Opioid Addiction

Overview

What are opioids?

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 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.

What is addiction?

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 you develop a powerful urge to use the drug.

Symptoms

What are the signs and symptoms of opioid addiction?

Recognizing the signs and symptoms of substance abuse and addiction of opioids is often the first step toward treatment. Signs and symptoms can be physical, behavioral, and psychological. A primary sign of addiction is the inability to limit use of a substance beyond what is clinically recommended.

Other signs and symptoms of opioid abuse include:

  • Poor coordination

  • Drowsiness

  • Shallow or slow breathing rate

  • Nausea, vomiting

  • Constipation

  • Physical agitation

  • Poor decision making

  • Abandoning responsibilities

  • Slurred speech

  • Sleeping more or less than normal

  • Mood swings

  • Euphoria (feeling high)

  • Irritability

  • Depression

  • Lowered motivation

  • Anxiety attacks

What are the symptoms of opioid overdose?

An overdose of opioids requires immediate emergency medical treatment. If you suspect someone has overdosed on opioids, call 9-1-1 immediately.

Symptoms of an overdose include:

  • Unresponsive

  • Slow, erratic breathing, or no breathing at all

  • Slow, erratic pulse, or no pulse

  • Vomiting

  • Loss of consciousness

  • Constricted (small) pupils

Causes & Risk Factors

What is drug tolerance?

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 need a higher dose of the drug in order to get the same pain relief.

If you stop using an opioid for a period of time, your tolerance will begin to fade. Resuming the medication at the same higher dose when your tolerance was increased can be too much for the body to take. If you stop taking a medication, and then resume, talk to your doctor about dosage.

What is drug dependence?

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.

What is the difference between drug tolerance, dependence, and addiction?

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.

How do I know if I’m addicted?

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

How is opioid addiction treated?

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.

Other Organizations

Questions to Ask Your Doctor

  • How can I prevent getting addicted to opioids?

  • Is the medicine I’m taking addictive?

  • How do I know if I’m addicted to an opioid?

  • What should I do if I think I’m addicted to an opioid?

  • How do I know if a friend of family member is addicted to an opioid?

Bibliography

Opioid drugs include:

  • opium

  • codeine

  • fentanyl

  • heroin

  • hydrocodone

  • hydromorphone

  • methadone

  • morphine

  • oxycodone

  • oxymorphone

  • paregoric

  • sufentanil

  • tramadol

What should I do if I think I’m addicted?

The first step in breaking addiction is realizing that you control your own behavior. The following steps will help you fight your addiction:

  1. Commit to quitting.Take control of your behavior and commit to fighting your addictions.

  2. Get help from your doctor. He or she can be your biggest ally, even if you’re trying to quit a drug he or she prescribed. Your doctor may be able to prescribe medicine that will help ease your cravings for the addictive drug. Talking with your doctor or a counselor about your problems and your drug use can be helpful, too.

  3. Get support. Certain organizations are dedicated to helping people who have addictions. They want you to succeed and will give you the tools and support you need to quit and move on with your life. Ask your family and friends for support, too.

Citations

  • Managing Opioid Addiction With Buprenorphine by Donaher PA, Welsh C(American Family Physician 05/01/06, http://www.aafp.org/afp/20060501/1573.html)

  • National Institute on Drug Abuse. Research Reports: Prescription Drugs: Abuse and Addiction: Opioids. Accessed 08/15/12

  • National Institute on Drug Abuse. Topics in Brief: Medication-Assisted Treatment for Opioid Addiction. Accessed 08/15/12