Mirroring the rise of the national opioid epidemic, Colorado has seen an enormous increase in opioid-related overdose deaths in the less than two decades. This article takes a look at just how bad the opioid problem has gotten in Colorado as well as what characteristics of opioids in particular make it such a dangerous and addictive drug.
Colorado Opioid Epidemic
A variety of agencies and institutions including the Center for Disease Control have declared the opioid abuse problem in the United States to be an epidemic. The CDC reports that in the past 16 years, America has witnessed a four-fold increase in opioid-related overdose deaths. Beyond that, it’s estimated that 91 Americans die every single day solely from opioid overdoses. These statistics are an alarming indicator of a rapidly growing problem with opioid abuse. And the problem is national too. In fact, almost all states witnessed an increase in drug overdose deaths from 2013 to 2014. Colorado is one of the many states that have felt the disastrous effects of such a rapidly growing substance abuse problem as state opioid overdoses have also quadrupled since 2002. Beyond these numbers, the Colorado Department of Public Health & Environment released a study showing the extent to which Colorado has been affected by the drug boom. For instance, 4.9% of Colorado residents are reported to use prescription pain relievers outside of their intended medical applications. From 2013 to 2014 alone Colorado saw an increase from 5.4 opioid overdoses per 100,000 to 6.1 per 100,000. Broken down even further, the number of Colorado counties with overdose death rates above 20 per 100,000 rose from one in 2002 to an astounding twelve counties, reflecting an overall rise in death rates in almost every Colorado county. The Colorado Health Institute reports that Colorado’s drug death rate is actually higher than the national average. In fact, several of the state’s counties have some of the highest rates of overdose deaths in the entire country. In order to combat this rapid and potentially catastrophic rise in opioid-related substance abuse problems, it’s necessary to first educate yourself on what opioids are, how they affect the body and the mind, and what makes them so addictive and dangerous.
What Is an Opioid?
An opioid is a compound that interacts with the brain’s opioid receptors to reduce the effects of both chronic and acute pain. Using opioids can also produce a euphoric effect that leads many people to start abusing the drug. Opioids can be both organic and synthetic. The organic form, typically referred to as an opiate, is derived from the opium poppy, an eastern Mediterranean native flower that has seen a burst in cultivation over the past several hundred years. Morphine is one of the main compounds produced by the opium poppy. This powerful pain reliever is used for a variety of analgesic applications and is also the fundamental ingredient in heroin. Because of the intensely pleasurable side effects of opioid use as well as the relatively rapid development of tolerance, opioids are both incredibly addictive and dangerous.
What Kinds of Opioids Are There?
Opioids come in two forms: illicit and legal. The illicit form of opioids is heroin, a Schedule I narcotic that is highly addictive and carries with it an intense high. Heroin is most commonly injected directly into a vein but it can also be snorted, smoked, or inhaled. One of the aspects of heroin that makes it so addictive is a quick onset of the effects (due to injection) as well as a particularly overpowering high. While heroin itself is an especially destructive drug, the rise in opioid-related disorders and deaths both nationally and in Colorado is due mostly to opioid prescription pain medicine. These painkillers are most commonly found in pill form but prescription medication abusers may also smoke, snort, or inject the crushed-up pills as well. Many of these prescription pills also contain a compound known as naloxone. This medication is an opioid antagonist. As such, it binds to the opioid receptors and acts as a means of blocking and reversing opioid effects on the body. While one of its primary applications is reversing an opioid overdose, it’s included in these prescription pills to deter users from crushing and injecting the medicine. As an opioid antagonist, injecting naloxone will bring on sudden withdrawal symptoms rather than producing a high, a process known as precipitated withdrawal. Given the meteoric rise of pain management prescriptions in recent years (300 million written in 2015 totaling a $24 billion market), it’s no wonder that there are a large number of prescription opioids available today. Here are just a few:
- Oxycodone (OxyContin)
- Hydrocodone (Vicodin)
The Danger of Heroin – Addictiveness
There are several contributors that make opioids so dangerous. The first is the addictiveness of these substances. Part of the reason for the high levels of addiction is that taking prescription medication carries with it a type of psychological freedom that using other drugs simply doesn’t. For instance, a heroin user is acutely aware of the fact that his or her abused substance is illegal. They hide their use from friends and family, purchase the drug illegally through dealers, and have been inundated with the message that heroin is an illicit substance by movies, TV shows, music, and other cultural mediums. Prescription medication, on the other hand, doesn’t carry that same kind of stigma. Sure, individuals that purchase such medications off the street are aware of its illegality and likely of their own substance use disorder. But the story can be a bit different for patients that have a legitimate prescription for opioids. For example, chronic pain accounts for 70% of opioids dispensed. Such prescriptions, while offering pain sufferers a bit of relief, can be followed precisely according to the doctor’s orders and still end up developing addictive behaviors in some patients. Recent studies have found that opioid dependence might be as common in non-cancer pain patients as 26%. These results indicate that more than one in four legitimate opioid prescription holders will end up developing a physical dependence, one of the main precursors to addiction. In essence, opioids can be particularly dangerous because users can accidently become addicted simply by following their doctor’s orders. There are a couple of factors that contribute to the rapid development of addiction in opioid users. One is that the high associated with opioids is more intense than many other substances, due in part to their fast-acting effects. When heroin is injected, for instance, users may feel an incredibly intense high almost immediately, but for a shorter period of time. Such short-lived intensity can cause heroin users to quickly crave another fix, thus beginning a cycle of addictive behavior. Another factor that contributes to rapid addiction development is the wide availability of opioid prescriptions. The CDC estimates that 1 out of 5 patients with non-cancer pain are prescribed opioids today, a number that many experts say is far too high considering the applicability of many over-the-counter drugs like Ibuprofen. In an effort to combat such widespread opioid prescribing, the CDC has developed a list of guidelines for physicians to consult before writing an opioid prescription. Other national health agencies like NIDA, SAMHSA, and the U.S. National Library of Medicine have also joined the fight by conducting various studies on the long-term effects of prescription opioid use.
The Danger of Opioids – Treatment and Withdrawal
While they may be meant to help users overcome their substance use disorders, the nature of opioid detox and treatment both play a role in the highly addictive nature of opioids. The detoxification process is integral to any substance abuse treatment plan. During this stage, the patient abstains from using the drug and the body acclimates to its absence. As with all drugs though, one of the effects of opioid dependence is that the brain has gotten used to its presence in the body. As such, it has significantly decreased production of natural chemicals like dopamine and serotonin since the opioids took their place. Once the opioids are removed, however, the brain is left with a reduced amount of pleasure-causing chemicals and consequently causes a number of physically uncomfortable side effects in the body. This process is known as withdrawal. While withdrawal from some substances like CNS depressants might potentially be fatal, opioid withdrawal is usually non-life threatening. Although, the symptoms of withdrawal from opioids are considered to be some of the most uncomfortable. These symptoms include:
- Painful cramping
- Intense muscle aches
These symptoms of withdrawal are actually one of the main reasons addicts tend to relapse during the early stages of treatment. In order to combat such serious side effects of opioid detoxification, many rehabilitation centers will use medication assisted treatment (MAT). In this kind of treatment plan, a substance abuser is given medication such as Suboxone or other forms of buprenorphine in order to lessen the severity of these symptoms. The downside is that many of these medications are actually opioids themselves. As such, they also have the potential for abuse and addiction. What’s more, some users with particularly long histories of opioid abuse will be put on a long-term maintenance plan where they are regularly given small doses of these medications. These plans might last anywhere from one week to several years, essentially trading their addiction to opioids for an addiction to the maintenance medication instead. Beyond the improbability of a drug-free life that comes with using these medications, some substance abusers have even used them to stave off withdrawal symptoms in between highs. Instead of guiding them towards abstinence then, they are actually giving users the option of a more flexible opioid addiction. Given these potentially dangerous factors, it’s important that you select the addiction treatment center that meets your needs.
The Danger of Opioids – Lethality
Opioids are also notoriously easy to overdose on. In addition to the potential of unknowingly using it with other substances (due to cutting it with other drugs), opioid use has been linked with a disproportionately high number of deaths. For instance, the potency and addictive nature of opioids can cause a rapid increase in tolerance. If an opioid user has built up such a tolerance and then seeks addiction treatment, that tolerance drops much quicker than they might expect. As such, if they then relapse and go back to using the same amount of opioids that got them high before, their body will no longer be able to handle such an amount, leading to overdose and possible death.
The combination of addictiveness, treatment and withdrawal, and lethality of opioids make them one of the most dangerous and addictive drugs known today. As the statewide and national epidemics continue to get worse, one of the best ways to combat opioid abuse is through education. The more you know about this hazardous drug, the better equipped you’ll be to fight off and overcome addiction.