Narcotic Abuse and Addiction
What is narcotic addiction?
Narcotic or opiate addiction is a is a dangerous long-term affliction associated with severe consequences for individuals, families and society, particularly in regards to increased risk of premature death and financial burden. Narcotic addiction is recognised as a brain disorder that is caused by prolonged use of narcotic or opioid drugs, including oxycontin, morphine, oxycodone, opium, heroin and others.
The medicinal use of narcotics can be very effective in minimising pain post-surgically and in a variety of chronic medical disorders. Indeed, using opioids in a clinically controlled setting minimises the risk of addiction while providing adequate pain control for patients. However, in addition to relieving pain, opioids can create an intense high when taken orally in large doses or when injected. This can increase the risk of abuse by inducing cravings, withdrawal symptoms, and euphoria. Therefore, addiction can occur from the prolonged misuse of prescribed narcotics, although addiction is most commonly associated with abuse of illegal substances such as heroin.
Causes of narcotic addiction and misuse
Addiction occurs over a period of time, when individuals become physically dependant on narcotics as their bodies become accustomed to their presence. Indeed, prolonged use of narcotics inhibits the brain from producing its own endorphins, or natural pain-killers, creating dependency on narcotics as an external source for relieving pain or creating feelings of ease and euphoria. Narcotic use can be seen on a continuum, which can progress from casual use to addiction. As the pattern of drug use approaches addiction, the desire for the drug assumes increasing control of the individual’s behaviour, making obtaining the drug the individual’s primary focus, often at the expense of family, social and work life.
Research has identified three interrelated domains which contribute to vulnerability to addiction, including neurological changes associated with narcotic abuse, environmental factors and genetic factors.
Indeed, narcotic abuse can affect neural networks associated with positive reinforcement or rewards. Over time, this results in complex physiological changes and related behaviours associated with addiction, such as tolerance, sensitisation, dependence, withdrawal, craving and stress-induced relapse. Environmental factors contributing to addiction include peer-pressure, stress, trauma and an adverse family environment. Genetic or inheritable factors have also been shown to influence vulnerability, which may delay or enhance the disorders progression.
Risk of addiction or abuse is also higher for individuals with a history of substance abuse than for those without such a history. Individuals with a history of underlying mental illness, including depression, may also be at high risk for abuse of narcotics. The use of opiates in chronic pain management has also been indicated as a risk factor for addiction.
Narcotic addiction symptoms
Individuals experiencing narcotic abuse often display a number of the following symptoms –
- Sedation or lethargy
- Euphoria or feelings of an intense high
- Constricted pupils with blood-shot eyes
- Weight fluctuation
- Digestive issues, including nausea, vomiting and constipation
- Shallow breathing and slurred speech
- Needle marks, which may hidden by long sleeves or may exist on other parts of the body
- Digestive discomfort, such as abdominal cramps, vomiting and diarrhoea.
- Muscle aches
- Rapid breathing
- Profuse sweating
- Intense cravings
- Dilated pupils
As the individual progresses from casual drug use to physical and psychological dependence, extreme physical and psychological discomfort can be experienced when the individual stops taking the drug over a prolonged time. Depending on the drug and dosage, withdrawal symptoms can last from a few days to a number of weeks. Although associated with discomfort, withdrawal symptoms are not considered life threatening unless they are compounded by a pre-existing medical condition. Common withdrawal symptoms include-
Narcotic addiction treatment
Individuals need urgent medical treatment in the case of narcotic overdose or withdrawal-induced seizures and unconsciousness. In these cases, seek medical help immediately.
For treatment of chronic narcotic abuse, psychological therapy can be effective for ameliorating symptoms and reducing cravings. Indeed, by replacing illegal or abused narcotics with a controlled legal opioid such as Methadone, many of the risks associated with a drug-abusive lifestyle can be overcome, such as the need to take part in criminal behaviours, and contamination from needle sharing and promiscuous behaviours, which can lead to transmission of HIV and other diseases. However, many communities are fearful of narcotic addicts and are reluctant to have methadone clinics in their vicinity. The stigma associated with methadone maintenance therapy also deters many individuals from seeking help.
More recently, the use of Buprenorphine in maintenance therapy has become recognised as a safer choice for many individuals suffering from addiction. Like methadone, Buprenorphine suppresses withdrawal and cravings. However, it has also been shown to be safe in higher doses, unlike methadone, which can be overdosed.
For relapse prevention and overcoming the psychological aspects of addiction, cognitive behavioural therapy has been widely used to provide individuals with alternative coping skills by identifying the complex thought processes and subsequent behaviours associated with drug abuse, such as positive and negative drug-related beliefs which precede drug taking.
Group therapy is argued to be especially effective in preventing relapse as it also targets the stigma attached to addiction. The presence of other group members who acknowledge having similar problems can provide support and be therapeutic in developing alternative methods of maintaining abstinence. Indeed psychotherapeutic intervention in combination with psychological therapy has been shown to significantly reduce clinical drop-outs, use of narcotics during treatment, use of narcotics during follow-up, and absences during treatment.
Dr. Gillian Moore-Groarke,
Ms. Amy-Rose Hayes,
Psychology Graduate PSI.
IrishPsychology.com, 5A Harley Court, Wilton, Cork.