Textbook Chpt. 11 Opioids

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Questions and Answers

What phenomenon contributes to the increased risk of overdose during the first two weeks following release from residential treatment?

  • Increased psychological cravings for the drug
  • Improved metabolic clearance of the drug
  • Enhanced drug potency due to new formulations
  • Loss of tolerance to the drug after a period of abstinence (correct)

Which central nervous system depressant is most commonly associated with increased risk when combined with heroin?

  • Caffeine
  • Alcohol and benzodiazepines (correct)
  • Antidepressants
  • Stimulants like amphetamines

Tolerance to heroin can diminish when the drug is used in what context?

  • In a new environment different from usual use settings (correct)
  • In a familiar environment where use typically occurs
  • When combined with stimulants to counteract effects
  • After switching to a different route of administration

What is one primary mechanism by which tolerance develops in individuals using heroin?

<p>Decreased sensitivity of receptors to the drug's action (C)</p> Signup and view all the answers

Which feature does NOT typically develop tolerance in heroin users?

<p>Nausea and vomiting induced by the drug (A)</p> Signup and view all the answers

What is the impact of injectable drug use on health risks compared to oral or inhalation methods?

<p>It increases exposure to diseases such as hepatitis and HIV/AIDS. (A)</p> Signup and view all the answers

Which of the following factors does NOT contribute to an increased risk of overdose?

<p>Low frequency of drug use. (B)</p> Signup and view all the answers

Which statement accurately reflects the effects of tolerance in opioid users?

<p>Tolerance does not develop to the euphoric effects of opioids. (C)</p> Signup and view all the answers

What is the primary pharmacological mechanism thought to be involved in developing tolerance to opioids?

<p>Downregulation of opioid receptors. (D)</p> Signup and view all the answers

How does the lifestyle of heroin addicts indirectly affect their health?

<p>It compromises housing and nutrition, causing overall health decline. (B)</p> Signup and view all the answers

Which demographic is most commonly represented among individuals visiting emergency departments for drug overdose?

<p>Individuals aged 20-34 years. (D)</p> Signup and view all the answers

What is a notable gender difference observed in unintentional drug poisoning cases?

<p>Males are more likely to experience unintentional drug poisoning. (B)</p> Signup and view all the answers

Which type of opioids is associated with the highest number of drug-poisoning deaths?

<p>Heroin and prescription opioids. (D)</p> Signup and view all the answers

What method of heroin administration has been reported the least by 8th, 10th, and 12th graders?

<p>Injection (A)</p> Signup and view all the answers

Which of the following opioids is most commonly reported to be illicitly used among high school students?

<p>OxyContin (B)</p> Signup and view all the answers

What was the percentage of non-college-attending young adults who reported illicitly using prescription opioids?

<p>16% (C)</p> Signup and view all the answers

What factor mentioned contributes to the recent rise in heroin use in the United States?

<p>Reformulated OxyContin with abuse-deterrent properties (A)</p> Signup and view all the answers

Which age group showed the highest lifetime heroin use according to the data provided?

<p>19-28 years, non-college attendees (C)</p> Signup and view all the answers

What percentage of grade-12 students indicated that prescription opioids would be 'fairly easy' or 'very easy' to obtain?

<p>42% (C)</p> Signup and view all the answers

Which of the following drugs is likely to result in the fastest onset of tolerance among opioid users?

<p>Heroin (A)</p> Signup and view all the answers

What is the primary way that most high school students obtain prescription opioids illicitly?

<p>Given or bought from family or friends (A)</p> Signup and view all the answers

Which of the following is NOT a pharmacological effect of opioid use?

<p>Increased respiration rate (A)</p> Signup and view all the answers

In the context of opioid withdrawal, which of the following symptoms is commonly observed?

<p>Intense cravings (A)</p> Signup and view all the answers

What is the trend in the use of Vicodin among young people from 2005 to 2014?

<p>Declined steadily (C)</p> Signup and view all the answers

What age group reported the highest rates of prescription pain reliever abuse disorder in 2014?

<p>18-25 year olds (A)</p> Signup and view all the answers

Which factor has contributed to the high number of chronic pain sufferers developing opioid addiction?

<p>Distribution of highly potent medications (D)</p> Signup and view all the answers

What percentage of opioids prescribed in 1999 were stronger than morphine?

<p>17% (C)</p> Signup and view all the answers

Which demographic reported the second-most illicit use of drug classes after cannabis?

<p>Young people (C)</p> Signup and view all the answers

What was the percentage of illicit non-heroin opioid use reported by 23-26 year olds in 2014?

<p>6.8% (D)</p> Signup and view all the answers

What shift occurred in opioid prescriptions from 1999 to 2012?

<p>More prescriptions for stronger opioids (C)</p> Signup and view all the answers

Approximately how many young adults (ages 18-25) were estimated to be nonmedical users of prescription pain relievers in 2014?

<p>978,000 (D)</p> Signup and view all the answers

What did research from the 1950s and 1960s suggest about the behavior of older heroin users?

<p>They often spontaneously discontinue use. (D)</p> Signup and view all the answers

What trend has been observed regarding the prevalence of illicit non-heroin opioid use among young age categories since 2010?

<p>A dramatic decline (C)</p> Signup and view all the answers

What is the primary effect of high doses of opioids on the respiratory system?

<p>Severe depression of breathing (A)</p> Signup and view all the answers

In which format was fentanyl indirectly used during the Moscow theater hostage crisis?

<p>As a gas pumped into the theater (A)</p> Signup and view all the answers

What is a common outcome reported among heroin users who attempt to stop on their own?

<p>High levels of spontaneous remission (D)</p> Signup and view all the answers

Which condition tends to show tolerance development when using opioids?

<p>Analgesic effects (A)</p> Signup and view all the answers

What factor does NOT typically influence the likelihood of maturing out of heroin addiction?

<p>Social support structures (A)</p> Signup and view all the answers

What is an observed effect of opioid use concerning the seizure threshold?

<p>High doses of opioids lower the seizure threshold (D)</p> Signup and view all the answers

What trend was noted regarding heroin use among individuals over 50 between 1994 and 2004 in the US?

<p>The proportion tripled in treatment programs (C)</p> Signup and view all the answers

Which of the following substances is not typically associated with causing convulsions at high doses?

<p>Barbiturates (B)</p> Signup and view all the answers

What is the estimated percentage range of addicts who may eventually mature out of heroin addiction?

<p>More than two-thirds to less than a quarter (C)</p> Signup and view all the answers

What may be a contributing factor to the increasing number of heroin addicts among seniors?

<p>Increased social isolation (C)</p> Signup and view all the answers

Flashcards

Opioid Mortality Rate

The rate at which people die from opioid-related causes.

Overdose Risk

The likelihood of experiencing a drug overdose, often due to factors like high drug use frequency or injecting drugs.

Drug Poisoning

A situation where someone takes a drug and suffers a health crisis, requiring immediate medical attention.

Shooting Up

The act of injecting drugs directly into the bloodstream using a syringe.

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Opioid Addiction

The continued use of opioids despite the negative effects on the user's lifestyle, relationships, and health.

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Needle-Associated Diseases

Health problems that arise from sharing needles, a common practice amongst opioid users.

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Polydrug Use

Using multiple drugs at the same time, leading to an increased risk of overdose.

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Lifestyle Effects of Opioid Addiction

The negative impacts on a user's lifestyle due to their opioid addiction.

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Illicit opioid use

The use of opioid pain relievers without a doctor's prescription.

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Decreasing illicit opioid prevalence

A decline in the reported use of illicit non-heroin opioids, particularly among young adults.

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Pain relievers: Second most illicit drug

Pain relievers are the second most illicitly used drug class in the US, after cannabis.

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Opioid abuse disorder: Highest rate in 18-25 year olds

The highest rate of opioid abuse disorder is found in young adults aged 18-25.

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Figure 11-3: Opioid use by age group

The percentage of people reporting opioid analgesic use without a doctor's prescription, categorized by age groups.

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Increased prescription of strong opioids

A shift in prescription practices towards prescribing stronger opioid analgesics, leading to an increase in potential for abuse.

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Opioid addiction risk in chronic pain

The risk of opioid addiction is higher for people suffering from chronic pain.

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Maturing out of heroin addiction

The idea that heroin addiction naturally decreases with age, as users mature out of their drug use.

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Aging and heroin use

The trend suggesting that as people get older, their use of heroin decreases, potentially suggesting a natural decline in addiction.

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Winick (1962) study

A study from the 1960s suggesting that heroin users tend to discontinue use as they age, potentially indicating a 'maturing out' effect.

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Loss of Tolerance in Heroin Users

The tendency for heroin users to experience a loss of tolerance to the drug after a period of abstinence, making them more susceptible to overdosing with their usual dose.

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Heroin Overdose: Mixing Drugs

Using a combination of heroin with other depressants like alcohol or benzodiazepines can significantly amplify the effects of heroin, increasing the risk of overdose.

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Heroin Overdose in Experienced Users

A significant number of deaths from heroin overdose occur among experienced users, suggesting that tolerance can fluctuate and overdosing is not always due to taking more than usual.

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Environmental Influence on Heroin Tolerance

Conditioned effects play a role in tolerance, and changing the environment in which heroin is used can lead to a loss of tolerance due to the absence of familiar cues.

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Prescription Opioid Overdose Deaths

Prescription opioid overdose deaths have surpassed heroin overdose deaths in the US, highlighting the growing concern over prescription opioid misuse.

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Maturing Out

The phenomenon where individuals gradually stop using heroin without formal treatment, often in their 30s or 40s after years of use.

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Spontaneous Remission of Opioid Addiction

A long-term study on Vietnam veterans showed that a significant portion of individuals addicted to various drugs, including opioids, recovered without seeking medical intervention.

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Opioid Overdose

A severe, life-threatening condition that can occur when someone takes a high dose of an opioid, resulting in a comatose state and respiratory depression.

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Fentanyl Overdose

A type of overdose that is specifically related to fentanyl, a powerful synthetic opioid.

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Fentanyl Gas

A type of opioid that can be inhaled, producing a rapid and intense high, and is often used recreationally due to its potent effects.

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Lowered Seizure Threshold in Opioid Use

The tendency for an individual to have an increased risk of seizure activity when using high doses of opioids.

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Moscow Theater Hostage Crisis

A tragedy where Russian security forces used a synthetic fentanyl analog during a hostage situation, unintentionally killing both hostage-takers and several hostages.

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Chemical Subjugation

The act of using a powerful drug to subdue or incapacitate individuals.

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Opioid Gas

A gas-like substance that can be inhaled, often possessing a strong, immediate effect on the body.

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Hostage Situation

A group of people who are held against their will, often in a stressful and threatening situation.

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Abuse-Deterrent OxyContin

A reformulated version of OxyContin designed to deter abuse by making it harder to crush or dissolve for injection.

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Opioid Prevalence

The rate at which people use opioids, expressed as a percentage of the population.

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Rising Heroin Use

The trend of increasing heroin use in the United States, likely due to factors like reformulated OxyContin and greater heroin availability.

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Monitoring the Future Survey

A survey conducted annually to assess drug use among American students, including heroin and prescription opioids.

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Trend of Illicit Opioid Use

The prevalence of illicit opioid use in the United States, as measured by the Monitoring the Future Survey, shows a significant increase from the mid-1990s.

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Non-Heroin Opioids

A category of opioids that includes medications like Vicodin, OxyContin, and Percocet, commonly used for pain relief.

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Accessibility of Prescription Opioids

The ease with which prescription opioids can be obtained, with a significant number of students reporting easy access.

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Sources of Illicit Opioids

Prescription opioids are often obtained illicitly through friends, family, or theft.

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Popular Illicit Opioids

The most popular prescription opioids illicitly used by teenagers and young adults, with Vicodin and OxyContin being the most common.

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Study Notes

Opioid Use Prevalence

  • Globally, approximately 0.7% of adults use opioids.
  • North America shows a significantly higher prevalence at about 3.8%.
  • Heroin use in the US has shown an upward trend recently, partially attributed to reformulated OxyContin and decreased heroin costs.
  • 0.9-1% of 8th, 10th, and 12th graders have used heroin in their lifetime, compared to 0.2% using methods besides injection.
  • College students showed lower heroin use (0.3%), while young adults (19-28) not attending college had a higher rate (1.4%).
  • Prescription opioid use (Vicodin, OxyContin, Percocet) is notably higher among young people outside of medical supervision.
  • 10% of 12th graders and college students used illicit prescription opioids.
  • Over 16% of young adults (not in college) had illicitly used prescription opioids.
  • Prescription opioids were largely obtained for free or from friends.
  • Illicit non-heroin opioid use increased in the mid-1990s and then flattened.
  • Use was highest among those under 30, peaking at 10% for 23-26 year olds in 2008 and 2010.
  • Vicodin use in young adults significantly declined since 2005 (from 9.3% to 4.8% in 2014).
  • Pain relievers are the second most used illicit drug class, after cannabis, with young people reporting the highest use.
  • Data from the 2014 National Survey of Drug Use and Health shows this.
    • More than 978,000 nonmedical users of prescription pain relievers were between 18 and 25 years old in 2014.

Opioid Overdose Deaths

  • Overdose deaths involving prescription opioids have increased considerably since 1999.
  • 70% of opioid overdose deaths involved natural and semi-synthetic opioids (morphine, hydrocodone, and oxycodone).
  • Methadone alone is responsible for 26% of prescription opioid overdose deaths in 2014.
  • In 2013, the US had a significantly higher rate of drug-related mortality than the global average (4.6 times higher).

Heroin Overdoses

  • Heroin overdose deaths in the US increased significantly from 2010 to 2013.
  • Overdose is the leading cause of death for heroin users.
  • Overdose risk is increased by mixing heroin with other central nervous system depressants (like alcohol or benzodiazepines). Many celebrities have died from this.
  • The risk of overdose is also increased when tolerance has greatly decreased due to a period of abstinence.

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