Opioid addiction is a long-lasting disease that can cause major health, social and economic problems . Opiods are a class of drugs that include illegal heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (oxycontin®), hydrocodone (vicodin®), codeine, morphine and many others . Opioid addiction is characterized by a powerful, compulsive urge to use opioids, even when not required medically. Opioids have a high potential for causing addiction in some people, even when medication is prescribed appropriately and taken as directed .
What Causes Opioid Addiction?
This condition results from a combination of genetic, environmental, and lifestyle factors, some of which have not been identified. Many of the genes that are thought to play a role are involved in the endogenous opioid system, which is the body’s internal system for regulating pain, reward and addictive behaviors . Opioid receptors exist in the nervous system and when endogenous or exogenous opioids (medications and heroin) attach to them, a series of chemical changes are triggered that leads to feelings of pleasure and pain relief. Variations in genes involved in other aspects of nervous system function (neurotransmitter pathways, differentiation) have also been indicated as risk factors. Non-genetic factors that have shown to increase the risk of addiction include history of substance abuse; depression or other psychiatric disorders; childhood abuse or neglect; certain personality traits like sensation-seeking and impulsivity; living in poverty in a rural area; associating with others who abuse opioids and having easy access to prescription or illegal opioids.
It is reported that as many as 36 million people misuse opioids worldwide . In the United States, this disease affects more than 2 million people . The prevalence of misuse and addiction continues to rapidly increase. In 2016, > 20,000 deaths in the United States were caused by an overdose of prescription opioids and another 13,000 were atttributed to heroin overdose. Drug overdoses are now the leading cause of death in United States adults under the age of 50 and opioids account for more than half of all drug overdose deaths.
Treatment of opioid dependence?
The main objectives of treating and rehabilitating persons with opioid dependence are to reduce dependence on illicit drugs; to reduce the morbidity and mortality caused by the use of illicit opioids, or associated with their use, such as infectious diseases; to improve physical and psychological health; to reduce criminal behavior; to facilitate reintegration into the workforce and education system and to improve social functioning . The ultimate achievement of a drug free state is the ideal and ultimate objective but this is unfortunately not feasible for all individuals with opioid dependence, especially in the short term. As no single treatment is effective for all individuals with opioid dependence, diverse treatment options are needed, including psychosocial approaches and pharmacological treatment. Relapse following detoxification alone is extremely common, and therefore solutions like electro-detox can be crucial in helping to reduce the symptoms of opioid withdrawal. Even though detoxification by itself rarely constitutes an adequate treatment on its own, it is a first step for many forms of longer-term abstinence-based treatment. Both detoxification with subsequent abstinence-oriented treatment and substitution maintenance treatment are essential components of an effective treatment system for people with opioid dependence .