Opium Abuse and Addiction
Opium is a dried liquid obtained from opium poppies which contains up to 12% morphine. Morphine is the alkaloid that is used to produce heroin for the illegal drug trade.
Being of similar structure, the opiate molecules occupy many of the same nerve-receptor sites and bring on the same analgesic effect as the body's natural painkillers.
Opiates first produce a feeling of pleasure and euphoria, but with their continued use the body demands larger amounts to reach the same sense of well-being. Malnutrition, respiratory complications, and low blood pressure are some of the illnesses associated with long-term use. Morphine is also responsible for harmful effects such as lung edema, respiratory difficulties, and even cardiac or respiratory collapse.
Long-term use of morphine in chronic pain management can lead to physical dependence. Chronic pain patients will find that, at an appropriate dose of medication, tolerance to the euphoric effects develops while pain is successfully controlled for years at the same dose. A drug abuser posing as a pain patient will quickly develop tolerance to the euphoric side-effects of the opiate he is prescribed for pain. As a result, such patients will demand an increase in their dose more often.
Opium, like almost all illicit substances, causes withdrawal symptoms when use is stopped or temporarily interrupted. The desire to avoid the sometimes intolerable feelings of withdrawal keeps many opium users using despite the negative consequences.
Opium withdrawal symptoms include: nausea, sweating, diarrhea, mood swings, insomnia, depression and muscle twitching.
Pharmacologically based treatments are available, including naltrexone, methadone or ibogaine. However, it should be emphasized that these treatments are for those suffering from true opioid addiction, and not from physical dependence resulting from the appropriate use of opioids for chronic pain.
In the event that a patient with chronic pain no longer suffers from the same degree of pain, it is not difficult for the patient and treating physician to gradually taper down the prescribed opioids until the patient has entirely discontinued opioids use. Of course this is only possible if the patient's underlying pain has been mitigated, successfully treated, or otherwise been resolved.
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