Opioids (say: “oh-pee-oyds”) are a type of medicine often used to help relieve pain. They work by lowering the number of pain signals your body sends to your brain and by changing how your brain responds to pain. Doctors most often prescribe opioids to relieve pain from toothaches and dental procedures, injuries, surgeries, and chronic conditions such as cancer. Some prescription cough medicines also contain opioids.
Opioids usually are safe when they are used correctly, but people who misuse opioids can become addicted. Misusing opioids means that you don’t follow your doctor’s instructions for how to take the medicine, or you take the drug illegally.
Addiction is a disease that affects your brain and your behavior. At first, you have control over your choice to start using drugs. If you misuse a drug, its pleasurable effect eventually makes you want to keep using it. Over time, your brain actually changes in certain ways so that a powerful urge to use the drug controls your behavior.
Drug tolerance is when your body, over time, gets used to the effects of a drug. As this happens, you may need to take a higher dose of the drug to get the same effect. For example, people who take an opioid for a long period of time often become tolerant and need a higher dose of the drug in order to get the same pain relief.
Drug dependence is when the way your body works changes because you have taken a drug for a long time. These changes cause you to have withdrawal symptoms when you stop using the drug. Withdrawal symptoms can be mild or severe, and may include sweating, nausea or vomiting, chills, diarrhea, shaking, pain, depression, insomnia, and fatigue.
If you have been taking a prescription opioid for a long time, your doctor can help you avoid withdrawal symptoms by gradually lowering your dose over time until you no longer need the medicine.
Drug tolerance and dependence are a normal part of taking any opioid drug for a long time. You can be tolerant to or dependent on a drug and not yet be addicted to it.
Addiction, however, is not normal. It is a disease. You are addicted to a drug when it seems that neither your body nor your mind can function without the drug. Addiction causes you to obsessively seek out the drug, even when the drug use causes behavior, health, or relationship problems.
You might be addicted if you crave the drug or if you feel like you can’t control the urge to take the drug. You may also be addicted if you keep using the drug without your doctor’s consent, even if the drug is causing trouble for you. The trouble may be with your health, with money, with work or school, with the law, or with your relationships with family or friends. Your friends and family may be aware of your addiction problem before you are, because they notice the changes in your behavior.
Treatment for opioid addiction is different for each person, but the main goal of treatment is to help you stop using the drug (this is called detox) and avoid using it again in the future (this is called avoiding relapse).
To help you stop using the drug, your doctor can prescribe certain medicines to help relieve your withdrawal symptoms and control your cravings. These medicines include methadone (often used to treat heroin addiction), buprenorphine, and naltrexone.
After detox, behavioral treatments such as individual counseling, group or family counseling, and cognitive therapy can help you learn how to manage depression, avoid the drug, deal with cravings, and heal damaged relationships.
The first step in breaking addiction is realizing that you control your own behavior. The following steps will help you fight your addiction:
National Institute on Drug Abuse. Research Reports: Prescription Drugs: Abuse and Addiction: Opioids. Accessed August 15, 2012
National Institute on Drug Abuse. Topics in Brief: Medication-Assisted Treatment for Opioid Addiction. Accessed August 15, 2012
Written by familydoctor.org editorial staff