Recently, opioid use has gained substantial attention of the public eye. Why is this? What are the symptoms of opioid use disorder and how can family be on the lookout? What are the treatment options? We will attempt to shed some light on what is now commonly referred to as the opioid epidemic.
While alcohol has most likely always remained the number one offender when it comes to substance use and untimely death, opioid deaths are steadily increasing. In the past 5 years, opioid death has nearly double from about 25,000 in 2012 to 50,000 in 2017, with the latter being based on provisional data. Regardless, in 2016, the data suggested 42,00 deaths, indicating an exponential increase compared to the past where the increase had appeared to be linear. This has strong and scary implications for what the future of opioid use holds, as the increase does not appear to be relenting.
Why are deaths increasing at an exponential rate? Has anything changed? With the advent of fentanyl on the scene, individuals may be unaware of what substance they are using, which can lead to easy overdose. Furthermore, as individuals enter treatment, they leave 30, 60, or 90 days later with a drastically decreased tolerance, return to using a substance like heroin in the fashion that they used to, which leads to overdose. This situation is exacerbated when an individual with decreased tolerance believes they are using heroin, but inadvertently uses fentanyl.
Alcohol death is a long, slow, miserable process, involving organ failure, and it's not pretty. Opioid death is typically quick and unsuspected. If you look at the population of most treatment centers, you will find primarily young heroin users in their 20s, maybe a few in their 30s. You do not see many heroin users after this age because death can occur so suddenly. Therefore, it is imperative to address opioid use immediately, as any use, especially if use is intravenous, can result in death.
Being on the lookout for symptoms of opioid use can be helpful for friends and family. Pinned or small pupils, frequent scratching, nodding out (leaning forward and appearing to fall asleep), a general state of sedation, and even burn holes in pants (if they smoke). Keep an eye out of paraphernalia like needles, spoons, baggies, or pills. If you are unsure but questioning whether a family member has a problem, reach out to us for consultation.
Options for treatment of opioid use are extensive. One increasingly popular modality is Medication Assisted Treatment (MAT). There are many options for MAT, but we believe medications like Naltrexone are most effective. While we support an individual's choice to use MAT, we believe that this needs to be done with a team of professionals, including medical and counseling. With or without MAT, we also recommend a combination of cognitive behavioral counseling with 12-step support groups. Our cognitive behavioral approach, integrated with other types of therapy, helps the immediate problem and empowers the individual towards a long-term solution, such as 12-step meetings of AA or NA. Counseling is time limited and goal oriented, while 12-step is a life-style adjustment and a long-term commitment that can help long after counseling has concluded.
If you think you have a problem with opioids, or you are concerned a family member might, please head on over to our Get Started page. Let us know that this is something we can help you with and we will be on contact with you shortly for a free consultation.