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Opioids are a family of related drugs that
relieve pain. All of the opioids (sometimes called narcotics) are chemically related to opium, which is a substance collected from
the poppy plant. Opioid drugs include opium, codeine, fentanyl, heroin, hydrocodone,
methadone, morphine, oxycodone, paregoric, and sufentanil. When prescribed
by a doctor, the pain-relieving properties of opioids are used during and
after surgical procedures, for the pain of childbirth, for injury, and for
other pain problems. Although opioid medications have helped millions of individuals
with pain, these drugs can be used inappropriately. The September 15, 2004,
issue of JAMA includes an article about abuse of
prescription opioid medication.
Drug abuse is a pattern of inappropriate drug
use that leads to recurrent problems in fulfilling obligations, impaired physical
functioning, conflicts with family and friends, and legal problems. Drug abuse
may progress to dependence (sometimes called addiction), manifested by a strong desire to continue the
drug despite the increasingly severe problems it causes, tolerance (a need for larger amounts of the drug to get the same effects),
and withdrawal symptoms if the drug is stopped.
Sedation, sleepiness, or lethargy
Avoidance and withdrawal from usual activities
Multiple visits to multiple doctors to increase
amounts of prescription drugs available for abuse
Blood-borne infections from unsterile injections,
including human immunodeficiency virus (HIV), hepatitis viruses, and bacterial
Job loss with possible financial devastation
Loss of family, friends, and career-related relationships
Increased chance of risky behavior, including driving
under the influence
Drug overdoses, which can lead to brain damage
Miscarriage, stillbirth, or infants with low birth
weight due to opioid abuse during pregnancy. Babies born to addicted mothers
will be born addicted to the opioid and will have withdrawal symptoms after
Recognition and admission that drug abuse exists is the first step in
treatment. Drug addiction is a chronic medical problem. It is a treatable
disease but relapse is a prominent feature. Relapse must be considered as
part of a treatment plan. Drug abuse counseling is an important part of treatment.
Participation in support groups, such as Narcotics Anonymous, may help individuals
in treatment for opioid abuse. Certain medications may be used as a part of
treatment. These include methadone, a long-acting opioid taken by mouth, which
can substitute for the harmful injection of illegally obtained opioids.
National Institute on Drug Abusehttp://www.nida.nih.gov
National Council on Alcoholism and Drug Dependence 800/622-2255 http://www.ncadd.org
American Psychiatric Associationhttp://www.psych.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on cocaine
addiction was published in the January 2, 2002, issue, and one on treating
drug dependency was published in the March 8, 2000, issue.
Sources: National Institute on Drug Abuse, American Psychiatric Association,
National Council on Alcoholism and Drug Dependence
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page
are appropriate in most instances, but they are not a substitute for medical
diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page
may be photocopied noncommercially by physicians and other health care professionals
to share with patients. Any other print or online reproduction is subject
to AMA approval. To purchase bulk reprints, call 718/946-7424.
TOPIC: DRUG ABUSE
Torpy JM, Lynm C, Glass RM. Opioid Abuse. JAMA. 2004;292(11):1394. doi:10.1001/jama.292.11.1394
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