Opioid Addiction

Learn the difference between opioid addiction, dependence and tolerance. Knowing how opioids affect people can deter their misuse in people considering abusing them.

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

Physical signs of opioid use and opioid addiction include:

• Sedation/sleepiness
• Confusion
• Pinpoint pupils
• Slower-than-normal breathing
• Constipation
• Slow reaction time

Behavioral Signs

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.

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
• Headache
• Chills
• Nausea
• Vomiting
• Diarrhea
• Sweating
• Anxiety
• Fatigue

Opioid Abuse Statistics

Opioid abuse rates vary depending on demographics:

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

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.

Intervention

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