Psychoactive Substance Use and Illicit Opioid Use and Mental Health in Hong Kong - Essay Example

Psychoactive Substance use and Mental Health (Hong Kong) Psychoactive Substance use and illicit opioid use and MentalHealth in Hong Kong Introduction In a broad perspective, opioid refers to all opium related compounds and elements. Opium is a term derived from a Greek word ‘opos’, meaning juice since this drug is obtained from the latex juice that is produced by opium poppy Papaver somniferum. All drugs such as the natural products of morphine, thebaine and codeine which are all opium derivatives are referred to as opiates (Van den Brink & Haasen 2006, 636). Analgesic narcotics are classified into three main groups. The first group which consists of heroin, morphine, and codeine are naturally considered to be derived from opium. The semisynthetic derivatives in this group include hydromorphone, hydrocodone, oxymorphone, dihydrocodeine, oxycodone, and buprenorphine. The remaining two groups are synthetic chemicals such as the phenylpiperidines which include the meperidineas well as the fentanyl, and the pseudopiperidines which include methadone and propoxyphene (Havens et al 2007, 101). Heroine and morphine were used first as medicine in the 19th century and later used illicitly for recreational purposes. Previously, the dependence of heroin and other opioid drugs has proved difficult to counter successfully whereby the poor result has been accredited to environmental characteristics, patient characteristics as well as other powerful reinforcing effects of the same drugs. The most common problems of opioid abuse are known to be nausea and constipation. These two side effects have been found to be difficult to deal with especially for constipation. The concept of agoinist-replecement therapy was introduced approximately forty years ago representing a breakthrough in opiod drugs management especially heroin. Developments in training have encompassed newer pharmacotherapies, Narcotics Anonymous and the psychosocial therapy (Davids & Gastpar 2004, 210). Abuse of Opioid following physiological effects; Analgesia These drugs tend to produce analgesia, mood changes, drowsiness as well as mental clouding but not all of these lead to loss of consciousness. Patients who report of pain claim that it is less intense and less discomforting which fades eventually after healing dosage of these drugs. Relief in pain is believed to be selective without affecting the other modalities of sense. Some patients are believed to experience euphoria. Vomiting, nausea, drowsiness, mental difficulties, apathy as well as the occurrence of decreased physical activities when given to pain free individual is common. The toxic effects and the subjective analgesic, which includes respiratory depression, may become more pronounced as the dose is increased. Morphine-class rarely causes slurred speech, significant motor in coordination as well as emotional liability (Havens et al 2007, 98). Effects on mood and reward Opioids through different ways induce exhilaration, peacefulness as well as other mood alterations like rewarding properties. Natural mechanisms involved in reinforcement of opioid are different from those that are involved in physical dependence as well as analgesia. Pharmacological and behavioral data tend to point to the probable role of dopaminergic pathways with other interactions between opioids as well as dopamine mediating the induced reinforcement of opuoid (Van den Brink & Haasen 2006, 640). Effects on the Neuron-endocrine system Opioid drugs tend to prevent the discharge of a gonadotropin- releasing hormone as well as corticotropin-releasing hormone (CRH) in the hypothalamus, which tend to reduce follicle-stimulating hormone (FSH), circulating luteinizing hormone (LH), ACTH, and beta-endorphin. This consecutively, decreases the concentrations of cortisol and testosterone in the plasma. Respiratory effects Opioid drugs and heroin tend to depress all respiratory process phases and also induce irregular and periodic breathing through partly or directly affecting the respiratory centers. There are rare cases of clinically important respiratory depression, which are occurring at standardized healing doses. The main mechanism of the respiratory depression involves a diminished responsiveness of the brainstem respiratory centers for carbon IV oxide. Effects on the gastrointestinal tract These drugs tend to stimulate directly the trigger zone of chemoreceptor for emesis in the postrema area of the medulla oblongata and this result to nausea and vomiting, an experience seen in some patients only. They also tend to reduce gastric motility as well as buliary, intestinal and pancreatic secretions and also delays food digestion in the small intestines. In the large intestines and the colon, peristaltic waves are reduced to the point of spasm delaying bowel contents from passing (Van den Brink & Haasen 2006, 636). Effects on heart cardiac muscles The heart does not contain opioid receptors and thus there are no direct effects brought about by morphine on its muscles. Nonetheless, opioid agonists tend to indirectly affect the process of cardiovascular process through the suppression of reflexive vasoconstriction, which results to hypotension and bradycardia. In other cases of injections use of heroin and other opioid drugs, bacterial endocarditis may develop. Other effects of opioid drugs on individual health The misuse of opioid and heroin may also lead to effects on reflexes especially swallow and cough reflexes as well as papillary dilation. Morphine and other related opioids tend to lower the reflex of cough through directly acting on the cough center found in medulla. Morphine agonists also tend to constrict the pupils of the eyes through the excitation of the nerves of the parasympathetic, which tend to stimulate the pupil. Scope and impact of the abuse and prescription of opioids Opioids prescription represent one of the three major broad categories of the medications that present the abuse liability, whereby the other two are stimulants and the central nervous system (CNS) depressants. Various factors are likely to have led to the severity of the current prescription of the drug abuse problem. Such factors may include drastic increases in the number of prescriptions which are written and dispensed, great social acceptability of using medications for different varying purposes as well as aggressive marketing by pharmaceutical organizations. All these factors together have helped to create a broad general environmental availability of prescription medications generally and opioid analgesics in particular (Armstrong 2003, 515). Prevention Drugs are marketed to the public and when they are subscribed to the public, they are believed to be harmless and effective when properly used. The perspective that they are not safe and can cause addiction when abused and misused tend to rise a difficulty topic to express. Therefore, learners and scholars ought to focus much on research so as to discover the strategies that can effectively address this issue through targeted communication strategies. Realization of such a significant goal may be more complicated than development and execution of effective programs aimed at preventing the abuse of illegal. However, good prevention messages, which derive their evidence from scientific research, will definitely be hard to evade (Havens et al 2007, 100). Education when aimed at touching every part of the community with doctors included plays a major role in curbing misuse of opioid drugs. The government of Hong Kong ought to come up with advanced addiction awareness and prevention measures like diagnosing abuse of drug prescriptions. Intended centers to serve the whole country should be instituted targeting physician trainees such as medical students as well as resident physicians in care specialists such as family practice, internal medicine and pediatrics. The government should also educate the public through offering courses that entail safe prescription of pain and manage the patients who tend to abuse the prescription of opioids. The government should also institute bodies and organizations aimed at creating awareness of over dosage of opioid drugs among the teens and the youth who are the most susceptible members of the society affected by this menace. The government in conjunction with other non governmental bodies must also provide information containing the harmful effects associated with prescription of opioid and abuse of drugs (Davids & Gastpar 2004, 216). The national social and economic costs of illicit opioid use Misusing and abusing of opium prescription together with other drugs is economically burdening to any given country. The available and existing evidence indicate that those individuals who misuse and abuse the prescription of opioids incur very high costs while sourcing healthcare resources. The differences in the approaches used to expound this issue may make the estimation of the actual burden imposed on the society a difficulty subject to confront. Educating and screening patients using relevant technology critically establishes and maintains a balance through which patients access these drugs to relieve pain and the risks exposed to them when they abuse the drugs. (Davids & Gastpar 2004, 209). The addiction and abuse of opioids’ prescription is a very serious problem globally that adversely affects health, social and economic welfare the community and society. Research indicates that around 36 million people abuse opioids worldwide. The effects of this abuse and misuse are on the rise and really devastating. For instance, the number of unintentional overdose deaths in Hong Kong has been on the increase. A rising proof suggests that a link exists between increased non-medical use of opioid drugs and drug abuse in Hong Kong (Havens et al 2007, 99). Other social and economic costs Health care costs The impact of illicit opioid use in Hong Kong in the form of health-care costs is very hig and staggering. It is believed that most of the healthcare expenditures for illicit opioid use are financed through private and public insurance. More of this cost falls on the taxpaying public and also tends to increase insurance premiums for the citizens. Premature death Opioid abusers tend to die younger than the non-abusers thus losing years of potential productivity to the nation. This loss is passed on to the non-abusers through the loss of tax money to state and local government funds. Families and friends of opioid users who die young also suffer financial losses because of the absence of the diseased person’s income contribution. Many families tend to settle for welfare programs for support, which represents another cost to tax-paying public. Impaired productivity Employers tend to lose a lot of money due to abseeintism, sick leaves, employee’s compensation and general non-productivity which is caused by opioid abuse and related behaviors in the work place. Loss of productivity is brought about by low morale, depression as well as the tendency of the abusers to feel ill. Crime It is believed that crime suspects who enter correctional institutions are mostly opioid and other drugs abusers. It is tedious dealing with such criminals and correcting their behaviors is very high and uses taxpayer’s money (Armstrong 2003, 515). There are various interventions, which reduce the costs and harms of illegal and illicit opioid use, which include enforcement, deterrence, treatment and rehabilitation. Several assessments and research activities have shown that treatment is the by far more cost effective approach to reducing the adverse effects associated with illegal opioid use rather than enforcement. Proper screening of opioid patients, education and defensive treatment of any potential side effect of opiod abuse may assist in the maximization of the efficiency and effectiveness of treatments. This aids in minimizing the severity of the adverse and side effects of excessive use of opioids and heroin. Conclusion Opioid and heroin addiction has posed a major problem to deal with among the individuals in Hong Kong. Premature deaths in Hong Kong are majorly associated to opioid overdose and addiction. Nonfatal overdoses, described as the instances which lead to loss of consciousness and other respiratory problems such as depression may emerge also but are not that much lethal. Overdosing opioid and heroin may also lead to unemployment, singleness, heroin addiction, lack of current treatment for the heroin dependence as well as the concomitant use of alcohol and other benzodiazepines (Armstrong 2003, 520). Findings indicate that fatal heroin and opioid overdose victims are basically old with lot of experience in the drug usage. Similarly, through demographic factors of such victims, it has been understood that a big population of the individuals who overdose opioid and heroin has low concentrations of morphine in their blood due to loss of tolerance and polydrug use as some of the key factors explaining this scenario. Other risk factors for opiod overdose include self-medication, living in rural areas, mental illnesses and polypharmacy. 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