Neurobiology of Opiate Abuse - Research Paper Example

CAUSES AND EFFECT OF OPIATE DRUG USE AMONG TEENAGERS BETWEEN THE AGE OF THIRTEEN AND SEVENTEEN IN OUR COMMUNITIES Introduction Opium derived from opium poppy has been known for its addictive and psychiatric effects ever since the beginning of its cultivation by Sumerians in 3400BC. The opium poppy plant Papaver somniferum was termed as “Hul Gil” or “The Joy Plant” by the Sumerians. Ever since opium has been and still remains a cause of concern despite its numerous medicinal properties. Opiates are a group of naturally occurring alkaloids including morphine, codeine, heroine, thebaine etc. Besides this it also includes certain semisynthetic derivatives of these alkaloids e.g. hydrocodone, hydromorphone, oxycodone, oxymorphone, and levorphanol. Artificial or synthetic opioids are also available and include fentanyl, meperidine, methadone, propoxyphene, and tramadol. While the former have chemical structures similar to natural opiates that of synthetic opiates is distinct. Irrespective of nature of origin, opiates have acute as well as chronic psychological effects and are known to be addictive (Kim-Katz & Anderson, 2011). Drug abuse is one of the major issues dealt by governments worldwide with approximately 185 million people being directly involved during the period spanning 1998-2002 according to UNODC estimates. Of this 0.4% of the population in the diverse age group of 15 to 64 years was found to be addicted to opioids with half using illicit opioids such as heroin and the remaining addicted to prescription opiates. In U.S., specific patterns are observed in nature of drug use. While illicit drug use is more prevalent among the black adolescents; prescription drug is used more frequently by whites (Schroeder & Ford, 2012). Global burden of illicit opioid use is indicated by the fact that it was reported to be responsible for 0.7% of global disability adjusted life years (DALYs) in the year 2000 (Hall et al., 2006). Teenagers in the age group of 13 to 17 years form a highly vulnerable set of population with respect to drug abuse. National Drug Intelligence Center data indicates that in the year 2003 alone approximately 7.5 million individuals of this age group had fallen prey to illicit drug use at least once, of these 3.3% were reported to have used heroin (NDIC, 2004). A comparison of the data for the years 2008 and 2009 indicates a statistically significant rise in illicit drug use incidences in this age group (SAMHSA, 2009). Causes Evidence based researches investigating the etiologic factors of opioid use are few. Personal factors that have been reported to be responsible for opiate use among teenagers can be listed in to three groups: Individual characteristics Advances in the science of Genetics have provided grounds for the theory that substance abuse has a genetic component rendering one individual more susceptible to substance abuse compared to other. However, the evidences for the nature and extent of opiate dependence determined by genetic factors are yet to be investigated. Family Factors Results of studies investigating the role of family in drug use agree with the Social Control Theory. It has been found that teenagers with strong family bonds have lower probability of resorting to drug abuse compared to those with less family support (Ford, 2009). Further children exposed to physical abuse and witness to domestic violence involving parents and/or siblings exhibit symptoms of post traumatic stress disorder. Such stress related symptoms has been found to contribute to higher prescription drug abuse vulnerability (Gayla & Vickerman, 2011). Social Factors Researches on adolescent drug use provide support to the theories of social control, social learning and strain variables as major predictors of drug use. Academic, interpersonal or financial strains are important contributors to drug abuse. Incidences of community or family violence also lead to stress that may in turn raise vulnerability to drug use and addiction. However the most determining factor has been found to be social learning involving peer attitudes, impact of drug using friends, peer expectations and parental influences. Further social learning is a bigger factor contributing to use of illicit opiates while social control is the bigger contributor to prescription drug use (Schroeder & Ford, 2012). Drug Related Factors Drug related factors are also important contributors to rise in opioid abuse and addiction among teens. Some of the major contributing factors include recent changes in prescription practices rendering assess to prescribed medications easier. The situation is further aggravated by government approval of prescription drugs, extensive advertising and easy availability of prescription drugs over the internet. Finally exposure to opiates in form of analgesics has risen due to changes in drug formulations (Compton & Volkow, 2006). It has in fact been found that students often use opiates for relaxation, as analgesics and even for improving academic performance. Compared to opiates obtained from street vendors, prescription drugs available from pharmacies or leftover of family member medications have definite chemical composition and predictable effects. These factors have led to lower legal and health risks. Effects Biological Opium based drugs have an immediate impact on the body with the possible involvement of dopamine system which results in self rewarding and stimulating effect of opiate drugs. The immediate impacts are manifested as nausea, sedation, a feeling of euphoria, depression and itching. Repeated and frequent use results in development of tolerance to immediate effects which in due course results in symptoms of craving and withdrawal. During withdrawal depression, irritability and insomnia occur while craving occurs along with dysphoria. Long term use of opioids thus results in enhanced pain, addiction and abuse along with adverse effects on hormonal and immune systems of the body (Di Chiara & North, 1992). Adverse impacts of opiate use are aggravated when used in combination with another drug. Administration of opiates with other sedative or alcoholic beverages can lead to complications as a consequence of additive and synergistic effects. This is more likely to happen among teenagers who are unaware of these complications. Methadone taken along with fluvoxamine or sertraline that are selective serotonin reuptake inhibitors (SSRIs), lead to much higher levels of methadone in blood plasma compared to that ingested. This results since metabolism of methadone is lowered by SSRIs. Hence as a consequence of simultaneous uptake of SSRIs and methadone, fatal complications may result. Another example is Tramadol, which when ingested with opiates may lead to seizures and serotonin syndrome involving symptoms such as confusion, muscle rigidity, hyperthermia etc (Kim-Katz & Anderson, 2011). Opiate drug use is related to increased morbidity as a consequence of drug overdose, and psychological effects leading to violence and suicide. Another cause of opiate related morbidity results due to use of contaminated injecting equipments causing spread of infections such as AIDS, hepatitis B and C. Adolescents have been found to be most vulnerable to heroin related deaths (Hall et al., 2006). Social Social impact of opiate drug use is manifested in form of high incidences of violence and crime related to drug trafficking. Emotional and financial disturbances result in poor social and interpersonal relations (Ruetsch, 2010). Economic A 2005 study has reported that opioid abusers are responsible for much higher (8.7%) health care costs compared to nonabusers. Psychiatric comorbidities such as depression further add to the health care costs of opioid dependence. Interventions in form of treatment and psychiatric counseling are a major financial burden to the families of the opioid drug dpendent teens besides effecting individual health adversely (Ruetsch, 2010). Conclusion Injectible opioids and opioid overdose have been found to be the major causes of opium drug related morbidity among the teenagers. Besides death, high prevalence of opiate drug use among population in the age group of 12-17 years has been found to result in severe consequences such as hormonal and immune disturbances. A control strategy involving law enforcements such as ban on heroin has been quite effective in controlling heroin availability. However studies have indicated a rise in the use of prescription opiates for non medical purposes by teenagers. Strategies therefore need to be devised to making unavailable prescription opium drugs for non-medical purposes. In absence of effective treatment strategies involving opioid antagonists, detoxification and drug free treatment are common treatments used for opioid addiction. Finally the target populations of vulnerable teenagers need to be made aware of the extreme and adverse consequences of opiate drug use. References 1. SAMHSA,(2010). Results from the 2009 National survey on drug use and health: volume 1. summary of antional findings. Rockville, MD: NSDUH. 2. Compton, W. M., & Volkow, N. D. (2006). Major increases in opioid analgesic abuse in the United States: Concerns and strategies. Drug and alcohol dependence , 103-7. 3. Di Chiara, G., & North, R. A. (1992). Neirobiology of opiate abuse. Trends in pharmacological sciences , 185-93. 4. Ford, J. A. (2009). Nonmedical Prescription Drug Use Among Adolescents. Youth society , 336-52. 5. Gayla, M., & Vickerman, K. A. (2011). Posttraumatic stress in children and adolescents exposed to family violence: I. Overview and issues. Couple and family psychology: research and practice , 63-73. 6. Hall, W., Doran, C., Degenhardt, L., & Shepard, D. (2006). Illicit opiate abuse. In D. T. Jamison, J. G. Breman, A. R. Measham, G. Alleyne, M. Claeson, D. B. Evans, et al., Disease Control Priorities in Developing Countries, 2nd edition (pp. 907-31). Washington D. C.: World Bank. 7. Kim-Katz, S. Y., & Anderson, I. B. (2011, January). Prescription opiate/opioid drug abuse: a new epidemic. Retrieved May 2012, from Chest: http://www.chestnet.org/accp/pccsu/prescription-opiateopioid-drug-abuse-new-epidemic?page=0,3 8. NDIC. (2004, November). Teens and Drugs: Fast facts. Retrieved May 2012, from National Drug Intelligence Center: http://www.justice.gov/ndic/pubs11/12430/index.htm 9. Ruetsch, C. (2010). Empirical view of opioid dependence. J manag care pharm , S9-S13. 10. Schroeder, R. D., & Ford, J. A. (2012). Prescription drug misuse: a test of three crminological theories. Journal of drug issues , 4-27. Read More