Opioids vs Opiates
Understanding Opioids and Opiates
As we delve into the issue of substance abuse, specifically focusing on opioids vs opiates, it's important to understand these two terms. Although often used interchangeably, there are key differences that distinguish opioids from opiates.
Differentiating Opioids and Opiates
Opiates are chemical compounds extracted or refined from natural plant matter, specifically the poppy plant. They are the naturally occurring alkaloids found in opium, derived from the resin of the opium poppy, Papaver somniferum.
Opioids, on the other hand, are a broader class of drugs, which include not only naturally occurring opiates but also synthetic and semi-synthetic drugs that are structurally related to the natural plant alkaloids. These drugs, often synthesized in labs, mirror the chemical structure of naturally occurring opiates, hence their ability to engage the same cell surface receptors in the brain and body known as opiate receptors [1].
Examples of Opiates and Opioids
Given the differentiation between these two classes of drugs, familiar examples of opiates include morphine and codeine. These are derived directly from the opium poppy plant and have been used historically for their analgesic, or pain-relieving, properties.
Opioids include drugs such as hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), and oxycodone (e.g., Oxycontin, Percocet) [2]. Additionally, dangerous substances such as heroin, although never used as a medicine in the United States, also fall under the opioid category due to their structural relation to natural alkaloids [3].
Understanding the differences between opioids and opiates is integral to understanding the broader landscape of substance abuse, addiction, and treatment options. This knowledge forms the foundation for further exploration into the effects, risks, and management of opioid use.
Effects of Opioids on the Body
Understanding the mechanics of opioids and their impact on the body is essential to comprehend the broader discussion of 'opioids vs opiates'.
How Opioids Work
Opioids, whether naturally derived or synthetically created, act by engaging specific cell surface receptors known as opiate receptors. These receptors are denominated as µ (mu), κ (kappa), and δ (delta), and are predominantly found in the central nervous system, brain, spinal column, and other areas like the vascular, cardiac, lung, gut, and peripheral blood mononuclear cells.
These drugs work in the brain to produce a variety of effects, the most profound of which is pain relief [4].
Similarities in Opioid Effects
Despite the differences in their chemical structures, opioids share a common set of effects on the body. They are well-known and widely used for their profound pain-relieving impacts, but it's crucial to note that opioids do not decrease or treat the cause of the painful stimulus. Instead, they decrease its perception.
Additionally, opioids can induce other effects such as euphoria, changes in mood, drowsiness, and mental clouding. This can contribute to their potential for misuse and dependency, which poses a significant public health concern.
While the effects of opioids can be reversed using specialized opioid antagonists like naloxone, naltrexone, and nalmefene, these are predominantly used in cases of opioid overdose. They can also be used to manage some unwanted side effects of long-term opioid use, like constipation.
Understanding these effects is essential for anyone using opioids, whether for medical or non-medical reasons. It's always important to use these potent substances under the supervision of a healthcare professional to minimize potential risks and ensure safe use.
Risks and Dangers of Opioid Use
While opioids can provide significant relief from pain, their misuse can lead to severe health risks and complications including addiction. Understanding these risks is crucial for preventing and addressing opioid misuse.
Addiction Potential of Opioids
Opioid drugs, which include both prescription pain medicine and illegal drugs, possess a high potential for addiction, a condition also known as opioid use disorder (OUD). Both legally prescribed and illegal opioids can cause euphoria — a pleasurable sense of well-being — in some users. Not everyone experiences this sensation when taking opioids, but for those who do, this feeling can lead to a risk of repeated use of the drug.
Prescription opioids, when legally prescribed by a doctor and used as directed, can help relax the body and relieve symptoms of illness, injury, or surgical procedures. However, it's important to be wary of the risk of dependency and addiction, even when these drugs are used as prescribed.
Transition from Prescription Opioids to Heroin
Another significant risk associated with opioid misuse is the potential transition from prescription opioids to heroin. Prescription opioids and heroin are chemically similar and can produce a similar high.
In some instances, individuals switch to heroin due to its lower cost and easier accessibility compared to prescription opioids. Data from 2011 indicated that an estimated 4 to 6 percent of individuals who misuse prescription opioids transition to heroin, and about 80 percent of heroin users initially misused prescription opioids. Recent data suggests that heroin is frequently the first opioid people use [3].
Understanding these risks is a crucial step in addressing the opioid crisis. By being informed about the dangers of opioid use, individuals and communities can better prevent and combat opioid misuse and addiction.
Treatment and Management of Opioid Addiction
Addressing opioid addiction requires a comprehensive approach, from managing withdrawal symptoms to implementing effective medications and therapies.
Withdrawal Symptoms and Management
Individuals addicted to opioid medications may experience severe withdrawal symptoms upon discontinuation, including restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goosebumps, and involuntary leg movements. To help manage these symptoms, medications like lofexidine and devices such as the NSS-2 Bridge have been developed.
Medications and Therapies for Opioid Addiction
A combination of medications and behavioral therapies has proven effective for treating opioid addiction. Medications for opioid use disorders interact with the same brain receptors as prescription opioids, but when taken as prescribed, they do not produce the same effects as misused opioids.
Alongside these medications, behavioral therapies help individuals modify their attitudes and behaviors related to drug use, develop healthy life skills, and support other forms of treatment. This comprehensive approach can significantly improve the chances of recovery and long-term abstinence from opioid misuse.
Understanding the complexity of opioids vs opiates, and the unique challenges that come with addiction, is crucial for treatment and management. With proper support, recovery is possible. The journey can be difficult, but with perseverance and the right resources, individuals can overcome addiction and reclaim their lives.
Impact of Opioids in Canada
The opioid crisis in Canada is a serious public health concern that is affecting individuals across all demographics and provinces. This section will provide an overview of the opioid crisis statistics in Canada and discuss the impact of opioids on First Nations communities.
Opioid Crisis Statistics in Canada
In 2016, Canada experienced 2,861 apparent opioid-related deaths, which equates to eight people dying each day from opioids. Moreover, an average of 16 Canadians were hospitalized each day due to opioid-related poisonings in the same year.
The country also saw a significant increase in prescription opioids since the early 1980s. Alarmingly, over 20 million prescriptions were dispensed in 2016 alone, equivalent to nearly one prescription for every adult over the age of 18 years. Canada ranks as the second-largest consumer of prescription opioids globally, just behind the USA [5].
Synthetic opioids, such as fentanyl, have become increasingly prevalent in the illegal drug market in Canada. For instance, fentanyl was involved in 68% of illicit drug deaths in British Columbia and 53% of apparent opioid-related deaths nationally in 2016.
The rate of apparent opioid-related deaths in Canada was 7.9 per 100,000 population in 2016. Western provinces such as British Columbia and Alberta reported some of the highest death rates, with British Columbia reporting a rate of 20.7 per 100,000 population and Alberta reporting a rate of 14.4 per 100,000 population. These two provinces alone accounted for the majority (56%) of opioid-related deaths in 2016.
First Nations Communities and Opioid Crisis
First Nations populations in Canada are significantly impacted by high rates of problematic substance use. First Nations individuals are five times more likely than their non-First Nations counterparts to experience an opioid-related overdose event and three times more likely to die from an opioid-related overdose. First Nations women, particularly older women, represent a higher proportion of opioid-related deaths in British Columbia and Alberta.
These statistics illustrate the devastating impact of the opioid crisis in Canada, particularly on vulnerable populations such as First Nations communities. Addressing this crisis requires comprehensive strategies, including prevention, intervention, treatment, and management efforts.
Addressing the Opioid Crisis
The opioid crisis, characterized by the misuse of opioids and opiates, poses a significant public health challenge. It is critical to understand the initiatives and strategies in place to address this crisis, particularly in the light of rising opioid-related deaths and hospitalizations.
Government Initiatives and Programs
The Canadian government has recognized the escalating opioid crisis and has taken steps to address it. Health Canada provides comprehensive information on opioid medications, overdose, the effects of opioid use, assistance for opioid use disorder, and related health risks.
Resources are also provided for responding to Canada’s overdose crisis, including details of current federal actions, data, surveillance, and research on opioids and other substances. The Canadian drugs and substances strategy and government programs are also outlined [6].
These efforts are particularly crucial given the increasing prevalence of opioid use and the associated risks. In 2016, there were 2861 apparent opioid-related deaths in Canada, equivalent to eight people dying each day. Furthermore, on average, 16 Canadians were hospitalized each day due to opioid-related poisonings in the same year, affecting individuals across all ages and socioeconomic groups.
Strategies for Prevention and Intervention
Effective prevention and intervention strategies are integral to combating the opioid crisis. One of the main areas of concern is the significant increase in prescription opioids since the early 1980s. In 2016, over 20 million prescriptions were dispensed, equivalent to nearly one prescription for every adult over the age of 18 years. This positions Canada as the second-largest consumer of prescription opioids globally, after the USA.
Addressing this issue requires a multifaceted approach, including improving prescribing practices, increasing access to treatment for opioid use disorder, and enhancing public awareness about the risks associated with opioid use.
Another escalating issue is the rise in synthetic opioids like fentanyl in the illegal drug market. Fentanyl, which was first reported in British Columbia and Alberta in 2011, was involved in 68% of illicit drug deaths in British Columbia and 53% of apparent opioid-related deaths nationally in 2016.
To combat this, law enforcement agencies need to work in collaboration with health services to target the supply of these dangerous substances. Additionally, harm reduction strategies, including safe consumption sites and the provision of naloxone kits, can play a crucial role in preventing opioid-related deaths.
In conclusion, addressing the opioid crisis requires a comprehensive and collaborative approach, encompassing government initiatives, prevention strategies, and effective interventions. By understanding the distinct characteristics of opioids vs opiates, individuals and families impacted by substance abuse can navigate the resources and support available to them.
References
[1]: https://pubmed.ncbi.nlm.nih.gov/31643200/
[2]: https://www.oregon.gov/adpc/pages/opiate-opioid.aspx
[3]: https://nida.nih.gov/publications/drugfacts/prescription-opioids
[4]: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/opioids
[5]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034966/
[6]: https://www.canada.ca/en/health-canada/services/opioids.html