million Americans have used opioids for nonmedical purposes and among these, many have been abusing more than one narcotic agent. Of course, if someone is prescribed an opioid, he should continue to take the medication as prescribed. Now, just because someone is on an opioid for pain relief most certainly does not mean he is abusing the drug or that he will become addicted. There is a long road to travel in developing an addiction. The journey usually starts with taking prescription pills and leads into something else. When taken as instructed, the opioid relieves pain but can also cause drowsiness. But when taken in abundance, it can lead to feelings of comfort and enjoyment. Opioids not only reduce pain signals but also release large amounts of dopamine, which causes feelings of pleasure. This reinforces the dependent user to continually repeat that particular experience—this leads to addiction (National Institute on Drug Abuse, 2018). But it can also control the heart and breathing rate—this leads to death. to use the same amount of drugs that they were used to before they were incarcerated or admitted. Instead of using a small portion to start with, they swallow, inhale, or inject a large quantity. The opioid receptors in the brain are not able to handle the amount and no longer inhibit pain, but now suppress the breathing and the heart rate (bradycardia). Once this occurs, the person is now in a full overdose. Troilo (2018) stated: In the two weeks after their release, recently incarcerated people are almost 42 times more likely to die from an overdose than the general population. With such an apparent risk and dire consequences, states need to prioritize the widespread adoption of proven strategies to lower the risk of opioid overdoses among formerly incarcerated people . properties and similar high as prescription pills, and is much less expensive and easier to obtain, individuals often switch from pills to heroin (Pearl, 2018). This is reinforced by the reports that nearly 80% of heroin users indicated that they first used prescription opioids (National Institute on Drug Abuse, 2019). It all boils down to drug availability; heroin is prevalent because the pills are not. can build up throughout the tissues (Renzoni, 2019). Fentanyl and morphine decrease blood flood in the glomeruli, a group of capillaries that filters waste products from the blood (Mallappallil, Sabu, Friedman, & Salifu, 2017). Opioids are also known to cause urinary retention, especially in the elderly, which leaves a significant amount of urine in the bladder, and they are unable to excrete waste properly. If the kidneys are no longer functioning properly, dialysis or a kidney transplant may be required (Renzoni, 2019).
for prescribing opioids, screening for opioid abuse, and other related materials (American Medical Association, 2018). To decrease opioid prescriptions, physicians are now using the Prescription Drug Monitoring Programs (PDMP), a database that allows them to make sensible decisions about prescribing an opioid during the care of the patient. The approach has been working, as opioid prescriptions from 2016 to 2017 decreased by 19 million (American Medical Association, 2018). An article in the International Journal of Molecular Sciences (2018) pointed out: Recent data from the National Institute on Drug Abuse noted that the prevalence of heroin abuse and dependence in young adults has increased significantly. In New York City, the mortality rate from drug overdoses tripled between 1990 and 2006; it is not limited to being an inner city problem and widespread use of prescription drugs for non-medical use was noted among rural youth in the USA. In adults, approximately 5% reported nonmedical opioid use; about twelve Tolerance Individuals taking opioids repeatedly over an extended period generally develop some type of tolerance. The body no longer reacts to the same medication and amount in the way it did at first. With the continued presence of the drug in the bloodstream, the person has to take more of the substance to receive the same effects before the tolerance. Overdoses are common in individuals recently released from prison or from a substance abuse rehabilitation center. Before they were admitted or incarcerated, they had built up a tolerance to the drug. Their brain receptors were accustomed to the high volume and strength of the opioid. Once they are admitted and the drugs leave their system, the tolerance goes back to the level it was before they began using drugs. In essence, there is no tolerance. However, once these persons are released, they often begin Heroin Heroin can be injected by the use of a syringe, snorted by the use of straws, and smoked by vaporizing. There are many reasons why there is a rise in heroin abuse. First, because of the medical community crackdown on writing scripts, prescription opioids are available, but they are rather more difficult to obtain than heroin. Doctors are not so apt to give someone a prescription as they used to. Secondly, because heroin offers nearly the same chemical Opioids affect kidneys Kidney dysfunction, acute or chronic, is common with the continual use of opioids. The kidneys are responsible for the elimination of nitrogenous waste (uric acid, ammonia, urea) from the body (Mallappallil, Sabu, Friedman, & Salifu, 2017). When not working properly, waste is retained in the body tissues (Renzoni, 2019). Morphine causes renal ischemia leading to acute kidney injury. Additionally, the drug can cause the vasoconstriction, which leads to renal deoxygenation. Heroin use leads to rhabdomyolysis, a condition in which muscles and tissues begin to disintegrate and the proteins are released into the bloodstream, which
STIGMA
There is definitely a stigma when it comes to drug addiction. There is often a cloud of shame and guilt and disgraced feelings of being weak-willed or not strong enough to beat the addiction. Though not intentional, inappropriate comments from family members or friends such as “Why
are you doing this to us?” or “Just stop using drugs!” can be hurtful and even perpetuate matters. This can lead to a withdrawal from family and friends and even extracurricular activities.
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Book Code: FNJ0524
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