What are the side effects of long term opiate use?

Question by Preya19: What are the side effects of long term opiate use?
I’ve been taking about 7 pills a day for about three years, always either vicodin, percocet, or oxycontin. It’s safe to say I’m addicted, though functionally so. I’m not so concerned with the addiction aspect, but are there any other effects I should be concerned with?

Best answer:

Answer by Mathieu
Firstly it important to give some basic definitions. You are NOT taking opiates you are taking opioids (they are commonly and inappropriately used interchangeably). Also the dose you take it critical, all of these drugs come in a large range of doses.

Also may people are not exactly sure what drug is what and the opioid dose they take since many opioids are combination products (they have an opioid and another drug).

Drugs containing oxycodone, a semi-synthetic opioid with a greater potency than morphine. In The US these are all schedule II drugs.
Examples:

Percocet (also has acetaminophen, often called APAP), Percodan (also has Aspirin), OxyIR (this only contains oxycodone), and OxyContin, a continuous-release medication

Drugs containing hydrocodone, a semi-synthetic opioid with a potency similar to morphine. In The US these are schedule III controlled substances. All drugs with hydrocodone are combination products.
Examples:

Vicodin (5/500), Vicodin ES (7.5/750), and Vicodin HP (10/660). The first number is hydrocodone and the second number is acetaminophen. Lortab, Lorcet, and Norco are other examples of brand names with hydrocodone and acetaminophen.

Substance dependence (the medical term for addiction) is defined the repeated and maladaptive use of a substance, despite clinically significant impairment or distress due to continued use of the substance within a 12-month period.

There is also the less severe diagnosis of substance abuse.

Diagnoses are abuse/dependence are based on improper use and consequences from use.

Commonly problems associated with opioid abuse include-
Failure to fulfill major job obligations at work, school, or home
Recurrent opioid use in hazardous situations, such as driving or operating heavy machines while impaired
Opioid-related legal problems
Social and interpersonal problems caused by or exacerbated by opioid use

A diagnosis of substance dependence (addiction) requires at least 3 of the following, occurring in a 12-month period.

1) Tolerance (This happens in people without a substance abuse problem and should not be considered addiction alone)
2) Withdrawal (Like tolerance, this can occur with legitimate use and should not be considered addiction)
3) Opioids taken in larger amounts or for longer periods than intended
4) Persistent desire or unsuccessful efforts to cut down or control opioid use
5) A significant amount of time is spent in activities to obtain opioids
6) Important social, occupational, or recreational activities are given up or reduced
7) Continued opioid use despite knowledge of having a persistent or recurrent physical or psychological problem

Tolerance and withdrawal may be absent in some opioid addicts.

Unlike how most drugs of abuse work, the major risks of opioid use are more intertwined with the significant physical and psychological dependency. And most consequences are not caused by the opiod directly (ie physical damage to the body). The problems are normally due to the addiction which is behaviour.

Millions of people take opioids long-term for legitimate chronic pain and at most 1% develops a problem. However most people using medically will develop tolerance and physical dependency (but not psychological dependence or cravings).

However long term opioid use can cause severe apathy, somnolence, depression, anxiety, and people who have pain and abuse opioids may make the pain worse when opioids are abused. Also IV drug use caries many very serious risks.

Opioid addicts have a significantly higher risk of opioid poisoning and death.

Part of the reason I am saying this is because many people claim to be “an addict” because they have withdrawal if they miss a dose. That is NOT addiction at all, the behaviors are real addiction.

It is also very important to be very aware of how much acetaminophen (or Aspirin or Ibuprofen) you are using. Taking two or more Vicodin HP tablets (the largest dose) is exceeding the maximum dose of acetaminophen which is 1,000 mg at one time and 4,000 mg/day. Taking too much acetaminophen is often associated with more health problems than opioids. Acetaminophen kills about 1,000 people in North America.

I don’t know why are you not concerned with the addiction risk because even if you function well now that can radically change in a heart beat.

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