Opioid use is associated with many symptoms common to the abuse of other psychoactive agents, such as anxiety, paranoia, dysphoria, depersonalization, irritability, restlessness, and craving.
There is a relatively high rate of illicit heroin and opioid abuse in most areas of the country. The highest figures may be due to the recent growth of heroin use in San Diego County, and the fact that such use is not detected. Furthermore, there is a high rate of abuse of prescription medication. Although the majority of abusers are men, it is evident that both sexes can be adversely affected by this issue. The high rates of abuse are difficult to explain and are of concern for those charged with the responsibility of caring for the public. Preventive measures include improved education and awareness and control of prescription opioid use.
Results from a recent paper suggest that addiction may not only be defined by the compulsive use of a substance but also by the persistent reward process. Therefore, it is necessary to prevent the risk of developing an addiction to an addictive substance before it is established.
A significant number of individuals are prescribed a variety of medications for the management of opioid abuse. The use of antidepressants, selective serotonin reuptake inhibitors (SSRIs), and stimulants have been demonstrated in clinical studies on the use of prescription drugs to treat alcohol and cocaine use disorders. The use of these medications should be examined in a broader sample of individuals who take medicines to obtain a better understanding of the use of such agents in the general population. A number of medications may be used to treat opioid use disorders, but the role of each type of drug used is yet to be established.
There is a lack of consensus on the true cause of alcohol and drug abuse and most theories about addiction are a product of the limitations of current knowledge and research. However, current theories have made significant advances in explaining the mechanism through which drugs are rewarding and/or addictive, which is still an important topic in relation to both the prevention and treatment of drug use and dependence.
Even though patients are likely to continue to abuse opioids, there will be a shift in the population to non-opioid forms of abuse after successful treatment of opioid abuse. These non-opioid forms of abuse have been associated with a much reduced likelihood of chronicity of abuse. Opioid-positive patients, those with a history of opioid abuse, those who reported a lifetime history of a number of different types of abuse, and those who report having switched to nonprescription opioids are likely to continue to use opioids.
Although the overall high intensity group used more opioids than the control group, these results suggest that the placebo effect is a significant factor in the outcome of this treatment strategy.
In the United Kingdom, the leading cause of opioid abuse is prescription opiate dependence and treatment related pain. There were no significant differences between male and female subjects.
Opioid-abusing adolescent siblings are more likely than non-abusing siblings to be the parent of their parent's opiate-using siblings than siblings without opioid abuse. In a recent study, findings suggest that drug-specific genetic risk does exist in the family, indicating the need to investigate gene-environment interactions with a genetic basis.
The use of high-intensity therapy for opioid addiction does not translate into fewer relapses, and relapse rates are comparable with that achieved with low- and intermediate-intensity therapy, if not actually greater. Therefore, in terms of effectiveness, we caution against the introduction of high-intensity therapy for opioid dependence. What differences might exist in treatment effectiveness between different high-intensity treatment approaches are unclear.
Opioid abusers are at high risk for other kinds of harm. They are at risk for a variety of physical and psychological harms; the high level of comorbid medical problems found in our sample suggests that the health professionals involved in a drug rehabilitation treatment assignment must screen their patients for these concerns.
Recent findings suggests that clinical trials for opioid use disorders should be targeted towards high-risk patients. Furthermore, the results also suggest that it is important to pay close attention to the number of trials and patients in addition to the risk-benefit ratio of the clinical trials.