Opiates act by attaching to specific proteins called opioid receptors found naturally in the body in the brain, spinal cord and other organs. Once attached to the receptors there is a perception of pain reduction and some experience a euphoric response to opiates because the drug affects the reward system of the brain due to an increase in dopamine. Dependence is due to normal adaptations to chronic exposure but addiction is distinguished by compulsive drug use despite the consequences. Tolerance is the need to take higher and higher doses to get the same effect.
My experience is that many times opiate use starts with Loratab or Loracet, Percocet, and then progresses to Roxicet, Opana and Heroin. The use progression normally begins with taking the pill by mouth, then snorting it, to intravenous use. Typically, legal issues progress the same way as nasal use leads to misdemeanor charges while intravenous use leads to felony charges to support the habit.
Addiction to opiates is caused by the need to intensify the experience of the reward. As the need gets stronger, the use increases and many speed-ball or combine opiates with an upper like methamphetamine to intensity the effect. Intravenous use is responsible for the rampant increase in Hepatitis C, greater sensitivity to pain, endocarditis, pulmonary embolism, brain damage similar to Alzheimer’s, kidney damage, and death.
Someone using opiates has extremely constricted pupils, may be hyper and full of energy when moving, drowsy when not, have anxiety, mood swings and depression. One might also find evidence of straws, syringes and spoons.
Opiates take all pleasure and joy except for the drug. Opiate addiction can start with a prescription and is extremely important to take never take more than prescribed. There is hope and help out there for opiate addiction. Education is the key.
Cynthia Mason is a master’s level therapist working in three local jails and Recovery Court.