Chapter 1. Overview Of Opioid Use Disorders . 1.1. Diagnosis

During the state of SUD it is question whether the individual suffering from such a disease should be held accountable for their actions. Another distinguishing factor between SUD and abuse is that SUD are not static entities but rather evolve over time (Doweiko, 2015). This evolution or rather stages are ranged from 0-4 which include total abstinence to middle to late stage addiction. SUD must also meet certain criteria’s in the DSM-5 manual. There are 4 general categories to determine if an individual suffers from SUD (Doweiko, 2015). The categories consist of impaired control over substance, multiple attempts to quit, activities center around getting substance, using, or recovering from using, and pharmacological effects of the drug. Manifestations, spiritual, vocational, primary disease, and potential to be fatal is also considered in the diagnosis criteria of SUD. Substance abuse on the other is used when individual uses a substance or compound for no medical reason or the substance is used in excess (Doweiko, 2015). Abuse has no physical dependency from the chemical, has no automatic physical

The choices he used to cope with his life events created his disorder. It almost seemed as inevitable for him to avoid this path because the cues that presented themselves were all just factors that amplified his poor mental health outcome. The biological indicator, the alcohol dependence for stress relief, and then the substance abuse that was evoked by the physicians were all measures that built on top of each other. The DSM-V categorizes substance use disorder as a combination of substance abuse and substance dependence. It is said that only two symptoms need to be apparent in order to be diagnosed with the disorder. Mark’s pharmacological effects of tolerance and withdraw of the pain medication are alone enough criteria for the diagnosis. In conclusion, Mark substance use disorder is a cluster oh his behavioral, cognitive, and physiological symptoms which resulted in his continue use of the substances despite the evident

The United States is currently in the grips of an opioid addiction epidemic, in fact, in 2014 drug overdoses became the number one cause of accidental death in the United States, beating out both car accidents and gun violence (Opioid Epidemic, 2016). Of those drug overdoses, 60% involved an opioid. An opioid is defined as natural or synthetic chemicals that bind to receptors in your brain or body (Kirby, 2016). Opioids are typically prescribed to address severe or long term pain. Although they do a lot of good, when misused they can have deleterious effects on the health of an individual and are highly addictive.

Opioid is a narcotic analgesic class of drugs which includes that of heroin, the synthetic variation fentanyl and other analgesic as oxycodone(OxyContin), hydrocodone, codeine, and morphine. These drugs adhere specifically to the opioid receptors in the PNS and CNS. Main functions as a receptor ligand is to reduce pain which is why it is prescribed by physicians at a lower dose. A common side effects of these drugs is euphoria and

both the beneficial effects, and the undesirable side effects. Opioids are classified in to natural opiates, semi synthetic opiates, fully synthetic opiates, and endogenous opioid peptides. The three receptors found in the body are delta, mu, and kappa.

Opioids was first cultivated from the poppy seed, in the 3400s B.C. by the lower Mesopotamians, known as the “Hul Gil” or the “Joy Plant”. Such a small plant to give the ability of an aphrodisiac, calming affect over the body and mind, then best believe word traveled fast. The opioids effect made an impact on Hippocrates, “father of medicine”, who used the poppy seed as a liquid medication to help with the pain in certain cases between 460 to 357 B.C. Later, one Chinese doctor, sometime between 220-264 A.D., used the poppy opioids concoction for these undergoing operations and have the patients relax yet conscious. After a small disappearance from the public, opium pills were later concocted by Paracelsus and was named laudanum. Sometime much later, Friedich Wilhelm Adam Sertürner isolated morphine and it became the non-pain pill available throughout the world. It was a common drug during the American Civil War, thus beginning the opioids addiction. Then in 1898, heroin became manufactured as a substitute for morphine for its non-addictive state afterwards. In 1916, oxycodone was created to have less affective dependencies of morphine and heroin. Many laws have been passed to help the addiction and dependency for these drugs:

The report is a continuing study of how prescription drugs such as; painkiller, oxycodone, codeine, hydrocodone, fentanyl, morphine, epidemic and heroin can cause opioid addiction. People who are addicted to drugs can and will create long term damage to their body, which can bring medical issues, including lung or cardiovascular disease, stroke, cancer or AID’s. American Society of Addiction Medicine (ASAM) researcher stated, “That opioids chemical causes the brain and nerve cells to produce pleasurable effects and relieve pain.” (Nora D. Volkow, 2014). Now, when that happens the brain will relapsing causing individual pathologically to pursue reward or relief from the controlled substance. (Nora D. Volkow, 2014). There was a study done in

Opioids are drugs taken for relieving pain. This drug has its effect on the human body through the reduction of the intensity of neuro-pain signals which are relayed to the brain (Opioids, 2009). Classic examples are the painkillers that include morphine, methadone, and hydrocodone among others. Pain is a physical suffering caused by illness or injury and may vary from steady to constant and throbbing to pulsating. It is not reasonable for anyone of us to except no pain except for those who suffer from anhydrases. This is an unusual genetic disorder that makes one unable to feel pain. Opioids play a significant role in the health system but they can be hazardous if used for pleasure or in a case of addiction. It is therefore important that

Chemically related and interact with opioid receptors on nerve cells in the body and brain

Substance use disorder (SUD) occurs regardless of age, ethnicity or gender. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) organizes substance use disorders into substance abuse and substance dependence. Substance abuse is a maladaptive pattern leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period. If the abuse pattern and dependency are not addressed, it can cause a various spectrum of dysfunction in physical, psychological and social. Per impairment, the individual is enable to participate a meaningful occupation which eventually decreases one’s quality of living (QOL). Because having QOL and ADL participation are very

Since their development, Opiate painkillers have proved invaluable in the healthcare industry. The need for analgesia has been prevalent since the beginning of time itself and opium has been used as early as Ancient China and fought over in wars such as the Opium Wars. More modernly, this substance has been synthesized for potency and purity in achieving the ultimate pain reliever. It exists in drugs today such as OxyContin, Norco, Percocet, morphine, Dilaudid, Opana, and Demerol. In addition to relieving pain, these medications also produce euphoria and bind to opiate receptors in the brain which contribute to the development of forming an addiction. Opiate Addiction only grows as an issue in the United States due to its availability and lack of knowledge regarding addiction on behalf of patients receiving pain medication. This is why finding an effective cure or treatment to opiate addiction is imperative. Individual treatments for opiate addiction such as replacement therapy, rehabilitation, and support groups are flawed by themselves, however, in combination provide the most effective treatment for opiate addiction.

The article, DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale, discusses the reasoning behind changes that occurred in the DSM-5 in regards to substance use. The article discusses the reasoning as well as the research for redefining terms and the addition (and removal) of certain criteria. One of the notable changes was combining dependence and abuse rather than keeping them as two separate components of addiction. Additionally, the criterions in assessing addiction were revised. Consensus among “DSM-5 Substance Related Disorders Work Group” led them to drop criteria of legal problems while adding craving of drug of choice. The work group modified diagnostic criteria, the revision now requires that two or more criteria

DSM-IV criteria for substance dependence include several specifiers, one of which outlines whether substance dependence is with physiologic dependence (evidence of tolerance or withdrawal) or without physiologic dependence (no evidence of tolerance or withdrawal). In addition, remission categories are classified into four subtypes: (1) full, (2) early partial, (3) sustained, and (4) sustained partial; on the basis of whether any of the criteria for abuse or dependence have been met and over what time frame. The remission category can also be used for patients receiving agonist therapy (such as methadone maintenance) or for those living in a controlled, drug-free environment.Tolerance, as defined either by the need for increasing amounts of

and?Demerol? among others. These drugs are also classified as a schedule II drug. Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood of causing dependence when abused.? All of this information has been confirmed by the FDA.

Chapter 14 and the DSM IV defines substance abuse as “a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances” (Ashman, 4th edition 2013, pg. 442).