Narcotics and Addiction: Special Report

Dr. Frances Edye Contributor

What are narcotics?

The word narcotic is used for the group of drugs or medications that are opioids. Opioids were originally developed from the opium poppy in parts of Asia. Some opioids are now made synthetically. The least powerful opioid is codeine, the most powerful is fentanyl. Heroin is almost as powerful as fentanyl. Commonly prescribed opioids are morphine, Dilaudid, and OxyContin.

Most opioids are powerful painkillers – in fact they are the most powerful painkillers available – they are very important in the treatment of pain, especially pain due to cancer or a broken bone.

So what harm are they?

Like so many things that are very good and useful, they have a dark side. Many people, usually not taking them to relieve pain, can become addicted to opioids. In Canada, the opioid people most commonly become addicted to is OxyContin.

Why would people become addicted to them?

We don’t understand fully how and why addiction happens but we have some good ideas. As well as relieving physical pain, opioids relieve emotional pain through the release of a chemical that makes us feel good. So if our life is difficult or stressful or things are not going well for us, we are particularly prone to become addicted to opioids because of its chemical components. We keep wanting to have that good feeling again and so after a time, the only time we feel normal is when we have our opioid on board. When used regularly, we go into withdrawal if we stop them suddenly. Withdrawal is a very unpleasant sensation that includes runny nose, runny eyes, cramps in our stomach, diarrhea, and aches everywhere. Even after withdrawal ends, a sensation known as craving continues. Because we have felt so good on the opioid, without it our mind and body keeps telling us that we need to have it. With opioids, craving can continue for years. Narcotic addiction is a very serious problem throughout Canada and indeed in much of the world. Narcotic addiction can happen to anyone and, when it does, it is dangerous and sometimes even fatal. It wrecks lives, homes, and even communities.  

As humans, we actually produce our own internal opioids, called endorphins, which help us to soothe ourselves and relieve our own pain.  Most people know that, for example in a hockey game, someone may get a very painful injury, but continues to play and hardly notices the pain. It seems that when we are doing something that is really important to us, like sports, our bodies produce enough endorphins to relieve any pain we feel. Endorphins are also probably the reason that we feel so good from strenuous exercise. In fact, an exercise program is one of the important parts of the prevention and treatment of opioid (narcotic) addiction.

So what about treatment?

The most effective treatment for any addictions happens where the addicted person lives. For most people, the most important part of treatment is peer support groups. Examples of peer support groups are Narcotics Anonymous (NA), Alcoholics Anonymous (AA), Methadone Anonymous (NA). The traditional teaching of AA is that the initial treatment of addiction is 90 meetings in 90 days. It is therefore important that meetings are available to addicted people daily either in their communities or online through chat rooms or via the tele-health network. If these groups are not available to addicted people in any community- including First Nations, then sometimes the addictions worker or workers in the community has to set them up and get them going. Addictions workers are also important for individual counseling and running groups for addicted people.

Occasionally, it is necessary for people to leave the community and go to residential programs for treatment for three to six months. When people leave the community for treatment it is very important to realize that residential treatment is only the beginning of real treatment. This, as in the paragraph above, needs to happen in the addicted person’s own community, where he or she lives.

Conclusion.

Narcotics are very important painkillers. They need to continue to be prescribed for people who need them. Some narcotic addiction is preventable, mostly by people having meaningful and satisfying lives. Some narcotic addiction will always happen – it is treatable, as outlined above.

Our current epidemic of narcotic addiction is not cause for hopelessness, but for action.

Dr. Frances Edye is a psychiatrist who also holds a bachelor of science in pharmacy. She was born in Sioux Lookout, now lives in Winnipeg and has been practicing medicine since 1985. She provides psychiatric service one day a week, by telemedicine, to First Nations in the Sioux Lookout zone.