Opioid Use Disorder Essay Example

An opioid use disorder is a pattern whereby an individual uses opioids (natural or synthetic agents with opium-like effects) compulsively leading to distress or severe impairment. Opioids are addictive substances that alter the reward system of the brain and cause feelings of "high" or pleasure. This alteration disrupts normal brain functioning and causes one to forget or neglect normal activities. Opioid abuse developed from the unregulated use of opioids in the 1800s as prescriptions for pain and ailments. Initially, the drugs were solely used in the management of cancer pain but later got adopted for use in the treatment of non-cancer pain treatment. This paper analyzes the etiologic factors of opioid use disorders, consequences, and management/ treatment. Since opioid use disorder has devastating outcomes and can be life-threatening, it is essential to understand the etiologic factors of the dysfunction, the health complications and consequences, and effective treatment and management processes.

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The major etiologic factors of opioid use disorder include genetics, environmental influences, pharmacology, comorbidities, and developmental influences. Genetics is the primary cause of vulnerability to substance use disorders such as OUD (Sharma, Bruner, Barnett, & Fishman, 2016). The risk of OUD is conferred through allelic variants to genes coding for dopamine transporters, dopamine receptors, cannabinoid receptors, serotonin transporters, serotonin receptors, opioid neuropeptides, and opioid receptors. Environmental factors such as exposure to opioid use by peers and family, adversity, and stress increase the risk of general substance use including opioids. Other environmental factors that are unique to OUDs include exposure to the use of opioids for non-medical use, access to opioids, permissiveness by influential persons, exposure to opioid analgesics, and the abuse of opioids by role models, family, and peers. Developmental vulnerabilities and psychiatric comorbidities confer the risk for the use of opioids (Sharma, Bruner, Barnett, & Fishman, 2016). Examples of such conditions include anxiety, depression, extreme extroversion, executive control problems, cognitive impairment, impulsivity, excitement-seeking, and effective regulation. Pharmacological factors include withdrawal after the discontinuation of medical opioid use, neuroadaptation, and physiological dependence. Opioid abuse resulting from any of the risk factors or vulnerabilities has hugely negative consequences.

The consequences of continued opioid usage include addiction, withdrawal, legal involvement, death, secondary complications, acute hospitalizations, morbidity, and mortality. Addiction is a chronic illness similar to hypertension or asthma, whose primary characteristics include cycles of relapse and exacerbations (Turner, Fogger, & Frazier, 2018). Addiction is the most complex effect of OUDs with severe social and health outcomes. Withdrawal occurs to individuals who use opiates for both recreational and medical purposes. Most individuals crave the drugs after discontinuation and end up finding them. Individuals experiencing withdrawal are vulnerable to law breakage, primarily when the discontinuation results from lack of funds for recreational buying. Opioids have very high levels of dependence and can lead to users isolating themselves from social activities, reducing involvement with peers and family, and experiencing mood changes. Addiction, isolation, and withdrawal result in psychiatric disorders such as depression, anger, anxiety, and irritability (Sharma, Bruner, Barnett, & Fishman, 2016). These disorders result in high rates of criminality, victimization, risky sexual behaviors increasing the risk of HIV, increased hospitalizations and even death. These complications require a comprehensive treatment strategy that applies medication and non-medical interventions.

Opioid use disorder is treatable through psychosocial approaches and neurobiological treatments. There are numerous evidence-based psychotherapies applicable in the treatment of OUD and other SUDs. Most psychotherapy treatments focus on behavior orientation. Also, psychoeducation of patients on strategies to reduce harm is critical. The principle of most psychoeducation strategies is to start low and go slow. Patients are advised on the right supply to reduce overdoses and warned against mixing opioids with other substances such as alcohol or benzodiazepines (Fuehrlein, & Ross, 2017). Information about injections mechanisms, needle usage, and use of naloxone rescue equipment is vital. Neurobiological treatment is also necessary for OUD, the most successful; approach focusing on opioid receptor level. Treatment mostly involves the use of pharmacotherapies such as methadone and buprenorphine, which are synthetic opioids, full agonist and partial agonist respectively (Fuehrlein, & Ross, 2017). Methadone reduces the harms associated with OUD including criminal activity, hepatitis B and C, HIV, and overdose death (Fuehrlein, & Ross, 2017). Buprenorphine can suppress the use and effects of heroin and increase treatment retention. OUD medications should always be used together with suitable psychosocial treatments.

Conclusion

Therefore, opioid use disorder is a deadly illness and a severe public health issue that costs most countries billions of dollars to manage. The disorder has severe health, social, and economic outcomes, thus making it essential to study significant etiologic factors, consequences, and treatment mechanisms. A greater understanding of the manifestation and effects of the disorder is necessary for policy development regarding the usage of opioids and management of resulting conditions. OUD can result from numerous risk factors, especially continuous medical usage, genetics, and environmental factors. Opioid use disorder has serious social and health consequences whose severity increases with time. Management of OUDs is similar to that of other substance use disorders. The treatment process requires a combination of both psychosocial and neurobiological interventions. This treatment focuses on the health conditions as well as habits that drive the use of opioids. Researchers are keen on identifying other non-addictive pain relievers to reduce pharmacological vulnerabilities.

References

Fuehrlein, B. S., & Ross, D. A. (2017). Opioid Use Disorder: A Desperate Need for Novel Treatments. Biological Psychiatry, 81(7), e43-e45.

Sharma, B., Bruner, A., Barnett, G., & Fishman, M. (2016). Opioid use disorders. Child and Adolescent Psychiatric Clinics, 25(3), 473-487.

Turner, C. C., Fogger, S. A., & Frazier, S. L. (2018). Opioid Use Disorder: Challenges During Acute Hospitalization. The Journal for Nurse Practitioners, 14(2), 61-67.