Interference with role fulfillment: The individual's use of opioids repeatedly interferes with the ability to fulfill obligations at work, home, or school.
Danger to self: The individual repeatedly uses opioids in situations in which it may be physically hazardous (while driving a car, for example).
Legal problems: The individual has recurrent opioidrelated legal problems (such as arrests for possession of narcotics).
Social problems: The individual continues to use opioids despite repeated interpersonal or relationship problems caused by or made worse by the use of opioids.
OPIOID INTOXICATION.The DSM-IV-TRspecifies that the following symptoms must be present in order to meet diagnostic criteria for opioid intoxication:
Use: The individual recently used an opioid.
Changes: The individual experiences significant behavioral or psychological changes during, or shortly after, use of an opioid. These changes may include euphoria initially, followed by slowed movements or agitation, impaired judgment, apathy("don't care attitude"), dysphoric mood (depression, for example), or impaired functioning socially or at work.
Opioid-specific intoxication syndrome: The pupils in the eyes get smaller. In addition, drowsiness or coma, slurred speech, and/or impaired memory or attention during, or shortly after, opioid use occur.
OPIOID WITHDRAWAL.The DSM-IV-TRspecifies that the following symptoms must be present in order to meet diagnostic criteria for opioid withdrawal:
Abstinence: Either the individual has stopped using (or has reduced the amount of) opioids, or an opioid antagonist (i.e., a drug, such as naloxone, that blocks the action of opioids) has been administered.
Opioid-specific withdrawal syndrome: Three or more symptoms develop after abstinence. These symptoms include dysphoric (negative) mood, nausea or vomiting, muscle aches, runny nose or watery eyes, dilated pupils, goosebumps, or sweating, diarrhea, yawning, fever, and insomnia.
Impairment or distress: The withdrawal symptoms must cause significant distress to the individual or impairment in functioning (socially, at work, or any other important area).
Not due to other disorder: The withdrawal symptoms cannot be due to a medical condition or other mental disorder.
Causes & Risks
There are no clear-cut causes of drug use other than the initial choice to use the drug. This decision to use may be highly influenced by peer group. Typically, the age of first use of heroin is about 16 years old, but this age has been dropping in recent years.
Certain social and behavioral characteristics, however, are more commonly seen among individuals who become dependent on opioids than those who do not. For instance, many heroin users come from families in which one or more family members use alcohol or drugs excessively or have mental disorders (such as antisocial personality disorder). Often heroin users have had health problems early in life, behavioral problems beginning in childhood, low self-confidence, and anti-authoritarian views.
Among opioid-dependent adolescents, a "heroin behavior syndrome" has sometimes been described. This syndrome consists of depression (often with anxiety symptoms), impulsiveness, fear of failure, low self-esteem, low frustration tolerance, limited coping skills, and relationships based primarily on mutual drug use.
Tests & Diagnostics
Diagnosisof opioid-related disorders are based on patient interview and observations of symptoms, including signs of withdrawal such as dilated pupils, watery eyes, frequent yawning, and anxiety, among others.
Prevention
The best single thing an individual can do to prevent opioid-related disorders is never to use illicit opioids such as heroin. Opioids are powerfully addicting, especially if used intravenously. The risk of becoming dependent on appropriately prescribed opioids, however, is generally low except for individuals who already have a substance use disorder.
On a larger scale, comprehensive prevention programs that utilize family, schools, communities, and the media can be effective in reducing substance abuse. The recurring theme in these programs is not to use drugs in the first place.
?opiod Dependence part 2Originally from: http://www.nursinglink.monster.com/news/articles/13154-opiod-dependence-part-2
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