Special Concerns of Opioids

Opioids are medications that are tightly controlled by the federal government and come under the jurisdiction of the Drug Enforcement Administration (DEA). This is because their potential for abuse and misuse is higher than most other medications. Consequently, harm can occur to self or others and therefore the government oversees their consumption closely by monitoring physicians’ prescribing, pharmacy dispensing, and patient consumption. This class of medications is associated with the potential risk of addiction.

Addiction has two components. Physical addiction occurs when anyone takes opioids for an extended period on a regular basis. The abrupt withdrawal of the medication will lead to a phenomenon of withdrawal called abstinence. Abstinence is manifested by profuse sweating, feeling very ill, abdominal cramping with nausea, vomiting, and diarrhea. There may be chills and the individual might have the sensation of insects crawling beneath one’s skin.

This phenomenon is the body’s way of indicating an absence of a drug previously consumed regularly. This phenomenon is something everyone will go through if taking opioids on a regular schedule for an extended period of time. The phenomenon may last hours to days and will eventually go away. The best way to avoid is to slowly decrease the amount and frequency of opioids being consumed. This slow taper will limit or eliminate the abstinence syndrome.

Psychological dependence is the addiction we all think of when considering addiction. This is characterized by preoccupation with the medication, expending all energy in procuring the medication, and consuming the medication for reasons other than pain. This phenomenon of psychological dependence is a spectrum from individuals having minor cravings to individuals depicted as “drug addicts” on television engaging in criminal behavior in an effort to fulfill their need.

The predilection to psychological dependence can be anticipated if an individual has a history of more than three of the following; (a) family or personal misuse of alcohol, illegal drugs, or prescription drugs; (b) age 16-45; (c) preadolescent sexual abuse; (c) psychological disease of depression, obsessive compulsive disorder, schizophrenia, bipolar disorder, or attention deficit disorder.