Opiates--notably, heroin, morphine and Oxycontin--represent a growing population within the overall culture of substance abuse. Lulled by the ease of smoking or sniffing these drugs, users often have little idea of the long-term consequences that accompany opiate abuse, including damaged immune systems, greater risk for infectious diseases and negative effects on brain function. The extremely addictive nature of opiates requires an intensive behavioral and medication regime to address them, representing the greatest challenge, from a pure treatment perspective.
Hospital emergency room admissions have been considered a reliable measurement of a drug's popularity. According to the Drug Abuse Warning Network, which monitors these trends, admissions for heroin abuse have increased by 35 percent since 1995, while heroin and morphine remain in the top four causes of drug overdose-related deaths. Among teens, heroin use rates have declined since the 1990s, according to the National Institute on Drug Abuse, though recent peaks were observed in 1996, 1997 and 2000 for those in grades eight, 10 and 12, respectively.
The short-term effects of opiate use include a dry mouth, flushed skin, heavy extremities and a surge of euphoria that lasts for only a few hours, or even a single dose, according to the National Institute on Drug Abuse. Users alternate between drowsy and wakeful states, known as "nodding off." As larger doses are needed to function, users shun "snorting"--or sniffing through the nose--for injection, which is the fastest way of feeling the effects.
Some of the earliest long-term opiate damage symptoms stem from their consumption. Many of the strongest opiates, such as morphine, are also available in pill form. Desperate users who cannot get them any other way may resort to grinding up the pills and injecting the dissolved material. This risky practice can result in vascular inflammation and permanent damage. Pill particles may also lodge in a small vessel, blocking off the supply to areas of the body--hardly a boon for users looking to buck the stigma of injection.
Other Permanent Symptoms
Chronic opiate abuse has been identified with many adverse health conditions, such as cellulitis, and infections of the heart lining and valves. Abscesses and collapsed veins are also likely to develop as users hunt for different injection sites around their bodies. Heroin also depresses respiration, which leads to various pulmonary complications, such as pneumonia. Permanent damage to the liver, lungs and kidneys is also likely, because many street drugs contain toxic additives that the system--already overtaxed from the addiction--cannot flush out easily, if at all.
Effects On Brain Chemistry
Opiates have also been shown to cast a long-term negative effect on brain chemistry. Through constant stimulation of key pleasure centers within the brain, and its reward system, opiate users are conditioned to want more of the drug. In extreme situations, sudden withdrawal by chronic users in poor health may prove fatal. This phenomenon makes it impossible for users to quit without help, as their never-ending euphoric state leaves them unaware that they are addicted. Such euphoric feelings may last for years, even after a successful treatment, and require additional followup.
For 30 years, methadone has remained the most common treatment option, primarily for its ability to decrease the desire for other opiate drugs, while reducing withdrawal symptoms and enabling the user to function. A more recently approved treatment, buprenorphine, has found greater favor in recent years for its ability to produce fewer withdrawal symptoms than those associated with methadone, although both drugs can be combined. Naltrexone is another approved treatment that blocks a person's ability to feel the effects of opiates, but has not been widely used, due to a poor track record of patient compliance.
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