From stick marks and infections to the psychological alterations and pains of withdrawal, opioids can take a heavy toll on the body and brain. It’s a lot for one person to handle, especially as many struggling with addiction feel the burden of a stigma that discourages them from speaking up about what they’re experiencing.
How opioids work
Opioids, including morphine and oxycodone, are pain relievers, and according to the National Institutes of Health are generally safe when used for a short time. Opioids work by activating opioid receptors on nerve cells and then blocking pain messages sent from the body through the spinal cord to the brain.
Addiction
According to the Mayo Clinic, opioids become most addictive when taken in a different method than what was prescribed. Most opioids come in pill form, but some will crush the pill so it can be snorted or injected, which delivers the medicine to the brain more quickly. The Mayo Clinic warns that taking opioids for more than just a few days — most opioids aren’t prescribed for longer than that — increases the risk of addiction.
Dr. Robin Parsons, chief clinical officer at Fairbanks Addiction Treatment and Recovery Center, explained that opioids can create a sense of “euphoria.”
“It’s the best pain medication,” she said. “If you’re a person living with chronic pain, you’re starting to feel good because you’re starting to be able to do things maybe you haven’t been able to do before. It’s all pleasure.”
But that same dose of opioid isn’t going to produce the same effect every time because the body builds up a tolerance. Eventually more and more is required to get that effect, until the person needs to use just so they don’t start experiencing withdrawal.
Parsons said addiction occurs in a more primitive part of the brain, so the brain desires the drug before the prefrontal cortex can make logic decisions, and the brain starts yearning for that opioid as though it’s something essential to life.
“You don’t decide if you want to drink water, right?” Parsons said. “You have to drink water. Your brain craves water. … People who are addicted have trained their brain that they have to use the drug. There’s no choice in it anymore.”
Physical signs
Parsons said one of the most common physical signs someone is abusing opioids is that they’ll “nod out,” where they can’t keep their eyes open and look like they’re about to fall asleep or pass out. There is also a risk of an infection, called an abscess, at the needle injection site. Abscesses can usually heal on their own, but some complications, such as swollen lymph nodes and sepsis, can occur if left untreated.
Withdrawal
Withdrawal from opioids is a symptom of dependence and can be severe. According to The National Alliance of Advocates for Buprenorphine Treatment, withdrawal can begin as early as four hours after the last opioid use.
“A person who is addicted to opioids is terrified of withdrawal,” Parsons said. “They’ll do anything they possibly can not to experience it. It’s like imagining the worst flu you could ever have from every angle of your body. That’s how sick you’ll get. It’s not tolerable.”
Withdrawal from opioids can be fatal, though it isn’t as common as it is with withdrawal from alcohol, but it can be so severe that Parsons said “you’ll wish you were dead.”
Laura Nowling, 34, who became addicted to morphine after getting breast implants and at her worst injected heroin every three to four hours, called withdrawal “the most uncomfortable feeling in the world.”
“You’re stuck in bed,” she said. “You have no energy. You don’t want to get up. You sweat. You’re sick. Just very uncomfortable and miserable.”
Nowling said she kept going back to the drugs then because “the sickness” was too much to handle.
Neonatal Abstinence Syndrome
Opioids and other drugs can be especially dangerous for mothers carrying a fetus, since that fetus could be born addicted to the substance the mother took while pregnant, leading to an array of potential problems at an early and vulnerable point in life.
When a baby is born experiencing withdrawal, it’s called neonatal abstinence syndrome (NAS). Symptoms can be minor, such as a runny nose or crying a little more than the average baby, but there are more severe possibilities. Rainey Martin, a perinatal clinical nurse specialist at Community Health Network, said babies exposed to opioids in the uterus tend to have higher rates of low birth weight and feeding problems, which can have a link to infant mortality.
It’s more difficult to pin down what the long-term health impacts are for those babies. Brooke Schaefer, a nurse practitioner who specializes in OB-GYN at Community Physician Network, said the limited research on that subject suggests a higher risk of learning disabilities such as attention deficit disorder.
“But we’re not totally sure yet about the long-term impacts,” Schaefer said. “It’s kind of new, so we’re still studying what that means for kids over time.”
Contact staff writer Tyler Fenwick at 317-762-7853. Follow him on Twitter @Ty_Fenwick.
ADDICTION CLINICS IN INDIANAPOLIS
Fairbanks Addiction Treatment and Recovery Center,
8102 Clearvista Parkway
800-225-4673
fairbankscd.org
Addiction Rehab Centers, 4745 Statesmen Drive, Suite A
844-551-4673
addictionrehabcenters.com
Indianapolis Comprehensive Treatment Center, 2626 E. 46th St., Suite J
317-754-2885
indianactc.com
Fall Creek Counseling, 2525 Shadeland Ave.
317-375-1901
fallcreekcounseling.com
Life Recovery Center,
3607 W. 16th St.
317-887-3290
liferecoverycenterindy.com
Progress House, 201 Shelby St.
317-637-9816
progresshouse.org
Families First,
2240 N. Meridian St.
317-634-6341
familiesfirstindiana.org
