Opioids are commonly used for the treatment of pain, but their non-medical use, prolonged use, and misuse can lead to opioid dependence and other health impacts.
Martin Akatch walks into a medically assisted therapy clinic for a routine counseling session. After spending hours with one of his therapists, he heads to the pharmacy for medication. This has been his daily routine since 2021.
“After a counseling session, I normally receive my daily dose of methadone and then head back to school for my lessons,” says the 43-year-old primary school teacher.
Martin is neat and in good health, a complete contrast to what he looked like when he first attended therapy three years ago. He willingly sought help after battling an addiction to pethidine, an opioid pain relief medicine, for four years.
“Those who knew me when I was battling addiction might fail to recognize me now. I will be completing my therapy sessions this year a fully changed person,” he says with a smile.
Until 2017, Martin led a normal life. He was a teacher, an author, and a public speaker. On weekends, he would go out to drink with friends at a local pub.
Trouble began in February 2017 when he started experiencing extreme abdominal pain. Initially, he ignored it and went out drinking, but the pain worsened. The next morning, he woke up with a swollen abdomen and had to rush to a health facility.
Medical tests confirmed that he had pancreatitis, a condition resulting from excessive alcohol consumption. To manage the pain, he was placed on pethidine, among other antibiotics. The drug had a sedating effect, making him feel high and fall asleep.
Doctors warned him about the addictive nature of pethidine and advised against frequent or unauthorized use. However, as the pain became unbearable, his dosage increased. Eventually, he was admitted to the hospital for three weeks. Upon discharge, he was advised to stop drinking alcohol and limit his diet to non-acidic vegetables.
Despite following the dietary recommendations, the pain returned a few days later. He was readmitted, placed on the same drugs, and discharged after two weeks. When the pain resurfaced, he could no longer afford in-patient services and resorted to buying over-the-counter drugs, including pethidine.
With the drugs, Martin could eat solid foods despite medical advice to the contrary. To evade the pain, he began injecting himself with pethidine. At first, a nurse in the neighborhood assisted him, but soon he and his wife became comfortable administering the injections themselves.
Over time, his dependence grew. He started taking up to 10 vials of pethidine daily. On one occasion, he suffered multiple convulsions and passed out after an overdose. His wife discovered hundreds of empty vials hidden in their house, confirming her suspicions about his addiction.
Financially, Martin was struggling. He borrowed from friends, online loan applications, and banks to sustain his drug supply. He also formed a network of friends addicted to the drug, ensuring a steady supply.
His addiction affected his work, leading to multiple transfers. Eventually, he stopped teaching temporarily and returned home, where he continued abusing the drug. His wife later enrolled him in a counseling program at a medically assisted therapy clinic, where he has been undergoing treatment.
According to experts, opioids include compounds extracted from poppy plants and semisynthetic compounds that interact with opioid receptors in the brain. They are commonly used for pain management but can lead to dependence and serious health complications.
Overdose can be fatal, with statistics estimating hundreds of thousands of deaths annually due to opioid use. A medically assisted therapy center was introduced in 2018 to address increasing cases of heroin abuse. The facility combines psychological counseling with methadone, a drug used to reduce cravings and withdrawal symptoms.
Methadone provides a similar effect to heroin but lasts longer in the system, reducing the frequency of drug use. Drug abuse is associated with an increased risk of sexually transmitted infections due to risky behavior and needle sharing. Other health impacts include weakened immune systems and increased exposure to infectious diseases.
One of the main challenges for those with opioid use disorder is the stigma associated with seeking medical help. The facility provides therapy for up to 12 months, with some clients staying longer depending on the severity of their addiction. The service is offered free of charge and has helped hundreds of clients.
However, the lack of boarding facilities remains a challenge. The medically assisted therapy clinic is one of three such facilities established by the government to rehabilitate individuals recovering from opioid addiction. Other commonly abused opioids include tramadol, a drug used for short-term pain relief.
