Impact of Addiction
Foundations of Addiction and Addiction Behavior
This paper will include information on the history of opioid addiction. Along with the history, this learner will discuss treatment options that work well opioid addiction. The history of opioid addiction has impacted the treatment that is given to those addicted. This learner will discuss the DSM-V criteria and the different severities of addiction a person can have. This paper will also include information on the social and cultural issues, legal and social consequences with the use of opioids, demographic factors that may apply to the onset use of opioids, and the impact opioid use has of families and intimate relationships.
Impact of History upon Addiction Theory and Treatment
Opiate addiction can be dated back to the 11th century when opium was used in Western Europe for medicinal purposes which became known as a “therapeutic drug”. From the 11th century opiate use has evolved into an epidemic. “The National Institute on Drug Abuse (NIDA) reports that an estimated 52 million people, 20% of those aged 12 and older, have used prescription drugs for nonmedicinal reasons at least once.” (Adams, 2016 p.7). Opium can be broken down into three main categories: (1) Morphine, (2) Codeine, and (3) Thebaine. Morphine is an active ingredient of opium which can be administered in different routes. These routes of administration would include intravenously, nasal, and oral. A derivative of morphine is heroin which is now the new pain killer because it is three times as potent as morphine. Although morphine is the most recognized ingredient in opiate addiction, codeine is .5% of raw opium where thebaine is .2% of raw opium (Levinthal, 2012).
During the 1900s historical events occurred because of the use of heroin. The Harrison Act of 1914 was passed and this act changed the idea of opiate use and the abuse. Although this act did not ban the use of opiates, it did make doctors register with the IRS and pay a small fee for every time they prescribed opiates which later tried to eliminate the recreational use and buying opiates from the black market. Heroin became a black market drug because it was odorless and easy to transport. In 1961 the price of opiates increased. This increased caused an increase in criminal behavior within urban areas and a shortage of opiates to be sold on the streets. In the 1990s the cost of heroin decreased which then allowed the opiate to be sold are more pure percentages. This decreased sparked the users to snort or smoke the opiate rather than inject it late in 1996 heroin consumption doubled worldwide.
There are many treatment options for people who become addicted to opiates. These treatments would include: detoxification with the help of naloxone, methadone maintenance, LAAM (Orlaam), Buprenorphine (Subutex), and Narcotics Anonymous (Levinthal 2012). “Methadone maintenance reduces and/or eliminates the use of opiates, reduces the death rates and criminality associated with heroin use, and allows patients to improve their health and social productivity”. Methadone is a slower acting opiate that is administered orally which binds with the endorphin receptors which prevents the euphoric effect and cravings as opiates would produce. LAAM and buprenorphine are synthetic opiates that last longer than methadone and can be used in place of methadone. Although LAAM and buprenorphine are similar, buprenorphine can be administered/prescribed by an office-based physician (Levinthal, 2012).
There are many addiction models that influenced the treatment available. The model of addiction that would that be most consistent with these treatment approach would be the biopsychosocial model. The biopsychosocial model has three main components: (1) the drug, (2) the person, and (3) the environment; these three factors work together to produce a person’s addiction (Lewis, 2014 p.25). This model also works as a team and collaborates with different therapies and is flexible for treatment plans. This model would be most consistent because with treatment that is available, the counselors work collaboratively with the nurses to coordinate their doses of treatment. The biopsychosocial model does not solely put the blame on the client but rather also puts the blame on the environment and their social learning experience. The biopsychosocial model would work well with treatments because with the treatment the client has to complete a biopsychosocial assessment which will allow the counselor to understand where their addiction came from and how to properly treat them.
DSM-V Criteria and Severity
When determining the DSM-V criteria and severity for heroin use, there are many factors that need to be considered. Although a person may be using heroin as their drug of choice, within the DSM-V they would fall under Opioid Use Disorder. This disorder “includes signs and symptoms that reflect compulsive, prolonged self-administration of opioid substances that are used for no legitimate medical purpose.” (American Psychiatric Association, 2013 p.542). Within the DSM-V Opioid Use Disorder, there are three severities: (1) Mild 305.50, (2) Moderate 304.00, and (3) Severe 304.00. Each of the severities is determined by how many symptoms a person has under the diagnostic criteria. The symptoms of opioid use disorder would include having the strong desire for opioids, the continued use without caring for the interference of social or work environments, using more than intended, the inability to reduce or control without assistance, and spending more time than needed to obtain and use the opioid(s) (American Psychiatric Association, 2013 p. 541).
The use of opioids can change severity due to different circumstances. For example a person may be taking OxyContin because of pain management and misuse the prescribed route of administration and the prescribed amount. OxyContin can be crushed, inhaled, or injected which then causes similar effects of heroin. Although the person may be taking the medication as prescribed, they can build a tolerance to the prescription medicine which then gives them an option to move to a harder drug such as heroin. Since heroin is a street drug and is usally used recreationally, this can move the severity of symptoms from mild to moderate depending on how often the person is searching for the drug and how much they are used to compromise for the tolerance of Oxycontin.
Social and Cultural Issues
There has been research that supports the idea that a persons socioeconomic status (SES) can be related to the opioid problem and/or epidemic. Jones (2012), has found that people who are from a higher SES are suffering more an opioid addiction than those of a lower SES. This was believed because people who are from a higher SES are able to be prescribed more or higher opioid medications. On the other side of a persons SES, researchers have examined whether or not a persons educational level can be a factor of opioid abuse. “Young adults who do not attend college are at high risk for non-medical prescription opioid use, while college-educated young adults are more at risk of prescription stimulant abuse.” .
Researchers Butler and Higgit (1996), Closserand Blow (1993), and Finch and Barry (1992) learned from studies and findings that “women over age 65 are more likely than men to see a doctor and to be prescribed a psychoactive drug.” . Along with the misuse of psychoactrive drugs such as cocaine and amphetamines, “Gomberg (1992) states that aging adult women are at a greater risk of substance misuse resulting from inappropriate prescription of psychoactive drugs than is any other age-by-gender group” . Many times women are more likely than men to seek additional help for their injuries or problems which then may lead to their opiate addiction once they are prescribed medications. Also there are different health issues that can be more unique to women than men therefore women seek additional help for those health issues.
Legal and Social Consequences
There are many ways that opiate use is impact the way consequences of the opiate addict legally. Illicit drug production, distribution, consumption, and possession are just a couple of ways that a person can have a criminal offence. “In the United States, for example, almost 60 per cent of all federal prisoners in 1994 were drug offenders, up from 45 per cent in 1988.” . When using illicit drugs, crime increases due to not only the use but because of the activity. Most of the crimes are related to the trafficking of the illicit drugs and territorial areas. Another way that the crime increases is due to the ones who are trafficking the drugs, need to fulfill their addiction as well which turns into theft or prostitution.
Knowing that women seek additional help for their problems more than men, their use tends to increase or escalate faster. With the escalation of use, the legal and social consequences of women are higher than men. These consequences do not always have to fall under the category of arrest and jail, rather they can also consist of abuse, rape, social stigmas, and victimization. Another demographic factor that may impact the way society imposes consequences upon the addict both legally and socially would be the socioeconomic status of the user. A persons socioeconomic status can consist of their income, education, wealth, etc. A person of a higher socioeconomic status may be more prone to use illicit drugs due to the frequent gatherings that they attend. This can impact the legal and social consequences of the person using illicit drugs because they may have the access to purchase the substance and have social relations with people who have the financial means which can cause their social relations to become a part of the illegal actions.
Impact upon the Family and Intimate Relationships
Being addicted to opiates can not only impact the person who is addicted but it can also impact their families and intimate relationships. A persons addiction can lead to spousal abuse, physical abuse, emotional abuse, financial problems, etc. “An estimated 75% of domestic violence incidents occur as a result of one or more of the individuals involved having used drugs or alcohol.” . Knowing that a family member or an intimate partner is addicted to opiates could potentially misuse and over dose can cause increase stress in the home environment and in relationships. “Researchers focusing on the role of family relationships in the creation and maintenance of drug-related problems have identified a strong connection between disrupted family relationships drug addiction.”.
Opiates can be an expensive habit and addiction. Opiate users may have the urge to use their preferred substance every four to six hours after their last dose; when they don’t use they may experience withdrawal symptoms. People who become addicted to opiates spend a great deal of money and may take money that is not theirs. People may take from their family or intimate partner which can cause relationship barriers and trust problems. Another outcome that results from a persons opiate addiction is the outcome of co-dependency. Co-dependency is a behavior that can involve a family member or a significant other take the responsibility of the care of an addict .
Although many people believe that an opiate addiction is when a person is using drugs such as heroin yet there are people who are addicted to prescription drugs such as Percocet, Vicodin, OxyContin, etc. Opioid addiction can be dated back to 11th century and is growing and becoming an epidemic. With the long history of opiate use and addiction there has been many treatments discovered to decrease the use and assist a person achieve stability. These treatments would include naloxone, methadone maintenance, LAAM (Orlaam), Buprenorphine (Subutex), and Narcotics Anonymous. The DSM-V is a diagnostic criteria that diagnosis a person with Opioid Use Disorder 304.00 which has three severities: (1) Mild 305.50, (2) Moderate 304.00, and (3) Severe 304.00. With any addiction there are social and cultural issues and legal and social consequences. Lastly an addiction can affect and impact the family and intimate relationships. This impact can bring the family closer or have their relationship become distant.
Adams, T. (2016). Opiate Addiction- The Painkiller Addiction Epidemic, Heroin Addiction and the Way Out. Petersburg: Rapid Response Press.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Feidler, K., Leary, S., Pertica, S., & Strohl, J. (2002). SUBSTANCE ABUSE AMONG AGING ADULTS: A LITERATURE REVIEW. Center for Substance Abuse Treatment, 1-66.
Jones, C.M. (2012). Frequency of prescription pain reliever nonmedical use: 2002-2003 and 2009-2010. Archives of Internal Medicine, 172(16). 1265-1267.
Joseph, H., Standcliff, S., & Langrod, J. (2000). Methadone maintenance treatment (MMT): a review of historical and clinical issues. The Mount Sinai Journal of Medicine, 347-364.
Levinthal, C. F. (2012). Drugs, Behavior, & Mondern Society. Boston: Allyn & Bacon.
Lewis, T. F. (2014). Substance abuse and addiction treatment: Practical application of counseling theory. Upper Saddle River, NJ: Pearson. ISBN: 9780132542654.