In Canada and in many other parts of the world, opioid addiction is increasingly considered a public health crisis. Calls for greater awareness, research, prevention, and accessible treatment options are being heeded as it becomes apparent that opioid addiction is having devastating effects for people across all demographics. Between Jan 2016 and June 2018, 9000 people in Canada died from opioid use, the vast majority of which were accidental overdoses. In Ontario between 2016-2017, hospital emergency department visits due to opioid overdoses increased by 73%.
Opioids are a class of drugs often prescribed as pain medication for those experiencing acute or chronic pain. They act on the nervous system, relieving pain and producing feelings of relaxation or euphoria (a “high”). This latter effect has meant that they have a high potential to lead to addiction in some individuals, sometimes even when they are prescribed and taken as directed. Examples of opioids include fentanyl, codeine, morphine, oxycodone, hydromorphone and heroin, which can be manufactured and obtained by both legal (medical) and illegal means.
An opioid addiction occurs when there is a strong, compulsive urge to take an opioid drug—whether it is required medically or not—that negatively interferes with a person’s regular daily functioning and relationships. Those who are prescribed opioid medications should be aware of their addictive potential and inform their doctor if they have a personal or family history of addiction. Opioids are generally intended as a short-term medication, and long-term effects can include
- Increased tolerance: a higher dosage of the drug becomes needed to obtain the same effect. Tolerance increases the chance of overdose and also intensifies withdrawal symptoms when the dosage is lowered or the individual stops taking the drug.
- Addiction or dependence: opioids are highly addictive, and many people require professional support from their care provider to safely reduce dependence.
- Liver damage: serious liver damage is a major risk of opioid use, particularly when the opioid is combined with acetaminophen (as it is in many prescription painkillers) or when it is taken with alcohol or other drugs.
- Increased pain: though opioids are often prescribed to reduce pain, some individuals will experience opioid-induced hyperalgesia, a greater sensitization to pain.
- Infertility in women and potentially fatal withdrawal symptoms in babies born to women taking opioids
Fortunately, there are many effective treatments for opioid addiction, including therapeutic support, detoxification (managed withdrawal), and medication-assisted treatment (methadone; naloxone for acute overdose). Often a combined approach is taken between a medical and mental health professional to support individuals with the physiological and psychological effects of reducing dependence on the opioid. Counselling can address the underlying factors that led to the addictive behaviours and change the thought patterns that supported them, as well as assist with building healthier coping skills, managing setbacks, and repairing damaged personal and professional relationships. If you or someone you know is struggling with a potential opioid addiction, reaching out to a qualified clinician can be the first crucial step toward recovery.
By: Zoë Laksman, Psy.D, C.Psych and Laura Clarridge, Ph.D.
Zoë Laksman has practiced as a Registered Clinical Psychologist at The Clinic on Dupont since 2007. Laura Clarridge is a certified executive coach who helps her clients find fulfilling educational and career pathways. Their backgrounds and training have shaped their interest in promoting improved psychological health, interpersonal functioning and wellness. They work together as a clinical team and as the developers of The Clinic on Dupont’s online presence.