Opioid abuse in the U.S. has reached levels that officials across the board agree can no longer go unnoticed or untreated. President Donald Trump in 2017 formally declared the opioid crisis a public health emergency, which observers say is an important step in addressing the epidemic of opioid misuse.
An estimated two million people in the United States suffered from substance use disorders related to prescription opioid pain medicines in 2015, according to the National Survey on Drug Use and Health for that year. And data from the report show that treatment admissions linked to these medications more than quadrupled between 2002 and 2012, although only 18 percent received treatment for prescription opioid use disorders.
What Are Opioids?
Opioids are a class of prescription medications that are used to treat moderate-to-severe pain. Drugs in this class, which include the illegal drug heroin, interact and bind with opioid receptors on the nerve cells in the body and brain. They reduce pain messages to the brain and thus the feelings of pain in users.
These medications are intended for short-term use and are considered safe when taken as prescribed by a doctor for a short time. However, the feelings of euphoria and relaxation in addition to pain relief make them easy to misuse and abuse. This means users take more than the quantity prescribed, take them without a prescription, or take them in a way that is inconsistent with how they are supposed to be taken. Even users who have legitimate prescriptions and use the drugs regularly can still develop a dependence on them, and dependence can lead to addiction.
What Happens If Opioid Abuse Continues?
When taken at higher doses than what is therapeutically necessary, opioids produce a strong sense of euphoria. When this happens, the brain is flooded with neurochemicals such as dopamine and serotonin, which activate the reward and pleasure pathways in the brain. This makes the use of opioids pleasurable and reinforces the behavior of taking high doses as the action is associated with pleasure.
Continued opioid abuse over a prolonged time can lead to building a high physical tolerance to the pain relievers. When people take large doses of opioids, they will have more of the drug in their systems than they have opioid receptors with which the drug can bond. However, with prolonged, habitual, and heavy use of the drugs, the brain begins developing additional opioid receptors that can bind with more and more of the drug.
As a result, people who use opioids in this manner will find themselves increasing the dose of the opioid they are taking to achieve the desired effects. At this point, they have developed a dependence and are on the road to an addiction that can lead to overdose or death.
Long-Term Effects of Opioid Abuse for Addicts
The “desired effects” that users set out to get when they abuse opioids harm the body and mind and come with serious, life-threatening risks.
Here are some specific opioids and the long-term effects they can have on users’ physical and mental health.
Codeine – Prolonged use of codeine can cause a number of effects on the body that can lead to death. Respiratory depression, when a person’s breathing becomes shallow or dangerously labored, is possible. Other medical complications include cardiac damage to the body’s vital organs and coma. Using this drug for long periods can quickly cause physical dependence and can lead to addiction.
Fentanyl – This powerful synthetic opioid is estimated to be 80 to 500 times stronger than morphine. DrugAbuse.com warns that first-time users experimenting with this Schedule II drug or using it recreationally are in extreme danger of overdosing on it. Chronic fentanyl use increase users’ risk for significantly damaging decreased oxygen in the body’s tissues and damage of multiple organ systems. Long-term use can also result in users exhibiting poor judgment in personal and professional situations.
Heroin – The long-term effects of repeated heroin use include physical structure and physiological changes in the brain. This results in imbalances in neuronal and hormonal systems that are not easily reversed, according to data cited by the National Institute on Drug Abuse. Chronic users also may find problems with making decisions and regulating their behavior. These conditions have been linked to the breakdown of white matter in the brain that results from regular heroin use. Addiction, of course, results from prolonged use. People who use methods that allow the substance to reach the brain quickly are at increased risk of developing an addiction to it.
Hydrocodone – Frequent use of this opioid, which is sold under the names Vicodin, Norco, and Lortab, can result in several physical health problems, such as acetaminophen toxicity, liver damage, and sensorineural hearing loss. Mental health is at risk as well with chronic use.
Hydromorphone (Dilaudid) – Chronic hydromorphone users are at risk of developing physical and psychological problems. Anxiety, depression, mood swings, and reckless behavior are some of the challenges that come with the long-term use of this drug. Prolonged abuse could lead people to move on to heroin, which commonly happens when prescription opioids are abused. Severe side effects include chest pain, breathing problems, and seizures.
Methadone – Methadone dependence is difficult to break once established, even for those who use it as a substitute for opioid addiction treatment. It is estimated that about 5,000 people die yearly from abusing this drug. Its effects have been likened to those of the illegal addictive opioid heroin.
Morphine – People who chronically use or abuse morphine can cause irreversible damage to their vital organs. Excessive use threatens the respiratory system, putting users at risk of breathing problems, and the cardiovascular system, which brings on chest pains, collapsed veins, and abnormally low blood pressure. Chronic morphine users may have a hard time passing urine or feel pain while urinating. They also may have renal damage.
Oxycodone – Chronic oxycodone users may develop a physical and psychological dependence over the long term. Users may have trouble sleeping, experience changes in balance, depersonalization, and mood swings, among other problems. Paranoia, depression, and hallucinations have been associated with long-term oxycodone use. Serious consequences can result from the long-term use of oxycodone that contains acetaminophen. Kidney and liver failure have been associated with the use of this drug as well as cardiac arrest, heart failure, low blood pressure, seizures, suicidal ideations, and more.
Percocet – Prolonged use of Percocet, a combination of oxycodone and acetaminophen, can cause structural and functional changes in the brain. Chronic users may experience lightheadedness, difficulty concentrating, or memory loss as a result of changes in the brain. Psychological challenges include depression, paranoia, confusion, insomnia, hallucinations, and personality disorder. Users also could exhibit mood swings, introverted behavior, and other behavioral changes.
Long-term effects of opioid use also can trigger structural and functional changes in the brain that cause users to lose much of their ability to cope with pain naturally without the use of pain medication. In other words, long-term opioid use has been found to cause significantly decreased pain tolerance. Additionally, users begin to experience pain more intensely since they don’t consistently have high levels of opiate painkillers in their systems.
Many people who misuse and abuse prescription opioid medications may find they need professional help at an addiction rehabilitation or treatment center to get off the drugs and on the path to recovery.
Effects of Opioids Can Linger Beyond Recovery
Once opioid users become and remain sober, their brain chemistry and neurological functioning will begin to stabilize and return to a relatively normal state. However, there are lingering effects that can remain with a person in recovery from opioid addiction for months or even years after their use has stopped. These effects, or symptoms, are known as Post-Acute Withdrawal Syndrome (PAWS), and they are an unfortunate consequence of having been a habitual substance abuse for a prolonged period.
The lasting psychological effects brought on by prolonged opioid use are arguably the most persistent. Without the daily, habitual abuse of opioid pain relievers, individuals are confronted with their undiluted emotions, which can be overwhelming at first. It takes time to adjust to this as the return of one’s emotional sensitivity often feels like an emotional flood. Additionally, many people who have overcome an opioid addiction will be prone to experiencing depression. Ongoing treatment that involves counseling and methods, such as a 12-step program, can help people manage their PAWS symptoms as needed.