For the most part when someone pictures a long term opiate user they picture a homeless individual living under a bridge somewhere, pushing a shopping cart filled with their belongs along the road. They see a rather dirty, scruffy man, who is begging for change at the intersection, and while they are not entirely wrong, as some opiate addicts do wind up homeless, this archetype of the opiate addict is not what the average long term user looks like.
It is interesting because as a society we have created a zeitgeist around addiction that does not resemble what addiction truly is, or how it manifests itself in the individual addict. We have in a very real sense created an other out of the addict, displacing them from society, and in doing so, we have neatly tucked them away in the peripherals of our mind, which in turn has allowed us to skirt the issue and mass incarcerate addicts in turn.
However the reality is that the long term opiate addict statistically speaking has a job, is not homeless, may have spent some time in jail because of their addiction, and more often than not lives a tremendously isolated life. They more often than not look sickly and underweight and very often they have a greyish tint to their skin and sunken eyes due to the years of drug abuse.
Long term opiate addiction, while not necessarily resulting in homelessness, is not a pleasant thing to witness. Many times individuals who have abused opiates for a long period of time, and have resorted to using the drug intravenously, will have at some point contracted any of the following diseases or infections:
- Staph infections
- Abscesses
- Cellulitis
- Necrotizing fasciitis
- Botulism
- Tetanus
- Septic thrombophlebitis
- Bacterial endocarditis
- Hepatitis C
- HIV
Each of the above listed disease and infections are potential long term effects of opiates and the longer that an individual uses for the greater chance they have at contracting one of these illnesses.
Beyond that and on more the social long term effects of opiates, using for an extended period of time almost always results in social isolation and depression. The reasons for this are fairly clear as it is almost impossible to manage and maintain relationships when you are using opiates all of the time. This isolation in turn fuels the addiction in a vicious cycle of isolation and further usage that can be very difficult to break.
More often than not the long term opiate user no longer uses with other people and instead chooses to use alone at home because they do not want to share their drugs and they more then likely have attempted to convince others that they are no longer using.
One of the most frightening long term effects of opiates is how extended exposure to opiates can actually greatly damage the grey matter in the brain, which control muscle movement, sight, hearing, speech, decision making, and behavioral choices. If prolonged exposure is not discontinued sometimes this damage can be permanent, causing individuals to have problems with their motor functions similar to what “wet-brain” looks like in an alcoholic.
Similarly, long term opiate abuse can cause chronic and clinical depression, due to the fact that the brain has become accustomed to getting it dopamine from a source outside of the body and so it stops creating certain chemicals in the brain that lead to feelings of wellness and joy.
While we briefly touched on some of the long term physical effects of opiate abuse above, the list below covers the most commonly experienced side effects from long term usage. While they are fairly common among long term users, withdrawal symptoms have been left off this list, as they are capable of being experienced by both short term and long term users and are not the direct result of either.
This list is by no means a comprehensive one, and there are long term effects that lay outside of the scope of this guide, but rather the effect listed below are ones that almost every long term addict can expect to experience if they continue to use.
Nausea and vomiting
Usually nausea and vomiting are considered to be short term effects of opiate abuse, since many first time users get sick when they first ingest these powerful substances, but vomiting and nausea are also long term effects of opiate use as well. In fact some studies have shown that long term opiate use can cause Cyclical Vomiting Syndrome which is characterized by recurrent attacks of intense nausea, vomiting, abdominal pain, headaches and migraines. Doctors are not entirely sure how the two are linked, but there does seem to be some causality involved.
Abdominal distention and bloating
It is commonly known that opiates can cause constipation, in fact it is even one of the long term effects on this list, but it is less known that over time opiates actually slow down the bowel causing Narcotic Bowel Syndrome. The symptoms of Narcotic Bowel Syndrome include bloating or abdominal distention. The latter is caused by air or fluid accumulates in the abdomen, which causes it to expand outward, beyond the normal girth of the stomach.
Constipation
Any individual who has been addicted to opiates can attest to the fact that constipation is one of the most uncomfortable long term effects of opiate use. While not inherently life threatening, although it can be, individuals who are addicted to opiates will find it tremendously difficult to pass a bowel movement, even if they are using stool softeners. This can result in anal fissures and other various medical conditions that are both uncomfortable and dangerous.
Liver damage
While it is possible to experience liver damage as a result Hepatitis C or one of the other contractible diseases that IV opiate users are at risk of catching, one of the leading causes of liver damage from long term opiate use, is actually the result of acetaminophen mixed with opiates in certain pain kills. Many people may be surprised to know that acetaminophen (or Tylenol) when taken in high doses for an extended period of time actually destroys the liver. In many painkillers the dosage of acetaminophen is 500mg per pill, and when taken a few times a day, this is enough to cause severe liver damage.
Brain damage due to hypoxia
This is a tremendously frightening and tremendously dangerous long term effect of opiate abuse. To start with hypoxia refers to when an area of the body is not receiving enough oxygen and in this particular case the part of the body in reference is the brain. This long term effect can come about in a number of different ways, but the two main ways that most people experience it are from an overdose, in which the individual experiences complete respiratory arrest, or from prolonged opiate use, where the individual experiences chronic labored or shallow breathing. The former is fairly straightforward in how it occurs, because the brain is damaged due to the fact that the individual is not breathing. The latter is a little more complicated because it occurs over a long period of time where the brain is deprived of the oxygen that it needs. Opiates in general depress the respiratory system and if this goes on for long enough, irreversible damage can occur.
Development of tolerance
While this may seem rather obvious, some people are initially unaware that using a substance for an extended period of time while cause they to build a tolerance to that substance. In the case of opiates this can be particularly dangerous, because it means that an individual who is engaged in long term opiate abuse has to take toxic levels of the drug in order to not experience relapses, which is not only expensive but potentially fatal given the current climate of opiate abuse in this country. In fact, this long term effect is one of the main killers of long term opiate users, because if they stop using for a period of time and relapse back into using (the same amount that they were accustomed to using) they could suffer a fatal overdose. The same thing goes for if a long term opiate users gets a bag of heroin that is laced with fentanyl of some other highly potent opioid.
Dependence
Besides developing a tolerance to opiates, the only other long term effect that is guaranteed is dependence. It should be noted that there is a difference between dependence and addiction, but often times the two go hand in hand and an individual experiencing a physical dependence to a substance more than likely also suffers from addiction. With that said, experiencing dependence to opiates is a horrifying ordeal because it means that if you stop using them for even a few hours you begin to experience terrible withdrawal symptoms that will rival even the worst flu you have ever had. Once an individual becomes dependent on opiates it can prove very difficult to get off of them and often times medical intervention is necessary in order to break the cycle of dependence. The other issue with experiencing dependence after long term opiate abuse is that an individual will often times find it incredibly difficult to stay clean and sober from opiate use (if they do not seek help) even after extended periods of clean time. This is in part because opiate use can actually change the way that the brain functions and can cause cravings and obsessions that are almost impossible to battle.
