Increased Risk of Needle Sharing in People Experiencing Opioid Withdrawal

You may think of people injecting drugs as being something rare and hidden in the shadows of society. Perhaps you have only seen it in movies and the concept seems like something far removed from real life. 

However, in America today, the opioid crisis is unfortunately all too real. It is something pervasive, far-reaching, and dangerous. Opioid addiction can be detrimental to a person and their family. Due to the withdrawal symptoms that accompany opioid addiction, a person will most likely require treatment for a successful recovery. 

Opiate Addiction & How It Starts

Opiate addiction can happen to anyone. A person will usually not start by injecting opioids, but it can gradually escalate to this over time. The opioid crisis in America was triggered by an excess amount of opioid prescriptions throughout the 1990s. This means people legally obtained prescription drugs such as morphine, oxycodone, and codeine. Due to the rewarding effects of ingesting opiates (feelings of pleasure, positivity, and relaxation), people became addicted to these drugs. 

The Addiction Cycle

Substance addiction generally follows a cyclical trend, starting with the initial use of the substance. Initial use of opiates may be through prescription drugs. This can then progress to substance abuse, where the person starts to use the substance in higher doses. Abusing opiates can also manifest as a person using the drugs to obtain pleasure, rather than for the purpose they were prescribed for. For example, a person may be prescribed oxycodone for back pain, they use it as prescribed initially, but then continue to take it even after the pain has subsided. 

The danger of drug abuse is that over time, a person can develop a physical and/or mental dependence on the drug. They will also develop a tolerance to the drug, meaning they will have to increase the dose to obtain the rewarding effects. Those within this cycle will struggle with withdrawal symptoms if they suddenly stop taking the drug. Depending on the severity of the addiction, withdrawal can range from mild to severe. Severe opiate withdrawal can present symptoms such as anxiety, depression, shakes, tremors, nausea, and vomiting. It can be extremely difficult for a person to overcome such symptoms on their own. 

Withdrawal

When someone has developed a dependence on opioids, sudden cessation of the drug will cause difficult physical and mental symptoms. There are different forms of addiction treatment available to help those going through withdrawal. Drug rehab centers are a common way that people overcome drug addiction and they are particularly useful for those who have developed a physical dependence on the substance. 

A New Study

A new study by the University of Southern California (USC) outlines how those experiencing withdrawal from opiates are at a high risk of sharing needles or overdosing. This study recruited participants who consume opiates in certain locations around San Francisco and Los Angeles. It is an original study, the first of its kind, to investigate the experiences and frequencies of withdrawal. This study used a large cohort of opiate users, with over 800 participants. Of this group, 85% have experienced withdrawal from opiates in the six months before the interview. 

When asked to describe their withdrawal symptoms, the participants described them as being moderately painful to extremely painful. This highlights how difficult it can be to stop taking opioids and overcome the addiction alone. It sheds light on how vulnerable those within this community are during the withdrawal period. These results show how addiction treatment is vitally needed for the withdrawal portion of the addiction cycle.

This study further highlights the need for intervention programs. It also argues that the government should make medications that can assist in withdrawal accessible to this population. One such medication is the drug buprenorphine. 

Buprenorphine is very effective as a medically assisted detox drug as it works by attaching to the opioid receptor in the brain. This blocks the rewarded opiate effect and therefore, stops withdrawal symptoms. Knowing that opiate withdrawal is a common health issue in the United States and that 85% of the opioid-addicted population will experience it, the availability of buprenorphine could make a huge difference. 

Relapse 

Relapse occurs when a person is addicted to a substance and cannot withstand the painful withdrawal symptoms. To stop the symptoms, they ingest more opiates. The USC study found that when a person is going through opioid withdrawal, they are likely to engage in risky behaviors. Experiencing a drug withdrawal can be very dangerous for this reason. Such risky behaviors include needle-sharing and non-fatal overdoses. 

Needle Sharing

A person who is feeling desperate to stop their withdrawal symptoms may use a needle that someone else has already used, despite the potential health risks. Sharing needles can result in contracting illnesses of the bloodstream, such as HIV, Hepatitis C, and Hepatitis B. 

HIV is passed through contact with infected blood, so sharing needles is a common way this virus is passed from person to person. Unfortunately, it is very common among those affected by drug addiction. HIV affects the immune system and can be life-threatening. While there is no cure for HIV, it can be well-managed with medication. 

Hepatitis B is a virus that affects the liver and can be passed from person to person through blood, urine, or semen contact. Similarly, Hepatitis C also affects the liver but is passed through contact with infected blood. Hepatitis C is mainly passed through sharing needles. 

Overdose

The USC study also found that the severity of withdrawal symptoms experienced was significantly correlated with non-fatal overdose. The more pain a person experienced when attempting to stop the drug, the more likely the person was to overdose upon relapsing. 

The Future of Recovery

The CDC reports that in twenty years, from 1990 to 2019, almost half a million people died from an opiate overdose. This data includes both prescription opiates and illegal opiates such as heroin. 

This new study shows that withdrawal symptoms are a potential cause of opioid overdose. The results strongly suggest that overdose deaths could be prevented if medical detox drugs, such as buprenorphine, were more widely available. It also shows a surprising knock-on effect of making these drugs available. Minimizing withdrawal symptoms means minimizing needle sharing. This could even help stop the spread of viruses like HIV, Hepatitis B, and Hepatitis C. 


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