Overview of Narcotic Abuse
Opioid drugs, also called opiates or narcotics, have been used since the beginning of recorded history. Opium is derived from a white liquid produced by the poppy plant, first cultivated in the Middle East and Asia. It was used therapeutically in ancient cultures to induce calm and to relieve pain, and recreationally to induce euphoric dream states. Today, physicians prescribe narcotics for pain relief. Whether plant derived (natural) or synthetic, narcotics are sometimes still referred to as opioids.
Narcotics produce intense pleasure and general calmness:
- Drowsiness, tranquilization, or sleep
- Feeling of well-being
- Pain relief (analgesia)
- Temporary euphoria; a "high"
Narcotics like morphine, heroin, codeine, opium, hydrocodone, oxycodone, meperidine, and methadone bind to certain painkilling sites in the brain. With consistent use, they build up in the brain and block the production of endorphins, the brain's natural painkilling chemicals. Opium, morphine, and heroin (a derivative of morphine) were commercially available for purchase in the United States throughout the 19th century.
For complaints of diarrhea, menstruation, and headache, physicians commonly prescribed opioids in the form "tonics," elixirs," and "cordials" much in the way aspirin is used today. Their use, and even abuse, was less likely to be seen as problematic. Opium dens provided a place for people to smoke the drug. However, as policy makers began to address the social consequences surrounding narcotic addiction, drug use became stigmatized as a lower-class recreation. Shortly thereafter, the general public became intolerant of narcotic, now illicit, drug use. Abuse was defined as a problem and using heroin and smoking opium were eventually made illegal.
Narcotic abuse is defined by impaired function and interference in the daily life of the user. Users often develop serious physical, social, and mental health problems that compromise well-being and affect family and friends. Narcotic abuse costs the nation $10 billion a year in treatment, care, and lost productivity; this does not include the cost of treating use-related diseases, like AIDS.
Incidence and Prevalence of Narcotic Abuse
A 1999 National Household Survey on Drug Abuse reported that approximately 15,000,000 people in the United States use illicit drugs. Approximately 1% of the adult population in the United States abuses narcotics. Some evidence suggests that about 5% of adults aged 18 to 25the group with the highest lifetime prevalence of useuse or have used narcotic drugs like heroin. Other estimates put this number higher. Men in the United States use illicit drugs slightly more than women. Narcotic abuse among non-Caucasian people is reportedly highest, especially in urban areas.
Addiction: How Narcotics Work
The biochemical effects of narcotic drugs are what make them addictive. Narcotics bind to painkilling sites throughout the brain, known as opioid-U receptors or the "reward pathway." This leads to slower uptake of neurotransmitters, like dopamine, between neurons. Immediate effects include cessation of pain, drowsiness, and a feeling of well-being associated with pain reduction. With chronic use, the brain may stop producing endorphins, natural painkilling chemicals, and the user develops tolerance. The user must replace the missing endorphins with narcotics in order to feel good and to avoid the painful effects of narcotic withdrawal. The user becomes dependent on increasing amounts of the drug to feel good. Abuse usually leads to dependence.
Addiction is a chronic illness of the brain. Although one initially chooses to use narcotics, addiction is more than a behavioral problem; it is physiological and psychological. Compulsive use and relapse after recovery are a few of the behavioral problems that result from dependence. Use and relapse may be enforced by environmental cues, like peer influence and specific cultural stimuli. Breaking the habit of drug addiction is difficult and requires detoxification, changes in lifestyle, and therapy.
Risk Factors for Narcotic Abuse
Psychological and environmental risk factors for narcotic use include the following:
- Antisocial and experimental attitudes (i.e., rebellious nature) during adolescence
- Environmental factors
- Family problems
- Gang membership
- Inner-city culture
- Wealth or disposable income
- Family history of substance abuse and drug addiction
- Low self-esteem