Opioids like methadone, oxycodone, and hydrocodone are so addictive that that many people are continuing to use them despite the high possibility of death from overdose.
Oftentimes, these individuals defend their use by indicating that they have a prescription for them which, in their minds, makes them feel as if they’re exempt from this type of result. They couldn’t be more wrong.
According to statistics provided by the Centers for Disease Control and Prevention (CDC), more than 41 people die daily from opioid overdose. Almost half of these have a prescription for this category of drugs, which mean that they had them legally but died anyway. What makes opioids so compelling even though this could be the eventual result and, perhaps more importantly, why should you, a DC, care so much about the answer?
Opioid addiction from a DCs perspective
Two researchers—Thomas R. Kosten, MD and Tony P. George, MD—with connections to Yale University School of Medicine, VA Connecticut Healthcare System, and Connecticut Mental Health Center set out to answer both of these questions via an article published in Addiction Science & Clinical Practice. First, Kosten and George indicate that fully understanding opioid addiction “can be invaluable to the clinician” because it enables you as a healthcare provider to better understand why a patient is behaving a certain way.
Knowing more about this particular addiction also allows you to create a more realistic treatment program by taking the patient’s addiction into account. This can be very beneficial, especially if the patient is experiencing a lot of musculoskeletal pain, thus the reason he or she may be taking the opioid to begin with. So what lies behind the addiction?
Opioids addictive properties
Kosten and George identify brain abnormalities from chronic opioid use as the main cause of opioid addiction. However, that’s a rather simplistic explanation as Kosten and George also indicate that these abnormalities are also complex. For instance, brain abnormalities could have existed prior to the addiction, causing the opioids to further the abnormality.
Abnormalities caused by the addiction itself occur when the opiate reaches the brain via the bloodstream. There it attaches itself to mu opioid receptors, which are the same receptors “that reward people with feelings of pleasure when they engage in activities that promote basic life functions, such as eating and sex,” says Kosten and George.
This feeling is accentuated by opiates’ effects on the area of the brain responsible for memory. In other words, because the person remembers how good the opioids made him or her feel in the past, it creates a craving to continue that use in the future “in spite of many obstacles.”
Additionally, environmental factors like undergoing major amounts of stress and having friends who use opioids can complicate opiate addiction even more says Kosten and George. In this case, external cues strengthen the need to use, further strengthening internal cues.
How to help patients with an opioid addiction
Knowing how opiates work, why they are so addictive, can help doctors of chiropractic better understand why one of their patients continues to use despite the fact that that use can easily result in an overdose-type of death. But there are other things you can do as well.
One option is to have the name and phone number of a local opioid addiction agency or support group on hand to give to the addict. This enables the patient to create a stronger support system as he or she fights the addiction. At a minimum, providing a link to an online website, such as the Substance Abuse and Mental Health Services Administration (SAMHSA), can give the patient a place to go to begin the recovery process as well.
Because this type of addiction is best fought with a strong support network, it may also help the patient to encourage family members and friends to join Nar-Anon. Nar-Anon is a support group for loved ones of addicts, providing them the support and tools they need to encourage a safe and effective recovery process.
Finally, offering your own support and encouragement can go a long way too. Something as simple as talking to your patient about his or her progress enables you to help the addict celebrate the successes and brainstorm ways to overcome the obstacles to recovery. That makes you, the DC, an important part of the recovery process.
