Identifying and Treating Opioid Substance Use Disorders in the LGBTQ+ Community

A person who identifies as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) faces social stigma, discrimination, and other challenges not shared by heterosexuals. There is also a greater risk of harassment and violence for them. This and other stressors put sexual minorities at higher risk for behavioral health problems.

Moreover, surveys so far show that sexual minorities have higher rates of substance misuse and substance use disorders (SUDs) than heterosexuals.

What is Opiate Addiction?

Opioids are pain-relieving drugs manufactured synthetically by pharmaceutical companies or derived from poppy plants. Legal drugs like codeine and morphine are examples of opiate drugs, as are illegal drugs such as heroin and opium. Although these drugs may benefit those suffering from pain, when they are not used according to a physician's prescription, they can pose a high risk of addiction and other harmful effects.

Because opiates block pain receptors, they are particularly addictive and harmful, causing changes in brain chemistry over time. A person can temporarily escape from the world around them when using opiates because they produce feelings of euphoria and tranquility. Addiction to opiates is not only dangerous, but it can be deadly if left untreated.

How Does Opioid Addiction Develop?

Currently, it is unknown why some people become addicted to opioids and others don't. For most people, opioids relieve pain and create a sense of euphoria. After taking opioids, experiencing euphoria may indicate an addiction risk. It is possible for people to experience this euphoria when they are taking opioids as prescribed by their doctors.

Despite this, some factors contribute to opioid addiction even before someone starts taking these drugs - legal or illegal. The likelihood of your loved one becoming addicted to opioids increases if they:

• Are young, specifically in their teens or early 20s.

• Live in stressful circumstances, like poverty, unemployment, or being an LGBTQ+ member.

• Have a history of substance abuse.

• Have family members who abuse opioids.

• Aren't happy at work, at home, or with friends.

• Have had previous legal troubles, including DUIs.

• Regularly deals with high-risk people or high-risk environments.

• Suffer from severe depression or anxiety

• Engages in thrill-seeking or risk-taking

Additional factors like genetics, psychology, and environment can contribute to addiction, which can develop quickly or over time. Everyone who takes opioids is at risk of addiction, regardless of age, income, or ethnicity.

When opioid use disorder is in its early stages, people may take opioid drugs because of their pleasurable effects. Eventually, the pleasant sensations fade away. When withdrawal symptoms occur, opioids may be taken more frequently or at higher doses to restore the euphoria.

It is more likely that an individual will become addicted to an opioid if they take it regularly. In general, becoming physically dependent takes a couple of weeks, depending on the person. In most cases, taking an opioid for a day or two is not a problem, but some studies have shown that even the first dose can contribute to opioid dependence.

Opioid Abuse Signs and Symptoms

It's common for people to hide their drug abuse in the early stages of opioid addiction. As time goes on, however, they start showing signs of abuse. A person may experience different signs of opioid abuse depending on the type of opioid he or she is using:

Behavioral symptoms:

• Providing false information to obtain opioid prescriptions.

• Receiving multiple prescriptions for opioids from multiple doctors.

• Taking medications from others.

• Borrowing money.

• Absences that are unexplained.

• Performing poorly at work.

• Self-isolation from family and friends.

Physical symptoms:

• An apparent change in appearance, such as weight loss or a change in hygiene.

• Symptoms of IV drug use, such as scabs, sores, or puncture wounds.

• A lack of coordination and motor skills.

• Problems related to the digestive system, such as vomiting or diarrhea.

• Constipation.

• Nausea.

• Constricted pupils.

Cognitive symptoms:

• An inability to think clearly.

• Problem-solving and judgment are impaired.

• Poor impulse control.

• Disconnection from one's surroundings.

• Concentration problems.

Psychosocial symptoms:

• Fluctuations in emotions.

• Unprovoked and sudden outbursts.

• Irritability.

• Anxiety.

• Depression.

• Paranoia.

Effects of Opiate Addiction

Without proper treatment, opiate addiction can adversely affect a user in multiple ways. As well as affecting health, opiate addiction can also negatively impact many other areas of their life.

Addiction to opiates may have the following effects:

• Discord within the family.

• There is a lack of interpersonal relationships.

• Expulsion from school.

• Loss of employment.

• Legal problems or incarceration.

• Hospitalizations and commitments to mental health programs on multiple occasions.

• An increase in heart rate.

• Heart infections.

• Bacterial infections.

• An increase in blood pressure

• Veins that have collapsed.

• Complications and diminished lung function.

• Damage to more than one organ.

• The contraction of infectious diseases (HIV/AIDS, Hepatitis B and C).

• Arthritis.

• Suicidal ideation and attempts.

• Death.

Opioid Abuse & Co-Occurring Disorders

Addiction to opioids is often accompanied by other mental health issues, such as:

• Anxiety disorders.

• Depressive disorders.

• Bipolar disorder.

• Personality disorders.

• Posttraumatic stress disorder.

• Attention-deficit/hyperactivity disorder.

Addiction Treatment for Opioids

An individual's treatment plan for opioid use disorder is best when it is tailored to their specific needs. Several therapies may be needed before a person finds the one that best supports lasting recovery, as there is no single approach that works for everyone.

Several treatment options are available for opioid use disorder, including outpatient programs and residential programs, such as rehabilitation centers (rehabs).

As part of treatment in any of these settings, people may receive medications such as methadone, buprenorphine, or naltrexone, as well as support programs that can assist in recovery.

Only a small number of opioid use disorders require hospital treatment. In the event of a crisis due to physical or emotional distress, people with substance abuse disorders may go to the hospital emergency room. Patients are evaluated, assessed for primary needs, and then connected to treatment in most hospitals. Patients with opioid use disorders who also suffer from significant medical problems may be admitted to the hospital.

In the case of an opioid overdose, naloxone is used in an attempt to reverse the effects of the overdose. Overdoses may be reversed with naloxone, but addiction treatment addresses the underlying opioid use disorder in addition to flushing the drug from the brain's receptors.

Opioid Withdrawal Treatment (Detoxification)

Initially, the person must deal with withdrawals by helping them rid their bodies of opioids. Within six to 24 hours after stopping opioids, a person with a physical dependence experiences withdrawal symptoms. Depending on what drug the person has been taking, the amount of time will vary.

When you withdraw from opioids, you may experience the following symptoms:

• Abdominal cramping

• Agitation

• Anxiety

• Chills

• Insomnia

• Nausea

• Muscle aches

• Sweating

• Vomiting

After 72 hours, withdrawal symptoms may become more severe before they begin to subside. Opioid withdrawal is often uncomfortable but rarely dangerous, unlike alcohol or benzodiazepines. Methadone or buprenorphine can be administered as part of treatment to ease symptoms and ensure safety.

In order to avoid relapse, the person should continue treatment after the drugs are removed from their system.

Outpatient and Residential Substance Use Disorder Treatment

For more intensive treatment, an opioid user may decide to attend an outpatient clinic or a rehabilitation center. Various insurance plans cover different types of treatment. For specifics, talk to your insurance company.

Counseling for Opioid Use Disorder

A person's life is affected by opioid use disorder in a variety of ways. People can learn ways to counteract unhealthy opioid behaviors and thoughts through counseling and behavior therapy.

In addition to group therapy, relapse prevention training, vocational and educational services, community-based and family support, mental health assessment, and other resources, treatment centers may have their own mental health resources.

Drugs for Addiction

By reducing cravings or blocking opioid-induced pleasant feelings, there are many drugs available that can help people stop using opioids.

A person who suffers from opioid use disorder can use these drugs as part of their treatment. The drugs are not substitutes for the ones causing the person's problem; they are therapeutic treatments. When these medications are used in conjunction with high motivation and a good social support network, patients are more likely to achieve better results.

To treat opioid use disorder, methadone is administered in clinics and inpatient settings. In addition to helping with withdrawal symptoms and cravings, methadone also helps with addiction. Various forms of this drug are available, such as pills, liquids, or wafers. As a pain reliever, it can also be prescribed by doctors.

Another drug, buprenorphine, treats opioid cravings but does not produce euphoria. Many physicians prescribe this under the tongue daily as part of their office practice. As well as injections once a month, thin tubes can be inserted under the skin that lasts for six months. They can also deliver it.

It is similar in safety and side effects to buprenorphine and methadone in that both activate tiny receptors on nerve cells to control cravings. As maintenance treatments or as a taper-off treatment, they can be used in some cases.

Compared to methadone and buprenorphine, naltrexone has many distinct differences. The drug blocks opioids' euphoric and sedative effects rather than turning on opioid receptors. To begin taking naltrexone, a patient must be completely free of opioids in their system. Injections are administered once a month or orally. Almost every community offers training in administering naloxone to loved ones with substance abuse disorders.