What are the other Names for this Condition? (Also known as/Synonyms)

• Narcotic Dependence
• Opiate Dependence

What is Opioid Dependence? (Definition/Background Information)

• Opioid Dependence (or Opiate Dependence) refers to the physical dependence of an individual to opioids
• Opiates are a category of drugs prescribed to treat pain. They are derived from the poppy plant, which produces opium. Opioid drugs reduce the amount of pain signals that are sent to the brain and alters the brain’s response to pain
• Opioids are often prescribed for relief of pain due to toothaches, dental procedures, injuries, surgeries, and chronic conditions such as cancer
• Opiate drugs include morphine, codeine, heroin, methadone, oxycodone, and other drugs. The term opiate is often used to describe close relatives of opium, including codeine, morphine, and heroin, while the term opioid refers to the entire class of drugs
• Dependence is a brain-related medical disorder that occurs when the body’s functions change due to long-term use of a drug. Physical dependence to opioids in and of itself does not constitute addiction to opioids. However, dependence often accompanies addiction
• Opioid Dependence is age and race non-specific. Genetics can play a role in opiate drug use and dependence. Research indicates that women may become dependent on drugs faster than men do
• The causal factors for Opioid Dependence include the use of opioid medication for an extended period of time and gradual drug tolerance
• The signs and symptoms of Opioid Dependence include sweating, constricted pupils, depressed breathing and heartbeat, fatigue, lethargy, euphoria, and slowed reflexes
• The treatment for Opioid Dependence might include a physician gradually reducing the dosage over time until medicine is no longer needed, medication to help the patient detox and alleviate symptoms, as well as treatment groups and therapy
• Opioid Dependence can be painful and life-threatening, if opioids are taken in excess. The prognosis is dependent on the length of time and the severity of the drug use

Who gets Opioid Dependence? (Age and Sex Distribution)

• Opiate Dependence is age non-specific
• Research suggests that women progress from drug use to dependence more quickly than men, and suffer more physical and emotional consequences of drug use
• Genetics can play a role, as certain genes for addictive traits and disorders can cause one to become dependent on opiate drugs
• Opioid Dependence may be observed in individuals of any race and ethnicity

What are the Risk Factors for Opioid Dependence? (Predisposing Factors)

The risk factors for Opioid Dependence include:

• Mental illness, such as anxiety or depression
• Genetics
• Family history of addiction
• Abuse to other drugs, such as alcohol or cocaine
• History of childhood trauma, such as physical or sexual abuse, violence, or losing a parent

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Opioid Dependence? (Etiology)

The causal factors for Opioid Dependence include:

• Use of opioid medication for an extended period of time
• Opiates can trigger physical dependence, meaning that a person relies on the drug to avoid withdrawal symptoms. With use over time, greater amounts of the drug become necessary to yield the same effect in pain reduction. This occurrence is known as drug tolerance

What are the Signs and Symptoms of Opioid Dependence?

The physical signs and symptoms of Opioid Dependence include:

• Sweating
• Nausea and vomiting
• Diarrhea
• Constricted pupils
• Loss of appetite
• Slurred speech
• Slowed reflexes
• Depressed breathing and heartbeat
• Drowsiness and fatigue

The behavioral signs and symptoms of Opioid Dependence include:

• Depression and anxiety
• Mood swings
• Impaired coordination
• Lethargy
• Euphoria

How is Opioid Dependence Diagnosed?

Opioid Dependence is diagnosed using the following methods:

• A physician may diagnose Opiate Dependence with a thorough physical examination, correlated with a complete medical history (including family and social history)
• Urine or blood tests to screen for the presence of opiate drugs
• Depending on the physician’s concern for additional medical problems, the following tests may be performed:
  • CBC (complete blood count)
  • Blood chemistries and liver function tests, such as CHEM-20

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Opioid Dependence?

Complications due to Opioid Dependence could include:

• Opioid Dependence can lead to slow respiratory rate and heartbeat. Depressed respiration (hypoventilation) impacts the amount of oxygen that travels to the brain, a condition referred to as hypoxia. Hypoxia may cause acute or chronic psychological and neurological effects, such as coma or permanent brain damage
• Chronic use or abuse of opioids may lead to physical dependence, and in some cases, addiction
• Depression and other mental illnesses occur in patients experiencing Opioid Dependence
• Returning to opiate drug use: A majority of opiate overdose-related deaths occur when those who have discontinued or detoxed from the drug, return to opiate use. This is because withdrawal lessens one’s tolerance to the drug and lesser amounts are needed for an overdose situation

High doses of opiates could cause death from cardiac or respiratory arrest.

How is Opioid Dependence Treated?

The treatment measures for Opioid Dependence include:

• If one has taken a prescription opioid over a long period of time, then the physician can gradually reduce the dosage over time, until the medicine is no longer needed
• If overdose occurs, intravenous naltrexone can be administered in a hospital setting. Other drug treatments include the use of methadone and buprenorphine
• The medication known as methadone is often used as replacement for heroin or other opiates. However, methadone is also a highly addictive drug. For patients on methadone, physicians slowly decrease the dosage over time, lessening the intensity of withdrawal symptoms
• Following detoxification from opiates, it is recommended to follow long-term treatment and therapy, such as through self-help groups, outpatient counseling, day hospitalizations, or inpatient treatment
• Narcotics Anonymous (NA) meetings are recommended for individuals suffering from Opiate Dependence
• Long-term treatment can limit the adverse effects of Opioid Dependence and improve the individual’s daily functioning

How can Opioid Dependence be Prevented?

Preventive methods for Opiate Dependence could include:

• The use of opiate medication under the supervision of a qualified healthcare provider only
• Discontinuing the use of the medication beyond the prescribed amount or duration
• Discarding or disposing the remaining medications from home, if there are pills remaining after you have recovered from the condition, for which the pain medication was prescribed. This will reduce access to other members of the household too
• If you have been treated for Opiate Dependence or addiction, then it is very important to be aware of recurring signs and symptoms. If you feel that similar signs and symptoms of Opiate Dependence are occurring, then do seek immediate medical attention. This is a very important step in preventing the condition
• Always keep your follow-up appointment with your healthcare provider

What is the Prognosis of Opioid Dependence? (Outcomes/Resolutions)

• Opioid Dependence can be painful and life-threatening if opioids are taken in excess
• Opioid detoxification, under the care of healthcare professionals, can lessen the symptoms and pain from the condition
• The prognosis of Opioid Dependence is dependent on the length of time and severity of the dependence

Additional and Relevant Useful Information for Opioid Dependence:

Opiate Dependence is a common condition that not only impacts individuals, but also their family members. Proper health education is an important step at a community level to tackle this condition.