Opioid Addiction – Abuse, Dependence, And Treatment

Medically Reviewed by Johnelle Smith, M.D on May 7, 2020

The opioid epidemic has affected every city and town throughout the United States. There are many treatment options for individuals struggling with an addiction to heroin or prescription opioids. Choosing the right program is key to long-term recovery.

Medically Reviewed by
Johnelle Smith, M.D on May 7, 2020
Opioid Addiction, Abuse, Epidemic, And Treatment Options

The Opioid Epidemic

Opioid abuse and addiction have become widespread in the United States—enough so to be declared a national health epidemic. In fact, an estimated 115 people die every day from opioid overdose.

Opioids are highly addictive drugs, so people can develop an addiction to them after only a short time of use. Since many opioids are prescription drugs, misuse of opioids can also happen quickly and easily.

Before long, a prescription may run out, and once a person progresses from addiction to physical dependence, they’ll be seeking the mind-altering effects of opioids through other means, such as by seeking the illicit opioid, heroin. Research shows that four out of five people newly abusing heroin began with prescription opioid abuse.

Though the opioid epidemic continues to grow, much has been done in an effort to fight this dark trend, including tightening restrictions on writing opioid prescriptions and a wider availability of opioid addiction treatment programs.

What Are Opioids?

Opioids, also called narcotics or painkillers, are central nervous system depressants, which means they produce feelings of calm, relaxation, and euphoria. Used to alleviate moderate to severe or chronic pain, opioids can be part of an effective treatment plan.

However, the effects produced by the drugs are so powerful and effective at altering a person’s perception of pain that opioids quickly become addicting. For this reason, prescription opioids are rarely prescribed for more than a few days of use.

Previously, heroin abuse was one of the biggest areas of concern for drug misuse in the United States, but in recent years prescription opioid abuse has come to match or surpass rates of heroin abuse, making opioid abuse and addiction one of the biggest health concerns facing Americans today.

Prescription Opioids

Prescription opioids are where abuse begins for many people. Because a person needs a written prescription from a doctor to obtain opioids, they may not understand the risks of abuse and addiction associated with the drugs. Opioids are taken to treat pain, which means that a person may increase their dosage or frequency in an attempt to alleviate pain.

Unfortunately, people can very quickly develop tolerance to opioids, which means they no longer feel the effects to the same degree they once did. When a person develops tolerance, they may begin increasing dosage more and more to try to get the same effects, building an excess of opioids in the body and increasing the risk of overdose.

When a prescription runs out, if a person has become addicted to or dependent on opioids, they will likely begin “doctor shopping,” calling multiple providers trying to get an opioid prescription. If that doesn’t work, they may turn to other means, such as seeking heroin. Heroin is another opioid which produces similar effects and is easy to obtain and often less expensive.

Illicit (Illegal) Opioids

Abuse of illicit, or illegal, opioids such as heroin exposes a person to even further risks beyond addiction and dependence. Heroin can be cut with other substances, such as the potent prescription fentanyl or toxic substances. A person buying heroin can never guarantee its purity and is at risk every time he or she abuses it.

The way a person abuses heroin may also put them at increased risk for adverse effects. Injecting heroin can leave sores at the injection site, exposing a person to infectious disease, skin lesions, and other skin-related infections. Snorting can lead to damage of sinuses, nasal passages and tissue, and even lung damage. Smoking heroin can lead to a number of consequences, including increased risk of addiction and dependence since smoking introduces a drug into the bloodstream faster than other methods of administration.

No matter the method of abuse, taking heroin or other illicit opioids puts a person at increased risk of adverse effects, including developing addiction or dependence and overdose.

List Of Commonly Abused Opioids

Opioid drugs are identified by potency, with levels ranging from low potency to high potency, and can be natural (such as heroin in its pure form), synthetic (such as manmade prescriptions), or semisynthetic (such as fentanyl-laced heroin).

With opioid abuse rates soaring in every state in the nation, it’s important to know which are the most commonly abused opioids to know when to seek help for people at risk of abusing these drugs.

Commonly abused opioids include:

  • codeine
  • fentanyl
  • heroin
  • hydrocodone (Norco, Vicodin)
  • hydromorphone (Exalgo ER)
  • meperidine (Demerol)
  • methadone
  • morphine (Duramorph)
  • oxycodone (OxyContin, Percocet)
  • oxymorphone (Opana)
  • U-47700 (synthetic, combination opioid)

Defining Opioid Abuse

Opioid abuse is a broad definition for misuse of any opioids. This includes any use of illicit opioids, such as heroin or gray death, and misuse of prescription opioids. Because people take prescriptions for legitimate medical purposes, they may not perceive misuse of opioids as abuse.

Prescription opioid abuse includes: changing the dosage (increasing it to increase effects), increasing the frequency of dosage to overcome a tolerance, or changing the method of administration (such as crushing and snorting the pills or tablets, mixing the powder into a solution to inject, or consuming the drug any way other than intended).

Opioid Addiction And Dependence

For some, it may be difficult to tell when opioid abuse progresses into addiction or dependence. An addiction is a mental reliance on a substance, which means the person will begin experiencing strong cravings for the drug and will become preoccupied with seeking it, regardless of consequences.

People who have developed an opioid addiction may seek the drug through illegal means, as there is a large black market for illegal sales of opioid prescriptions.

Addiction may also prompt vast changes to a person’s appearance, hygiene, health, relationships, and occupational functioning. Once a person becomes addicted, how to seek and use opioids will affect every decision. With time, this can cause effects to finances, performance at work or school, rifts in relationships, lack of attention to health, and more.

This is especially true once a person develops a physical dependence to opioids, which means their body has come to rely on opioids to function. Withdrawal symptoms caused by dependence will keep a person caught in the cycle of addiction, especially if no treatment is sought.

Short-Term Effects Of Opioid Abuse

Opioids work by attaching to opioid receptors in the brain and other parts of the body, activating the receptors and producing feelings of altered perceptions of pain, euphoria, calm and relaxation. Short-term side effects result from the way opioids work in the body. Abuse of opioids often increases the intensity of these effects.

Short-term effects of opioid abuse may include:

  • constipation
  • dizziness
  • drowsiness
  • mental confusion
  • nausea
  • respiratory depression (slowed breathing)
  • vomiting

Long-Term Effects Of Opioid Addiction

Chronic or prolonged abuse of opioids can lead to long-term, adverse side effects. Having an opioid addiction or dependence increases the risk for experiencing long-term side effects.

Effects of opioid abuse can manifest in behavioral, physical, or psychological ways. A person’s behavior often changes to reflect their preoccupation with seeking and using opioids: they may stop taking interest in activities that used to interest them, stop participating in school or work, or become secretive and constantly try to hide drug use.

As opioid addiction progresses, a person may stop taking care of their health, neglect to eat, sleep, or drink enough to stay healthy, especially since constant drug use may suppress or otherwise alter a person’s perception of their vital needs.

Finally, opioid addiction and dependence can lead to an altered mental state by causing the development of or worsened mental conditions, such as depression and anxiety.

Opioid Withdrawal

If a person stops use of opioids once they’ve become dependent, they will experience uncomfortable and painful withdrawal symptoms. Opioid withdrawal is rarely life-threatening, but can be uncomfortable enough and so daunting to face alone that a person continues to abuse opioids to avoid these symptoms.

Withdrawal may occur as soon as a few hours after the last dose for those who are severely dependent on opioids. Duration of withdrawal can last a few days up to a few weeks or even longer. Severity and duration of withdrawal tend to depend on a few factors, including duration and severity of opioid abuse and drug of abuse.

Opioid withdrawal symptoms can include:

  • anxiety
  • body/muscle aches
  • constipation
  • diarrhea
  • goosebumps
  • increased blood pressure or heart rates
  • pupil dilation
  • respiratory depression
  • stomach cramps
  • sweating
  • tearing
  • uncontrolled yawning

Because withdrawal from opioids is so extreme, people are often powerless to successfully detox from opioids, or rid opioids from their body, without help. There are a number of detox programs which can help people successfully overcome their physical dependence on opioids and move on to treating their opioid addiction.

Medically-Supervised Detox Programs For Opioid Dependence

Experiencing opioid withdrawal can seem unbearable, so receiving medical monitoring and support can help a person stay strong during the detoxification process. Within medically supervised detox programs, patients can receive monitoring of vital functions, medication when necessary, and nutritional support.

There are a number of medications currently approved for treating opioid dependence, including methadone and buprenorphine (Suboxone, Subutex).

Both medications work similar to opioids of abuse, but methadone also comes with its own risk of abuse and addiction. Buprenorphine does not produce euphoria and comes with far less risk of abuse.

Detox is often necessary for those with an opioid addiction or dependence, but treatment does not stop with a detox program. For the best chance at a long-lasting recovery, patients should complete a medically supervised detox program and move on to formal treatment.

Treatment For Opioid Abuse And Addiction

There are many types of treatment programs for opioid abuse and addiction, but one of the most effective options by far is inpatient addiction treatment.

Inpatient treatment programs provide a place for patients to stay while receiving full-time, daily care, medication, participating in therapy and other treatments, and beginning recovery.

Drug and alcohol rehab centers with the most reputable inpatient programs will provide access to the best evidence-based practices as well as care from supportive, experienced staff. Programs are individualized for patient need, and patients will take part in any number of treatments which can include therapy, counseling, medication-assisted treatment, and more.

Those struggling with opioid abuse and addiction have a much lesser chance of beating these issues without help. Inpatient addiction treatment provides the best opportunity to help people overcome addiction issues, gain the skills necessary to manage addiction long-term, and get the tools they need to live a sober life in recovery.

This page does not provide medical advice. See more

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