Understanding Opioid Use Disorder

Claire Guevara, M.D. discusses the class of opioids, where they are derived from, the types of opioids that exist, how they are used, and how they can be abused.

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After serious injuries many patients are prescribed medicines for pain. Some of these medicines belong to a class we call opioids. Let me tell you a little bit more about what opioids are. Opioids work in the brain to produce a variety of effects, including pain relief. They are a class of drugs that share the main ingredient, opium, which is naturally found in the poppy plant, or other chemicals that work the same way but have been manufactured in a lab. Some opioids are available legally by prescriptions such as oxycodone or oxycontin, hydrocodone, Vicodin, codeine, morphine, and many others. Opioids can be prescribed for patients who may experience moderate to severe pain. From injuries surgeries and other medical problems. Research suggests they work best for short-term pain but may actually worsen pain if taken for a long time. These prescription opioids are sometimes obtained illegally, or used outside their intended use, which is both dangerous and illegal. Other opioids, like heroin, are always illegal.

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Dr. Claire Guevara discussed the details of how opioids work on the body.

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Sometimes patients are prescribed opioid pain relievers to help with pain from surgery or injuries. I'd like to take a couple of minutes to share how opioids work. Nerve cells throughout the body act much like electrical wires connecting different body parts and the brain, this is how different parts of the body communicate. Special receptors called opioid receptors exist in our brains, spines, and other body parts. Our bodies naturally produce chemicals that can attach, or bind, to those receptors and impact the messages that are sent between the brain and the rest of the body. When the receptors are blocked the message is blocked. Following an injury nerve cells send signals to the brain that we experience as pain. In response the brain naturally releases chemicals that help block the opioid receptors thus blocking some of the pain. Opioid medications are typically much more powerful than the chemicals produced naturally in our bodies. When opioid medications are present, they quickly bind, or attach, to those special opioid receptors, making it so the nerve cells can't communicate with the brain. In other words, they block feelings of pain by doing a really, really good job of blocking signals from the injured area up to the brain.
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Dr. Claire Guevara explains how opioids work in our bodies and outlines the wanted and unwanted side effects of opioids.

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There are a couple of important things to keep in mind about opioid pain relievers. First opioids are good for blocking pain, but they do not get rid of the source of the pain itself. Only proper treatment, rest, and time can effectively help your body heal and overcome that pain. Another important point is that opioids disperse around the body and bind to opioid receptors everywhere. Not just the site of the injury. This helps explain why opioids often have unwanted side effects. They impact other functions as they bind opioid receptors throughout the body. For example, you might feel really tired, dizzy, nauseated, or experienced vomiting, or constipation. One especially dangerous side effect is slowed breathing which can lead to death if opioids are misused. Sometimes other types of medications and exercises can help manage pain even more effectively, especially over time. Over the short term, opioids can be helpful in reducing pain, but this is not the case over the long term long-term. Opioid use actually changes the biology of nerve cells in a way that results in people being more likely to experience pain. So, it's important not to use opioids longer than prescribed to stay healthy and safe.

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Overdose Lifeline, Inc. Executive Director Justin Phillips discusses the possible causes and signs of an opioid overdose.

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You may have heard that opioids can be dangerous. One of the biggest dangers associated with opioids is the possibility of an overdose. Overdoses are extremely serious and can happen to anyone. So, it's important to know what they are. Opioids impact many different body systems and functions, including the part of the brain that controls breathing. An opioid overdose is when a person's breathing slows to a rate where they no longer get enough oxygen. 

Here are a few risk factors for overdose to be aware of: 

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combining an opioid with alcohol, benzodiazepines or other sedatives, 

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taking an illegal opioid such as heroin, or using opioid medications in ways other than prescribed, like taking them more often or at higher doses, or taking pills that weren't prescribed for you, 

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injecting opioids,

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some medical conditions like kidney, liver, or lung disease, 

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being over age 65 although overdose can happen to people of any age, 

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and having opioid use disorder. 

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Because an opioid overdose can happen to anyone, anywhere; everyone should be aware of the signs of overdose so they can help get the person immediate care.

Some key signs that someone may be experiencing an overdose include: 

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being unresponsive or not waking up if you speak to them or call their name, 

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slow irregular or stopped breathing,

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slow erratic or weak pulse, 

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nodding in and out of consciousness or totally unconscious, 

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constricted or very small pupils in their eyes, like a pinpoint,

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face or palms that are clammy to the touch, 

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blue or purple lips or fingertips, 

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vomit or gurgling noises. 

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Knowing these signs can help you and your family identify when someone is in need of emergency help.

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