Opioids and Potentiators: A Dangerous Combination

What are Opioids?

Opioids are a class of drugs that are either derived naturally from the opium poppy Papaver somniferum, or are created synthetically to provide the same effect on opioid receptors. In medicine, opioids are used in pain management since they are very effective at relieving pain. Some opioids, like loperamide, are used to treat symptoms like diarrhea. While opioids are designed for clinical use, they are commonly abused and pose a high risk for addiction and dependence. Sometimes their effects are enhanced by using opioid potentiators.

Opioids and Potentiators: A Dangerous Combination
An opioid potentiator is any substance that is taken in combination with opioids to enhance their effects. Potentiators interact with opioids in the blood to cause various reactions. For example, orange juice and grapefruit juice have been shown to increase the effects of opioids like oxycodone. Doctors may even recommend that their patients don’t take grapefruit or other citrus juices while they are taking prescription opioid medications.

Other potentiators include cold medicines, antihistamines and alcohol. Using potentiators can lead to serious complications and increase the risk of death due to overdose. Opioid potentiators can lead to different drug interactions in the body that can have unpredictable results. Some potentiators can lead to polysubstance abuse, which is characterized by abuse, addiction and dependence on multiple drugs. Polysubstance abuse can be much more difficult to treat than a single drug addiction.

Opioids are common drugs of abuse because they have such a high potential for addiction and dependence. People who abuse opioids are very likely to develop a tolerance to the drugs, leading to dependence and addiction. When a person becomes dependent upon opioids, they experience painful withdrawal symptoms when the drug begins to wear off in their bodies. Symptoms may become apparent just a few hours after the last opioid dose. Withdrawal symptoms are difficult to manage without professional treatment. Taking opioid potentiators can lead to more severe withdrawal symptoms.

Common withdrawal symptoms associated with opioid drugs are:

● Muscle cramps, tightness and soreness
● Abdominal pain
● Nausea
● Vomiting
● Excessive sweating
● Anxiety and irritability
● Depression
● Cravings for opioid drugs

Prolonged opioid abuse increases an individual’s chance of overdose. According to the DEA, more than 24,000 people died from opioid-related overdoses in 2014. Opioid-related overdoses make up a large percentage of the 120 people who die from drug overdoses every day in the United States. Use of opioid potentiators compounds that risk, since drug interactions can increase and intensify various side effects like suppressed breathing or changes in the heart rate.

Side effects of opioid use include:
● Constipation
● Itching
● Euphoria
● Dizziness
● Sedation
● Respiratory depression

Opioid addiction requires comprehensive care to manage withdrawal symptoms and begin the path of recovery. Treatment usually begins with a controlled detoxification in which the patient will have their withdrawal symptoms managed with opioid replacement therapy. Opioid replacement therapy involves using drugs like methadone that block the euphoric effects of opioids while preventing painful withdrawal symptoms. This treatment must be carefully managed to treat the symptoms safely while also ensuring that the patient does not become addicted to the replacement medication.

After detoxification, patients will go through other therapies like cognitive behavioral therapy to address possible psychological and emotional issues that may have led to their drug abuse. These therapies will help them form new mental processes and habits that will increase their chances of having healthy, productive lives without feeling the need to take opioid drugs.

Opioids and Potentiators: A Dangerous Combination
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