Managing the Medical Complications of Opiates

We are going to discuss the drug that has displaced methamphetamine as the biggest development in drug addiction in the last decade – opioids.

If this article were written at any other time in the last 100 years, opiate based content would be relevant because of heroin and a variety of medications that have been abused (for literally as long as our country has been in existence).

However, the recent epidemic of opiate drug abuse can be traced to the prevalence of OxyContin  – a highly potent painkiller that basically creates the same sensation as shooting or snorting heroin.  This phenomenon has exploded across the country into a tidal wave of heroin addiction and overdose.

Methadone and Suboxone

Methadone has been historically prescribed to manage cravings but it is also addictive and carries with it the risk of overdose.  Clinicians in recent years are gravitating toward using drugs like Suboxone instead to manage cravings that can overwhelm the early recovery process.

The Connection Between OxyContin and Heroin

Abusers of prescription drugs like OxyContin, Vicodin, Percocet, and others will often graduate to heroin when the prescription medication becomes too difficult and expensive to obtain.  A $5-10 bag of heroin will supply the same level of high as a $40 -$80 (street value) OxyContin pill.  Such  a drastic change from pills to street heroin seems like a major leap to the average person.  But if you factor in the unbearable torture of opioid withdrawals the switch becomes a more logical progression.  There are numerous OxyContin Watchdog Websites that chronicle the drug’s toll on our society.

Opioids can be taken:

  • Orally
  • Intravenously
  • Intranasally (snorting powder)
  • Inhaling the smoke (when a the drug is heated and burned)

The Dangers of Intravenous Heroin Injection

Obviously some risks in IV heroin use have been well chronicled.  The AIDS epidemic highlighted the danger of heroin needle sharing in the 1980s and 1990s.

Beyond the risk HIV, injecting heroin can lead to a whole host of other blood borne infections like septicemia and cellulitis.

Symptoms of HIV use include vein sclerosis (track marks) and occasionally thromboembolic events.  Patients in treatmet for IV heroin use will be carefully screened for:

  • Skin abscesses
  • Botulism
  • Bacterial endocarditis
  • Septicemia
  • Ceullitis

Relapse Warning

The danger of overdose during an episode of opioid abuse is everpresent and the respiration and heartbeat should be monitored as well as ensuring airways are kept clear.

Neurological Side Effects of Opioid Abuse:

  • Drowsiness
  • Lightheaded Sensation
  • Confusion
  • Myoclouns
  • Miosis
  • Hyperalgesia

Pulmonary SideEffects:

  • Respiratory suppression

Gastrointestinal Side Effecdts

  • Hepatitis C Infection
  • Hepatotocixity
  • Nausea
  • Constipation

Other Side Effects

  • Urniary Retention
  • Pruritus

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