The nation is in the midst of an unprecedented opioid epidemic. According to data collected by the Centers for Disease Control and Prevention (CDC), more than 80,000 people died from opioid-related drug overdoses in 2021. That’s 220 people a day.
Who Is Most at Risk of Opioid Use Disorder?
Opioid addiction can strike anyone, regardless of age, race, or socioeconomic background.
Still, certain populations are at a higher risk of opioid use disorder than others. These include people who:
- Are of younger age, particularly teens and young adults in their early twenties
- Have a personal or family history of substance abuse
- Are living in stressful circumstances, such as being unemployed or living below the poverty line
- Have had legal troubles in the past
- Are in contact regularly with others who are addicted to drugs or are frequently exposed to environments where there’s drug use
- Have a history of mental health issues, such as depression, anxiety, or post-traumatic stress disorder (PTSD)
- Tend to engage in risky behavior
- Use tobacco heavily
Common Questions & Answers
Symptoms of Opioid Use Disorder
It’s important to be aware of the signs of an opioid addiction in order to recognize a problem in yourself or a loved one.
People who are addicted to drugs may:
- Feel they need to use the drug regularly, daily, or even several times a day
- Have intense urges for the drug that block out any other thoughts
- Take the drug “just in case,” even when there is no medical need
- Take larger amounts of the drug over a longer period of time than intended
- Borrow the drug from others or “lose” it so that more prescriptions need to be written
- Seek the prescription from multiple doctors in order to have a “backup” supply
- Spend large quantities of money on the drug, even when they can’t afford it
- Need more of the drug to get the same effect over time
- Fail to meet work obligations
- Cut back on social or recreational activities as a result of drug use
- Experience a change in sleep patterns
- Continue the drug use, despite it causing problems in life or physical or psychological harm
- Do things to get the drug that they normally wouldn’t do, such as stealing
- Drive or engage in other risky behaviors under the influence of the drug
- Fail in attempts to stop using the drug
Treatment Options for Opioid Use Disorder
There are a number of different options available to treat opioid use disorder. The best strategy for most people, according to the American Society of Addiction Medicine (ASAM), is a combination of medication and counseling and behavioral therapies. This is known as medication-assisted treatment, or MAT.
Medication These include methadone (Dolophine) and buprenorphine (Subutex), two drugs that work by decreasing withdrawal symptoms and cravings. They act on the same targets in the brain as other opioids, but they do not make the person taking them feel high. Naltrexone (Vivitrol) is another option, which works differently from methadone and buprenorphine. It doesn’t help with withdrawal symptoms and cravings but rather takes away the high that you would normally get while on opioids.
There’s no set length of time for MAT, according to the ASAM. Individuals respond differently, but these medications can safely be taken for years.
The ASAM cites research that shows treating opioid use disorder with medication lowers the risk of overdose and death. But not everyone who could benefit from MAT has access to it. Use of these medications must be closely monitored, and only certain doctors can prescribe them. Some people also have the misconception that by taking these medications, they’re simply trading one addictive substance for another. According to the National Institute on Drug Abuse, that’s not the case.
Counseling Talking to qualified professionals about an addiction can be extremely beneficial in the treatment process. Counseling can include individual, group, and family counseling and often includes a combination of these plus medication. For more severe situations, residential/hospital-based treatment is advised.
Cognitive Behavioral Therapy Also known as CBT, cognitive behavioral therapy is an example of a form of individual talk therapy that helps patients recognize and stop negative patterns of thinking and behavior that can lead to the desire to use opioids.
Peer Support Groups For example, a community group that meets regularly, like a 12-step program such as Narcotics Anonymous or Medication-Assisted Recovery Anonymous. The SMART Recovery (Self-Management and Recovery Training) program also facilitates in-person and online group meetings.
Family Therapy This includes partners or spouses and other family members who are close to the patient. It can help to repair and improve family relationships, which often can contribute to addiction issues.
One element of the public health response to the opioid crisis is known as harm reduction. This means preventing overdoses and improving the quality of life for people with opioid use disorder, even if they aren’t able to stop using drugs. The Substance Abuse and Mental Health Services Administration supports many programs that are administered at the local level. Strategies include:
- Clean needle programs to stop the spread of infectious diseases like HIV and hepatitis.
- Outreach campaigns to connect people with treatment and social services.
- Education about and distribution of naloxone for reversing an overdose.
- Programs to provide fentanyl testing strips so drug users can check for contamination.
Opioid Use During the COVID-19 Pandemic
The COVID-19 lockdown interrupted many people’s treatment regimens, while social isolation and financial insecurity may have worsened addiction. Being alone in one’s home, with little to do but worry about what’s going on in the world, caused many to relapse.
But the federal government took steps to expand telehealth options for treating opioid use disorder during the pandemic by relaxing policies limiting remote appointments and prescriptions, as well as take-home medications. A study published in 2022 found positive results. More Medicare recipients were able to use telehealth for opioid use disorder during the pandemic than before it began, and those who did were more likely to stay in treatment and less likely to overdose.
How to Prevent Opioid Abuse
In an effort to combat the opioid epidemic, many in the scientific community are looking at ways to prevent addiction before it takes hold.
Doctors play an important role in helping curb the opioid epidemic by practicing safer and more responsible prescribing of opioids and screening patients for opioid misuse at routine medical visits.
Patients can also play a role in preventing addiction: Patients should never share their prescription drugs, nor should they stop or change a drug regimen without discussing it with their doctors first.
Can CBT Work for Chronic Pain?
Cognitive behavioral therapy (CBT) is a form of psychotherapy aimed at increasing mindful awareness, changing destructive thought patterns, and helping patients bring a rational frame of mind to life’s challenges.
It’s most often used to treat mood disorders, like anxiety or depression. But some researchers believe it can also play a role in alleviating chronic pain without the sometimes detrimental effects of opioids.
Experts say patients’ thoughts and beliefs play a pivotal role in how they experience their pain and how that pain affects their lives. Patients might, for example, avoid activities they enjoyed because they worry about aggravating their pains. Adults with chronic pain are often prescribed opioids to manage their pain, but CBT can give patients strategies they can use to disrupt some of chronic pain’s psychological complications.
The American Society of Addiction Medicine publishes a guide for people with opioid use disorder, plus their families and friends. It explains the assessment process and available treatments, including medications. The organization also has links to find a provider and support groups on its website.
The Substance Abuse and Mental Health Services Administration has a number of resources on its website, including a database of treatment programs.
You can also search for a doctor in your area who prescribes buprenorphine through this tool on the SAMHSA website.
This nonprofit hotline and online chat service allows someone using drugs alone to connect with a volunteer. That person is trained to listen for signs of an overdose and can alert first responders.
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