Mental, Physical Problems Increase Chance for Opioid Abuse
Recreational Opioid Use
Recreational opioid users typically take opioid medications in order to experience a sense of drug-related euphoria, rather than taking the medications for their intended ability to ease various types of significant pain. Strictly speaking, anyone who uses an opioid medication in this manner engages in a form of drug abuse. However, this definition of drug abuse differs from the official definition used as part of the diagnosis for medically serious opioid use disorder. Some people begin a pattern of recreational intake by misusing medications properly prescribed by their doctors. Others begin a pattern of recreational intake by doing such things as accepting medications intended for a valid user, stealing medications intended for a valid user or buying medications from a drug dealer.
Opioid Use Disorder
Opioid use disorder is one specific form of larger condition called substance use disorder. Some people with the condition are affected by medically serious opioid abuse; this means that they don’t have a chemical dependence on opioids, but still participate in drug-oriented or drug-fueled behaviors that substantially diminish their well-being and ability to meet responsibilities or maintain a stable routine. Others are affected by opioid dependence; this means that they have developed a chemical need for the presence of opioids in their brains and bodies. In addition (and unlike people who come to rely on the effects of their properly used opioid prescriptions), they experience repeated urges to consume more opioids, make opioid acquisition and use primary goals in everyday life and develop dysfunctional behaviors similar or identical to those found in opioid abusers. Since issues of opioid abuse and addiction are commonly strongly linked, doctors now use a single diagnosis of opioid use disorder to describe them in any given individual.
Charting the Risks
In the study published in Drug and Alcohol Dependence, researchers from Columbia University and Canada’s University of Manitoba used information from a large-scale project called the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to identify the mental and physical health problems that can contribute to both recreational opioid use and a transition from recreational opioid use to the serious abuse/addiction problems associated with opioid use disorder. The initial phase of this survey occurred in 2001 and 2005; a follow-up phase occurred in 2004 and 2005. All told, the researchers looked at 34,653 individuals from the survey age 20 and older.
During the first phase of the NESARC project, none of the chosen participants used opioids recreationally or had patterns of opioid use that qualified them for a diagnosis of opioid use disorder (opioid abuse or opioid dependence). However, at the time of the follow-up phase, significant numbers of the participants had developed these problems. The researchers concluded that several factors clearly predict recreational opioid use or an eventual diagnosis of opioid use disorder in recreational opioid users. The most prominent examples of these factors include the presence of any diagnosable mental health condition (including personality disorders, depressive disorders or other forms of substance use disorder) and the presence of chronic physical conditions such as arthritis, high blood pressure, narrowing of the arteries and other conditions grouped together under the heading of cardiovascular disease. Significant mental and physical problems often combine to increase an individual’s opioid use risks, as do multiple forms of chronic physical illness.
The authors of the study published in Drug and Alcohol Dependence believe their findings strongly indicate that the presence of combined, serious mental and physical health problems meaningfully increases any recreational opioid user’s chances of going on to develop opioid use disorder. They also believe that the combined presence of these problems can trigger the initial recreational use of opioid medications. In line with these conclusions, they urge all doctors to perform thorough mental and physical health histories before prescribing opioid medications to their patients.