How to Tell If A Loved One Is Abusing Opioids

Opioid abuse continues to be a nationwide problem.

In 2017, 70,237 overdose deaths were reported, according to the Centers for Disease Control and Prevention, and opioids — including synthetics such as fentanyl, pain relievers such as oxycodone, and street drugs such as heroin — factored into 47,600 of those fatalities. Seventy percent of preventable overdose deaths that year involved opioids.

It’s troubling because opioids can be an especially effective gateway to addiction. An estimated 21 to 29% of patients with opioid prescriptions for chronic pain tend to misuse them, and 8 to 12% develop an opioid use disorder.

Common Signs of Opioid Addiction

Opioids aren’t necessarily a villain in a pill bottle for everyone. Some people need them for chronic pain or during cancer or end-of-life-struggles. In such situations it’s important for a health care professional to monitor use to make sure dosing doesn’t veer into abuse territory.

When considering medication for short-term healing — such as wisdom tooth removal or a sprained back — more doctors are shying away from opioids and suggesting alternatives such as acetaminophen or ibuprofen.

For someone wondering how to tell if a loved one is abusing opioids, the most important question might be, what changes have you noticed? Changes tend to be a warning sign that something is occurring.

There are some red flags that point to use and misuse:

• Hanging out with a new crowd
• Abandoning family and long-time friends
• Losing interest in long-loved activities
• Neglecting hygiene and grooming
• Changing eating habits
• Suffering from flu-like symptoms
• Stealing
• Encountering financial problems
• Shifting moods
• Missing obligations, like work or school
• Experiencing sleep patterns

And of course, if you see people taking opioids with no signs of stopping, that’s a cause for concern.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has a checklist of 11 symptoms. If a person exhibits at least two of those within the past 12 months (including neglecting work or school, acting recklessly, or experiencing withdrawal) then they may have a substance use disorder.

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What Are the Chances My Loved One Could Be Addicted?

There’s no set of circumstances that guarantee addiction. It’s a mix of things. Everyone’s unique.

Opioids and other drugs reward the brain’s reward zones. Exercise or sex or food typically flood the brain with feel-good chemicals, but drugs easily override and retrain the brain to want more of the drug to achieve the same effect. Long-term, drug use can affect memory, judgment, learning, and how someone handles stress.

Drug use isn’t a guarantee of addiction, but a family with substance use behaviors, genetics (such as how one responds to substances), environment and influences, and experimenting with drugs and/or alcohol at a young age can all factor into addiction.

The Effects of Substance Use Disorder on Loved Ones

Substance use disorder has a profound impact on families.

A nonusing parent may try to overcompensate, covering for the using spouse while making up for the abuser’s neglect and shortcomings.

Children can react in a variety of ways. Some will take on the role of a surrogate spouse for the parent struggling with addiction. Others may use denial as a coping mechanism.

Extended family may feel neglect, concern, anger, or embarrassment.

Finances may be strained if legal trouble or property damage results from abuse. Some family members may self-medicate to cope, potentially continuing the addiction cycle.

How to Suggest Treatment

There’s little doubt about the suffering of family and friends because of the addiction, but there’s debate about what the best way to confront a loved one about their substance use disorder.

The “tough love” approach is not always seen as the best approach. There may be hope (and frustration) driving the ultimatum, but hitting rock bottom isn’t always the safest way to go.

Since addiction to drugs and alcohol is classified as a mental illness, the thinking is that treating it with empathy instead of disdain may be more effective.

Tough love is best when tempered with a bit of support. Parents may insist the addicted child quit using and start treatment, but experts also suggest they still offer some sort of support as well as seek professional help in order to develop a solid treatment plan.

How to Dispose of Opioids

When getting rid of opioids (and storing them), be cautious.

Keep medicines in a safe and secure spot. Be sure young children can’t find them. Also, it’s wise to make it harder for teens or other family and/or friends to find and misuse them.

Never share. More than half of people who misuse prescriptions tend to get them from a friend or family member.

Don’t just throw drugs away in the garbage. Disposed of wrong, people may find them and take them.

To safely remove leftover or expired medications, the Drug Enforcement Administration (DEA) has Take Back Day events listed on its website. Visitors can also search for places to dispose of unused and expired medications

If there are no instructions for safe disposal on prescription drug labels and there is no take-back program nearby, the DEA suggests taking the following steps:

• Remove the drugs from the original container. Mix them with some kind of undesirable substance such as used coffee grounds or cat litter.
• Place the mixture in a bag or container to prevent it from leaking or spilling into the garbage bag.

Generally experts advise against flushing medicines down the sink or toilet. The only time that is acceptable, according to the DEA, is when the labeling specifically says so. The Food and Drug Administration has safe disposal instructions too. It’s also a good idea to check to make sure your community doesn’t forbid the practice outright.

References

• cdc.gov – Drug Overdose Deaths
• nsc.org – Painkillers Driving Addiction, Overdose
• drugabuse.gov – Opioid Overdose Crisis
• Asahq.org – Opioid Abuse
• Hopkinsmedicine.org – Signs of Opioid Abuse
• healthblog.uofmhealth.org – How to Spot Signs of Opioid Addiction
• drugabuse.gov – Understanding Drug Use and Addiction
• ncbi.nlm.nih.gov – Impact of Substance Use Disorder on Families
• npr.org – Families Choose Empathy Over ‘Tough Love’ to Rescue Loved Ones from Opioids
• nimh.nih.gov – Substance Use and Mental Health
• abcnews.go.com – Parents Face Difficult Decisions When Dealing with a Drug-Addicted Child
• dea.gov – How to Properly Dispose of Your Unused Medicines
• fda.gov – Disposal of Unused Medicines: What You Should Know