By Sierra Waldrop

Opioids are now used by millions and are commonly prescribed to patients with moderate to severe pain and for a variety of conditions. An alarming and growing number of addiction rates and opiate-related deaths are causing healthcare providers, lawmakers and people across the country to take another look at the actual pros and cons of opioid prescriptions. Although they have been beneficial in assisting people with pain management and have benefited many, it is necessary to be aware of the very real effects of opioid use.

How Do Opioids Work?

Opioids activate opioid receptors in the brain by binding to them, much like how cannabis binds to the natural endocannabinoid system in the body. Neurotransmitters are then released that dull pain signals from the central nervous system and send signals that trigger feelings of pleasure and reward. This activation is another reason why it is easy to become addicted. Research shows “the opioid system controls pain, reward and addictive behaviors.”

Short and Long-Term Side effects

Not only are opioids incredibly addictive, but long-term effects from them are severe. Opioid medications are some of the most abused drugs in the United States, creating a crisis in the country labeled as “the opioid epidemic.” Although not near as severe, there are short term effects that can take place. Short term effects include;

  • Drowsiness
  • Paranoia
  • Nausea

As opioids are generally not meant to be taken for extended periods of time, the damage they can do to the body from prolonged use can be terrible. The higher the dosage of opioid medication, the more risk for occurrence of long-term side effects. They include;

  • Nausea and vomiting
  • Abdominal bloating and distention
  • Constipation – activation of opioid receptors can smoothen gastrointestinal muscles, which can lead to opioid-induced constipation. Long-term use could even cause muscles in the stomach to become paralyzed, leading to chronic constipation, which poses the dangers of hemorrhoids, anal fissures, fecal impaction and rectal prolapse
  • Brain damage – from hypoxia, resulting from respiratory depression. This can also cause disorientation and agitation.
  • Respiratory depression – Opioids work by depressing the central nervous system, and this can interfere with the body’s breathing mechanisms. Organs become oxygen starved, which can shut down the body completely. This can happen with people taking higher dosages than normal of opioids or taking them longer than necessary.
  • Liver damage.
  • Tolerance – patients also tend to build a tolerance, leading to dosages being increased over time, which continues to be more harmful to the body.
  • Impaired sex drive – Long term opioid use has been found to decrease sex drive. A 2017 study concluded, “We found that men with opioid use had a significantly increased prevalence of ED, which suggests that patients and clinicians should be aware of the potential role played by opioid administration and the development of ED (erectile dysfunction).” Female patients also experience lower sex drive and a tendency for vaginal dryness.

Withdrawal

Opioid withdrawal can be severe and mostly causes intense flu-like symptoms, but can also cause pain, depression, insomnia, anxiety, panic attacks, dehydration, fatigue, diarrhea, and intense craving for more opioids. To help lessen these symptoms it is necessary to wean off, instead of going cold-turkey.

An article by MinnPost titled “What’s it really like to withdraw form heroin and painkillers?” talks about the realities of what withdraw from opioids is like and shares 4 stories of past opioid addicts. One thing they could all agree on was the fact that although the physical effects were unpleasant, the psychological effects were harder to get rid of.

One of the people interviewed was Ian McLoone, LACD counselor, in his statement he said “At the moment, when you are experiencing the first few stages of withdrawal, even though you know that the worst that’s going to happen is that you will feel like you have the flu, there’s a psychological piece that is so terrifying and so disconcerting. You know that there’s a cure, and you know that it’s out there, and that’s why people will go to such lengths to quell those withdrawal symptoms. Even though it’s ridiculous and it’s weak and it’s pitiful, at the moment, it really seems like it’s the worst thing that can ever possibly happen. “

Can Medical Marijuana Help?

An article from the University of Missouri-St. Louis discussed the hope that cannabis provides in decreasing the opioid epidemic. It states “In an exhaustive review, the National Academies of Science and Medicine recently confirmed the efficacy of cannabis for chronic pain in adults. Interestingly, when given access to cannabis, individuals currently using opioids for chronic pain decrease their use of opioids by 40-60% and report that they prefer cannabis to opioids. Patients in these studies reported fewer side effects with cannabis than with their opioid medications (including a paradoxical improvement in cognitive function) and a better quality of life with cannabis use, compared to opioids.”

Cannabis can also help stop addiction from opiates. The Journal of Hospital & Medical Management reported that cannabis suppressed cravings of opioids and treats withdrawal symptoms. With only minor side effects (such as lethargy), it concludes that marijuana for addiction of opiates is “safe and effective.”

Medicalxpress explores the possibilities of cannabis quelling opioid use as well. The writer, a neuroscientist, stated: “However, our recent research finds that specific constituents in cannabis may have very profound effects – not only modulating the addictive effects of opioids but possibly serving as a treatment for opioid dependence and withdrawal.”

Amazingly, but not surprisingly, states that have legalized marijuana have seen a large decrease in opioid-related deaths.

Conclusion

In 2017, more than forty-seven thousand people died from opioids, which accounted for 67.8% of all drug overdose deaths. It’s thought that 40% of those deaths occurred from prescription opioids. The Council on Foreign Relations states that “Analysts say the problem started with the over-prescription of legal pain medications, such as oxycodone…”,  but acknowledges that the issue has become worse with an influx of synthetic opioids. Dozens of cities, as well as states including Ohio, New Jersey, Mississippi and even Oklahoma, are suing pharmaceutical companies, stating that they hid the risks of opioids, in favor of overselling the benefits from them. As cannabis becomes further legalized and accessible, giving Americans a safer option for pain relief, we can only hope that the opioid crisis will reduce and eventually disappear altogether.