[Institution Title]
Abstract
Substance abuse and addiction have been classified as a psychological condition as based under DSM-5 classification. Substances are classified according to categories under the Controlled Substances Act of 1970, which the US Congress specifies under Title II of the Comprehensive Drug Abuse Prevention and Control Act. This paper will concentrate on the discussion of opioid use disorder and how it gradually develops to be included among the substances commonly abused. Aside from delving into the discussion of the disorder, this paper will start by tracking down the history of use of the substance opium. At the same time trace down the process on how it became a substance classified as being highly addictive with serious side effects.
Keyword: Opioid Use Addiction, Morphine, Heroine, psychoanalytical theories
The History of Opioid Use
The long tradition of using opioids dates back to the early civilizations of 4,000 B.C. In fact, the early Sumerians called this as Hul Gil that translates to mean the joy plant. Some believe that opium possesses magical attributes because of its ability to provide a remedy to commonly experienced malady of the people at that time. However, in 460 B.C. the Father of Medicine Hippocrates contradicted this claim. Instead, Hippocrates contested and offered a more scientific of the miraculous healing gradient of the opium. According to the father of modern medicine instead of a magical attribute, opium is an effective narcotic and agent to prevent bleeding thereby significantly provide help in treating internal health problem and epidemics.
During the 19th century, the use of opium as a medium for treat common illnesses rose. In the western world, opium and its derivatives were even sold in groceries and local pharmacy without necessarily requiring a prescription. Soon, between 1830 and 1860 importation of opium in Britain increases. Eventually, it was even used in babies who were experiencing colic problems. The wide use of opium from reducing and totally eliminating pain, to diarrhea and common cough had been the reason for its popularity and wide public acceptance. However, by 1805, opium has undergone a series of experimentation and formulation by a German pharmacist. This resulted to deriving morphine from opium, the first step towards the formulation of what is now referred to a heroine. Nonetheless, this also starts the appearance of side effects from using opium derivatives. Among the side effects involve digestion problem. Thus, to avert this from occurring the developers decided to inject the drug than take it orally to prevent it from undergoing the process of digestion.
Following the tragic event of the American Civil War, many injured civilians and soldiers turned to morphine to relieve them of the physical pain caused by injuries. Since the morphine was economical, accessible and with no indication of being addictive, the use of morphine soon replace opium. There was even a period in history when morphine had been prescribed by doctors and distributed by Christian Chinese missionaries as a solution or cure for opium addiction. In 1898, Bayer decided to create a new derivative of morphine, and it was called Heroin. However, by the dawn of the twentieth century, the US Congress ordered for the banning of opium. Almost two decades after, the US Treasury Department’s Narcotics Division called for the total ban of all legal distribution of narcotics. This was furthers in 1970 by the Controlled Substances Act.
Theory on the Addiction of Opioid
In 1975, an article was published at a book entitled Opioid Dependence: Mechanics and Treatment. The article discusses the theory that sought to explain how the addiction of opioid develops. Author Abraham Wikler cited the use of psychoanalytical theories to provide the most logical explanation there was about opioid addiction. This asserts that one’s addiction for opium has nothing to do with the pharmacological component of the drug. Instead, the addiction develops because of how individuals process the intra-psychic impulse and archaic longing or the drug (Wikler, 1980). Wikler based his theory on the statements of earlier psychoanalysts like (Rado, 1984) and (Fenichel, 1948) who both asserted that an individual always has the control and power over his actions. Instead, the two psychoanalyst suggest that a man has the power to manipulate and control his psyche towards believing he is in desperate need of the substance. This is in the belief that it alleviates whatever psychological perception he has of a physical symptom that only a particular drug can remedy. Therefore, it is one’s psychological structure rather than the drug’s pharmacologic effect that causes the addiction.
Therefore, going back to the history of opium addiction, it can be recalled that it was mentioned that morphine was once used as treatment or cure for opium addiction. Morphine was a derivative of opium. If such was the case, morphine is no less different from opium. Only, that morphine was synthesized or perhaps more refined and processed than opium. This only implies than man has the capacity to delusion himself that his symptoms of addiction for opium was cured by morphine if only to gain access from morphine which is also opium when they started banning opium in the US.
Progression of Opioid Use to Opioid Use Addiction
DSM-5 incorporated a new diagnosis to Opioid Use Disorder. This new diagnosis combines the two disorders opioid dependence and opioid abuse. It also incorporated a range of illicit and prescribed drug under the category of the opioid classification. DSM-5 distinctly presents the classification of opioid as one that can be purchased off the streets that are categorically identified as illicit drug. However, there is a category that is prescribed and can be obtained from a pharmaceutical company.
According to an article published by Dr. Elizabeth Hartney, not everyone who is under the medication of opioid will eventually develop an addiction to a substance (Hartney, 2013). As explained in the psychoanalytic theories, it is upon the individual if he will develop an addiction. Otherwise, an individual can simply proceed with the medication under the prescribed dose.
DSM-5 indicates that a person under an opioid for the last 12 months would necessarily have to possess two of the following to be identified as one suffering from opioid use disorder (Hartney, 2013). These includes any two of the following symptoms:
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- Taking more opioid drugs than intended.
- Wanting or trying to control opioid drug use without success.
- Spending a lot of time obtaining, taking, or recovering from the effects of opioid drugs.
- Cravings opioids.
- Failing to carry out important roles at home, work or school because of opioid use.
- Continuing to use opioids, despite use of the drug causing relationship or social problems.
- Giving up or reducing other activities because of opioid use.
- Using opioids even when it is physically unsafe.
- Knowing that opioid use is causing a physical or psychological problem, but continuing to take the drug anyway.
The Implications of Opioid Use
An alarming statistics had been documented in a 2009 study suggesting that more and more young adolescents had been found using opium in the form of prescription opioid analgesics (Subramaniam & Stitzer, 2009). The study found that teenagers who began their addiction with opioid begins with prescription medication of opioid analgesic. Eventually, this would develop into heroin addiction and as young as the 12th grade; adolescents start experimenting with this drug leading to their addiction. As a result, the authors documented that the youth’s academic performance immensely suffer. In addition, it increases the risk that the youth will develop criminal tendencies and will be involved in criminal activities. Healthwise, their lack of knowledge on the use of syringes and presence of diseases that can be incurred from using contaminated syringes has also heightened the incidence of HIV and Hepatitis C among the young users. In fact, 75% of those who responded to the study confirmed that they share syringes with a friend. Also, ¾ of the respondents admitted to being sexually active thereby increasing the risk of contracting any of the above-mentioned illnesses.
On a study conducted by Kathleen Brady and Carrie Randall explored how gender difference could significantly impact opioid use addiction (Brady & Randall, 1999). Their study revealed that men are most likely to experience all forms of addiction as compared to women. In terms of substance addiction men are 35.4% more likely to be hooked than women who rated 17.9% (p. 242). In addition, as far as impact is a concern, men have more disruptive tendencies than women that include getting in trouble with the law, aggression, hostility and self-infliction.
Significantly, the studies revealed that the opioid addiction have severe social consequences. Addiction of opioid tends to disrupt social order. It affects social relationships as people who are under the influence of opioid have the tendency to be withdrawn (Karriem-Norwood, 2014). In addition, they lack focus and appears disoriented (Karriem-Norwood, 2014). Given this situation, opioid use addiction has serious social implications.
References
Brady, K., & Randall, C. (1999). Gender Differences on Substance Use Disorder. The Psychiatric Clinics for North America, 241-252.
Fenichel, O. (1948). The Psychoanalytic Theory of Neurosis. The Psychoanalytic Review , 110-112.
Hartney, E. (2013, September 19). Opioid Use Disorder. Retrieved from About.Health Website : http://addictions.about.com/od/dailylifewithaddiction/a/Opioid-Use-Disorder.htm
Karriem-Norwood, V. (2014, August 28). Pain Management Health Center: Opioid Addiction. Retrieved from WebMD Website: http://www.webmd.com/pain-management/guide/narcotic-pain-medications?page=2
Rado, S. (1984). Classics revisited. The psychoanalysis of pharmacothymia (drug addiction). Journal of substance abuse treatment , 59-68.
Subramaniam, G., & Stitzer, M. (2009). Clinical Characteristics of Treatment-Seeking Prescription Opioid versus Heroin using Adolescents with Opioid Use Disorder. Drug Alcohol Dependepence, 13–19.
Wikler, A. (1980). The Etiology of Opioid Dependence. In Opioid Dependence: Mechanics and Treatment (pp. 25-36). New York : Springer.
