How Self-Harm Overlaps with Opioid Addiction, and How to Treat Both

Substance Abuse, Self Harm Overlaps Opioid Addiction

The media has focused heavily on the opioid epidemic in the U.S., with a great deal of speculation about causes for the unprecedented rate of opioid abuse and self-harm. As opioid addiction rates have risen, so has attention on mental health problems coupled with substance abuse.

Self-harm is a symptom of mental health issues, and many people who exhibit this symptom also struggle with substance abuse. Understanding the link between substance abuse and mental soundness can help people seek appropriate treatment to stop the cycle of self-harm and addiction.

What Is Self-Harm?

Self-harm refers to the act of purposely harming yourself. It doesn’t pertain to situations in which you accidentally hurt yourself. Rather, self-injury involves a deliberate attempt to inflict pain and suffering on yourself.

Self-harm, which is also referred to as self-mutilation, self-injury or self-abuse, is common. Between 15 percent and 40 percent of adolescents engage in self-injury at some point, according to various studies. Accurate data on adults is more challenging to come by, as self-harm is highly stigmatized. Many adults who engage in self-harm do not admit to such behavior, even in anonymous surveys, but Mental Health America reported that self-injury occurs in approximately 4 percent of adults in the U.S.

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The most common forms of self-harm include:

  • Cutting
  • Scratching
  • Burning
  • Hitting or punching yourself or another object
  • Pulling out your hair
  • Poking or piercing your skin with sharp objects (e.g., pins, needles)
  • Picking at existing wounds or scabs
  • Carving words or symbols into the skin

Eating disorders, in which you strictly control your intake of calories or engage in purging, also are a form of self-injury. Additionally, engaging in other risky behavior due to low self-esteem can result in self-injury as well. Anything that harms your body and intentionally causes pain or discomfort to yourself can be a form of self-injury.

See Also: When Drug Addiction Becomes More Important than Your Relationship


Why Do People Hurt Themselves?

Determining what causes people to engage in self-harm can be complicated. In addition to the many forms of self-injury, there are myriad reasons why people engage in such behavior that stem from trauma and mental health issues. For example, self-harm is common among people who experience:

  • Anxiety
  • Bipolar disorder
  • Depression
  • Post-traumatic stress disorder
  • Schizophrenia

Keep Reading: Psychiatric Problems Among People Struggling With Heroin Dependence

All of these mental state problems are rooted in emotional dysregulation. Low self-esteem, a history of trauma, or intense self-dislike can cause a great deal of emotional pain. Engaging in self-injury is an unhealthy reaction to those intense emotions.

People who self-harm often describe it as a release for the emotions they cannot control. Although it may provide a short-term release, self-harm is ultimately very damaging. It can lead to serious injury and an increased risk of suicide.


Understanding the Relationship Between Self-Harm and Opioid Addiction

Although many people with opioid use disorder do not self-harm, many people who self-harm also struggle with opioid dependence or other substance abuse. Self-harm and substance abuse share a common cause: emotional distress.

Similar to how people decide to cut themselves to relieve emotional pain, for example, they may also turn to opioids to dull the pain they feel. Both of these approaches serve to temporarily diminish emotional pain but they do not take it away entirely.

If the root cause of the mental health issue is left untreated, symptomatic behaviors like self-harm and substance abuse can escalate. Prolonged use of opioids can then result in a physical dependence to the drugs, which further complicates the problem.

Not much data is available to determine exactly how many people struggle with both opioid addiction and self-harm. One study published on the National Center for Biotechnology Information website, however, found that adolescents who self-harm are four times as likely to have substance use problems in adulthood.

In 2015, 2 million Americans had an opioid use disorder involving prescription painkillers, and 591,000 suffered from heroin abuse, according to the American Society of Addiction Medicine. Although data on the co-occurrence of self-harm and opioid abuse is hard to come by, studies of suicidal behavior provide some insight. Suicide is the most extreme form of self-harm. One study found that 8 percent to 17 percent of people suffering from opioid addiction attempt suicide. If self-harm rates are similar, thousands of Americans suffering from opioid use disorder could also be engaging in forms of self-injury.

substance abuse

Rapid Opioid Detox Can Clear the Path for Successful Mental Health Treatment

Both self-harm and opioid addiction are external expressions of internal pain. They share behavioral triggers and root causes such as emotional distress and mental state issues. But long-term self-harm does not result in a physical dependence the way prolonged opioid use can. To effectively treat the real causes of self-harm and opioid abuse, the physical dependence on opioids needs to be removed first.

As long as the physical dependence on opioids is present, any mental health treatment will be severely limited in what it can accomplish. Removing that dependence increases a person’s chances of successfully building a healthier life.

A fast, safe and effective way to reverse physical opioid dependence is rapid detoxification. Rapid detox is a procedure in which a person is sedated for a short time in a hospital and monitored by a medical doctor.  This is to help them get through an accelerated acute withdrawal. During rapid detox, the patient has 24/7 medical supervision to ensure his/her safety and the successful completion of the procedure.

Learn More: The Benefits of Rapid Opiate Detox over Other Drug Treatment Programs

Once the detox process is complete, the patient’s body is no longer physically dependent on opioids. Free of that burden, he or she can then more effectively pursue treatment for the mental condition that prompted self-harming behavior.

After detox, various forms of therapy can help rapid detox patients explore the root causes of addiction and self-injury. As they physically readjust to being opioid-free, they can work with therapists to identify triggers and learn new coping strategies. Equipped with a healthier physical state and tools to improve their emotional health, they can find outlets for negative emotions that don’t involve drugs or self-injury.

See Also: How Does the Rapid Detox Process Work?

Published on March 14, 2019

Reviewed by Clare Waismann, CATC, Founder of Waismann Method® Advanced Treatment for Opiate Dependence