Opioid: abuse and addiction

Abstract

The non-medical use of prescribed drugs is becoming a major opioid threat to public health and law enforcement worldwide. 0.27 million (2.5% of the source population) were estimated to be opioid dependent, of which nearly 78,000 (0.7% of the source population) were injecting opioid users (IDUs), predominantly heroin (62%) but also buprenorphine (32.5%). High-risk behaviour was reported by nearly 60% of IDUs.

Full Text

RATIONALE The non-medical use of prescribed drugs is becoming a major opioid threat to public health and law enforcement worldwide. 0.27 million (2.5% of the source population) were estimated to be opioid dependent, of which nearly 78,000 (0.7% of the source population) were injecting opioid users (IDUs), predominantly heroin (62%) but also buprenorphine (32.5%). High-risk behaviour was reported by nearly 60% of IDUs. PURPOSE Focus on improvements to prevent and minimize abuse, misuse and diversion by increasing awareness regarding appropriate use. METHODS Scientific literature analysis. RESULTS Opioids are substances that act on opioid receptors (μ,κ,δ : G-protein coupled receptor acting on GABA) to produce morphine-like effects. Opioids are effective for the treatment of acute pain following surgery. They impair alertness, bring risk of dependence, tolerance and increase the risk that episodic headaches will become chronic. The withdrawal symptoms for opiates may include severe dysphoria, craving for another opiate overdose irritability, sweating, nausea etc. Every day more than 130 people die after overdosing on opioids. The misuse of and addiction to opioids-including prescription pain relievers, heroin, and synthetic opioids such as fentanyl-is a serious national crisis. In 2017, more than 47,000 died as a result of an opioid overdose. The binding in reward regions in the brain produces a sense of well-being, while stimulation of opioid receptors in deeper brain regions results in drowsiness and respiratory depression, which can lead to overdose death. Another contributing is the combined use of benzodiazepines (BZDs) or other central nervous system (CNS) depressants (like some sleeping pills), use of many drugs including opioids by pregnant women can result in a withdrawal syndrome in newborns, referred to as neonatal abstinence syndrome, which increased by approximately 500 percent in 2000 and 2012. Treatment: opioid agonist therapy (OAT), medications (Buprenorphine, methadone, Naloxone, Naltrexone) combined with behaviour counseling for a “whole patient” approach known as medication Assisted treatment (MAT). CONCLUSION Treatment services must be scaling up useful and safe program and policy options likely to be applicable in the setting, with our own assets as well as vulnerabilities. Additional research is needed to further study the effects and differences between abuse, misuse, and diversion. More importantly, there is a clear need to assess and develop technology for opioids, such as tamper-resistant formulations, to lower and minimize the risk of abuse.