physical signs may vary between the use phase and the withdrawal phase.
Common physical signs
- Drowsiness, slurred speech
- Fatigue, lack of energy
- Shallow breathing
- Poor coordination
- Constipation
- Nausea, vomiting, diarrhea
- Sweats, chills, runny nose, watery eyes
- Body aches, tremors
- “Track marks” at IV use sites
- Restlessness, insomnia
Classic behavioral signs
- Impaired memory or attention; irritability
- Mood swings
- Poor performance or attendance at work or school
- Shifts in daily habits or routines
- Loss of interest in hobbies and activities
- Isolation or secrecy
- A change in social circle or friend groups
- Neglecting personal hygiene and appearance
- “Doctor shopping”
- Financial trouble; unexplained requests for money
These are a signal that help may be needed, nothing more than that. If you are seeing them in yourself or in someone close to you, you are welcome to call us.
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