The recent surge in the misuse and abuse of opioid analgesics by the Ghanaian youth is alarming and very disheartening. Codeine containing antitussives are being mixed with various beverages, alcoholic and non-alcoholic and gulped down like shots of vodka while capsules of tramadol are swallowed like tic-tac. These practices can in part be attributed to ignorance about the systemic effects of such drugs on one’s health thus, necessitating this brief write-up.
Opioids are DRUGS indicated for Pain and used sometimes in extreme cases of cough, diarrhoeal diseases and other diagnosed conditions. Like all drugs, they are to be taken with caution and expert advice must always be sought. Opioids are only prescribed in the event of moderate to severe pain for the management of such. Hence when the pain is mild, Aspirin, Paracetamol and the Non-Steroidal Anti-inflammatory drugs (NSAIDS) such as Ibuprofen, Diclofenac, Naproxen etc. are preferred unless the patient has a condition that doesn’t allow for any of the aforementioned drugs to be used.
Like all drugs, Opioids have their side effects. These include:
- Mood changes – feeling high, euphoria, somnolence
- Sedation, Drowsiness, inability to concentrate
- Depression
- Gastrointestinal issues- stomach issues that can arise include Nausea and vomiting, Constipation, abdominal cramping among others. Constipation is usually the worst due to difficulty in its management. – which is
- Urinary retention
- Urticaria, Itching,
- Respiratory depression – breathing become slowed, shallow and may even cease in severe cases
- Brain damage due to reduced Oxygen to the brain from Respiratory depression.
After Tramadol or codeine pills are taken, they interact with brain receptors leading to the alteration of pain. In addition, dopamine activity is increased and contributes to feelings of reward in an individual. Such feelings reinforce the user’s desire to continually use the pills, albeit unconventionally, causing him/her to develop Dependence with time. Over time, the effects a particular dose or number of pills give decreases in a process known as Tolerance and might result in various cases of over-dose and drug misuse until an individual is completely addicted. More often than not a user does not recognize symptoms of addiction despite the negative consequences and adverse effects experienced. This corroborates the words of Dr. Russell Portenoy, a renowned pain specialist who defined addiction as a behavioural pattern characterized by loss of control over drug use, compulsive drug use, and continued use of a drug despite harm.
The psychosocial effects of abusing opioids are strained relationships with loved ones, diminished finances, decreased self-worth, among others. The short-lived feelings of ecstasy experienced with opioid abuse pales in significance to the long term detrimental effects on one’s health, wealth and overall wellbeing. That being said, our encouragement is to desist from taking drugs unless prescribed by a registered health professional. In addition, if you are caught in a web of opioid abuse, then please speak to your doctor, pharmacist or trusted health professional and you would be amazed by the help available to you.
By Caleb Oppong – Wiafe, Registered Pharmacist.