The effects of opiate use disorder

“Disease Process I”

Disease is a morbid process, having identifying characteristic symptoms, and the cause maybe known or unknown. The prognosis may also be known or unknown.

1) The addictive disease process is a chronic, progressive and potentially fatal disease that is characterized by:

a) Physical symptoms

i) Tolerance (the brain adapts to large amount of drugs/alcohol)

ii) Physical dependency (withdrawal, ex. Shakes tremors, sweats, body aches, insomnia, irritability, etc.)

iii) Pathological organ change (damage to organs, ex. Gastritis, abscesses, hole in nose, ulcers, etc.)

b) Behavioral symptoms

i) Loss of control

ii) Compulsion

iii) Continued use despite adverse consequences

2) Loss of control

a) Over Amount (it becomes increasingly less able to predict the amount of drug/alcohol one will use once started. With cocaine difficulty saving some of the drug for later use. As the disease progresses larger amounts are needed to satisfy the increasing desire.)

b) Over Time & Place (find it difficult to confine use to times and places when others use. Inappropriate times and places, work, church, driving, etc. Progression may begin to use alone.)

c) Duration of episode (correlates with loss of control over amount, may use until drug is all gone which prevents other activities)

3) Compulsion (behavior precipitated by craving, a physical hunger for the drug)

a) Difficulty stopping after starting. Ex: a cocaine user uses until all the drug is gone (cocaine run)

4) Continued use despite the adverse consequences (use despite the problems it causes)

a) Legal

b) Family/marital

c) Job

d) Sexual

e) Financial

f) Possibility of death

5) Not all drug use is addiction

a) Forms of use

i) Experimentation (1-3 yrs., used in low doses, response to drug is neutral or negative, use is occasional)

ii) Social user (no bad effects)

iii) Abuser (uses to get high or intoxicated, higher doses, experiments with different methods of ingestion, use will start to cause problems) ***At this stage these folks could go back to using socially or experimentally…but here is the danger, if you use more frequent higher doses and you are physiological susceptible to the drug then you will become addicted.

6) Some myths of addiction

a) Addiction is secondary to psychiatric illness (there are some people who are dual diagnose)

b) Persons become addicted because they have “addictive personalities”

c) Can return to social use.

d) Addicts come from sick families

e) Psychotherapy is the treatment method

Conclusion: Addictive Disease will progress and get worst if the disease is not arrested. Unfortunately most treatment centers treat the symptoms of the disease and not the disease itself.