Opioids are usually prescribed to relieve pain. However, if they are used for long periods, especially in high doses, opioid use disorder (also called opioid addiction or opioid abuse) can develop. Common opioids include prescription pain medications like oxycodone, hydrocodone, morphine and fentanyl, as well as illegal drugs like heroin.
Opioid overdose is the leading cause of overdose deaths in the United States, with 47,600 deaths being attributed to prescription and illicit opioids in 2017. Opioid use disorder can be treated with various types of rehabilitation programs.
To fully understand opioid addiction, it’s important to understand how these drugs are so addictive, as well as what their intended medical purposes are.
Opioids are quite addictive, making opioid use disorder possible for anyone who uses these drugs. When a person takes an opioid, the drug enters the brain through the bloodstream, creating a rush of endorphins and dopamine, which are neurotransmitters in the brain that lead to feelings of euphoria, pleasure and satisfaction. This opioid high is not like a naturally-occurring rush of dopamine or endorphins. The only way a person can experience it again is by using an opioid again.
How Are Opioids Abused?
Opioid use is considered abuse when opioid medications are taken in ways other than prescribed by a medical provider. Examples of opioid abuse include:
- Taking an illicit opioid drug that has no legal medical use (such as heroin)
- Taking someone else’s prescription opioid
- Taking a larger dose than what is prescribed
- Taking the opioid in a different way than prescribed (for example, crushing tablets and snorting them or mixing with liquid and injecting into a vein)
- Taking the opioid not to relieve pain, but to achieve a high
Opioid Dependence vs. Tolerance vs. Addiction
Dependence, tolerance, and addiction are related terms, but they all have their own particular meanings:
- Opioid dependence is present when a person’s body is so accustomed to the opioid being present that when opioid use stops, withdrawal symptoms occur. This occurrence is because the body is used to the opioid being there, and it cannot function normally if it is suddenly removed from the system.
- Opioid tolerance occurs when a person requires more and more of the opioid to achieve the same response as earlier doses. Tolerance occurs because the body grows used to the drug, and more and more receptors need to be activated for the person to obtain the high they seek.
- Addiction is the scenario in which a person cannot stop using the opioid, even if there are negative consequences associated with its use. Addiction is a disease, and though addiction is usually accompanied by tolerance and dependence, it does not occur in everyone who experiences opioid tolerance or dependence.
Opioid Addiction Signs
There are many signs and symptoms of opioid addiction. Many times, changes in several aspects of someone’s life may be seen. Financial, professional, legal, social and interpersonal problems may all occur when someone is dealing with opioid use disorder. Some signs of opioid addiction are physical, while others are behavioral.
Physical signs of opioid use and opioid addiction include:
- Pinpoint pupils
- Slower-than-normal breathing
- Slow reaction time
Behavioral signs of opioid addiction include:
- Withdrawal from normal activities
- Loss of interest in usual interests
- Socializing with other drug users
- Evolving different routines or habits
- Anxiety or nervousness
- Secrecy or dishonesty about drug use
- Having a primary focus on obtaining more opioids rather than other important parts of life
Side Effects of Opioid Abuse
Opioid use and abuse are associated with many side effects, some of them similar to the physical signs of opioid addiction. Certain side effects occur more with short-term opioid use, while others occur after long-term use.
- Drowsiness or sleepiness
- Small pupils
- Decreased breathing
- Higher chance for withdrawal symptoms to occur when stopping the opioid
- Long-term constipation, which can lead to more serious intestinal problems
- Low respiratory rates, which can be fatal
- Opioid dependence and addiction
- Overdose, which can be fatal
Opioids are sometimes used with other substances, including alcohol or other drugs. If opioids are used with other drugs that depress the nervous system, the combination can be deadly. Alcohol and benzodiazepines, along with several psychiatric drugs, can cause nervous system depression. Side effects of opioid use combined with these kinds of drugs can cause breathing difficulty, overdose, coma and even death. It is important to avoid the use of opioids with other substances that depress the nervous system.
Causes of Opioid Addiction
Addiction is a complicated disease, and the reasons for which it occurs are not yet well understood. There are possibly genetic components that predispose some people to substance addiction, as addiction disorders sometimes run in families. Also, because opioids can produce desirable, euphoric feelings and are often very easy to obtain, it is not difficult for people to become addicted to them.
People with negativity in their lives may be prone to addiction since they are not happy with how their lives are going and opioids make them feel better. People who use opioids for longer periods, even if using for legitimate medical purposes, such as after major surgery, are also prone to develop an addiction.
Opioid Withdrawal Symptoms
When someone’s body is dependent on opioids to function normally, withdrawal symptoms can occur if opioid use is stopped abruptly. Withdrawal can be very uncomfortable. Although opioid withdrawal is usually not life-threatening, a person may feel so awful that they go to extreme lengths to obtain more of the opioid, to stop the withdrawal symptoms. Symptoms of opioid withdrawal include:
- Flu-like symptoms
Opioid Abuse Statistics
Opioid abuse rates vary depending on demographics:
- Prevalence in Men
Based on data from 2014, about 5 million men reported abuse or misuse of prescription pain medications within the previous year.
- Prevalence in Women
Based on the same data from 2014, about 4 million women said they misused prescription pain medications in the previous year.
- Teen Abuse
Opioid Abuse and Treatment Trends in South Florida
According to data from 2016 to 2017, over 4% of people in Florida over the age of 12 reported misusing a prescription pain reliever over the previous year. For the 18 to 25 age group, the rate was over 6.5%. Pain reliever use disorder occurred in about 0.63% of people over the age of 12 in Florida over that same time, which was similar to the overall national average.
Opioid overdose is a severe condition that is frequently fatal. An opioid overdose can occur in anyone who takes a larger dose of an opioid than the body can handle. For some people who are tolerant to opioids, they may not know how large of a dose can cause an overdose. They may try to take too much because they are seeking the euphoric feeling. Opioid overdose results in slowed breathing to the point that coma and death can occur because the body and brain don’t get enough oxygen. Opioid overdose can be reversed in some cases with Narcan, a brand-name opioid reversal agent. If an overdose is not recognized quickly, reversal attempts may not work, and death can occur.
How to Help Someone With an Opioid Addiction
If you know someone struggling with an opioid use disorder, you can help them by asking them how they are doing and whether they are open to receiving help. Sometimes people may respond negatively to these questions, but it is beneficial for anyone struggling with addiction to know that there are people in their lives who care about them. If they are open to receiving help, they can be informed about rehab facilities, which offer extensive treatment options and can determine individualized treatment for opioid use disorders. The best thing to do to help someone struggling with addiction is to be there for them and help them find resources for professional treatment.
Sometimes an intervention with family and friends can help a person who is struggling with opioid use disorder. People with addiction problems may not be aware that their condition is affecting other people in their lives, so an intervention might help them see that addiction is causing larger problems than they may have realized. Interventions should be done from a caring perspective, so as not to make the person too defensive. It should focus on helping the person rather than berating them for their behavior. Remember, addiction is a disease, and a person with addiction may be very overwhelmed by how the addiction is controlling their life. People may not always be open to realizing that they have a problem, so it’s important to make sure they know they have help when they are ready to receive it.
Opioid Addiction Treatment Options
There are many options for treating opioid addiction, and not every person with addiction will find every option suitable. Treatment modalities have different pros and cons, and can best be sorted out by talking to a certified addiction counselor who works with a facility that can provide the proper type of treatment for each individual. Some types of opioid addiction treatment are:
Opioid Addiction Treatment Options
Medical detoxification is the process of eliminating drugs from the body, while treating withdrawal symptoms to keep the person as comfortable as possible. Detox is often the first step in the recovery process.
Residential or inpatient treatment is when a person receives addiction treatment and therapy while living in a facility. The types of treatment available while in a residential program vary from person to person, but this environment can provide a safe and comfortable space to aid in recovery.
Outpatient treatment may be an option for people who have completed inpatient therapy, or people who haven’t been dealing with addiction for long. They can still receive similar care to that offered in an inpatient program, but they do not live in the facility.
- Dual Diagnosis
People who have coexisting substance use disorders and mental health disorders are considered to have a dual diagnosis. Treating clients with dual diagnosis is more complex than treating those with single substance abuse problems, and an accredited facility with experience in dual diagnosis treatment can help a person overcome several problems at once instead of treating them one at a time. This method increases the chances of success in addiction recovery and can provide a path to increased quality of life more quickly.
Key Points: Understanding Opioid Abuse
Keep the following key points in mind when considering opioid abuse:
- Opioid addiction is a common problem in the United States
- Opioids are abused by not using them as directed by a medical provider
- Opioid dependence, tolerance and addiction are related processes, but not everyone with tolerance or dependence necessarily becomes addicted
- Opioid addiction is a disease and success in addiction treatment is best achieved with an individualized treatment program
- Opioid addiction can cause financial, legal, social and interpersonal problems
- Side effects of opioid abuse range from minor physical signs like pinpoint pupils to slowed breathing rates, coma and death
- Opioid addiction can be treated in a number of ways, including detoxification, inpatient rehab and outpatient rehab
If you or a loved one is struggling with opioid addiction, The Recovery Village Palm Beach at Baptist Health can assist with recovery. Contact The Recovery Village Palm Beach at Baptist Health now to learn more about how individualized treatment programs can assist in a safe, successful recovery.
The National Institute on Drug Abuse. “Overdose Death Rates.” January 2019. Accessed July 28, 2019.
MedLinePlus. “Prescription Drug Abuse.” December 28, 2016. Accessed July 28, 2019.
National Institute on Drug Abuse for Teens. “Tolerance, Dependence, Addiction: What’s the Difference?” January 12, 2017. Accessed July 28, 2019.
Substance Abuse and Mental Health Services Administration. “2016-2017 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia).” 2017. Accessed July 28, 2019.
National Institute on Drug Abuse. “Substance Use in Women and Men.” January 2016. Accessed July 28, 2019.
U.S. Department of Health and Human Services. “Opioids and Adolescents.” May 13, 2019. Accessed July 28, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.