Opioids are a class of drugs used to treat pain. They bind to opioid receptors in the brain, spinal cord, and elsewhere, mimicking the effects of the body’s natural pain-relief system. As a result, they’re effective painkillers.
Opioids are highly addictive, regardless of whether prescribed or obtained illegally.
Current estimates suggest that approximately 2.1 million people in the United States have an opioid use disorder.
Read on to find out more.
Opioids are known for their pain-relieving (analgesic) and sleep-inducing (sedative) effects. Other side effects include:
- sense of well-being
- pain relief
- slower rate of breathing
- erectile dysfunction
Dependence and addiction aren’t the same.
Dependence refers to a physical state in which your body is dependent on the drug. With drug dependence, you need more and more of the substance to achieve the same effect (tolerance). You experience mental and physical effects (withdrawal) if you stop taking the drug.
When you have an addiction, you can’t stop using a drug, regardless of any negative consequences. Addiction can occur with or without physical dependence on the drug. However, physical dependence is a common feature of addiction.
What causes addiction?Addiction has many causes. Some are related to your environment and life experiences, such as having friends who use drugs. Others are genetic. When you take a drug, certain genetic factors can increase your risk of developing an addiction.
Regular drug use changes your brain chemistry, affecting how you experience pleasure. This can make it difficult to simply stop using the drug once you’ve started.
The signs of addiction can vary according to the substance being used, but there are general warning signs you may experience. Signs you have an addiction can include the following:
- You want to use the substance on a regular basis.
- There’s an urge to use that’s so intense it’s difficult to concentrate on anything else.
- You take larger quantities of the substance or prolong substance use for longer periods of time than intended.
- As substance use continues, you take larger quantities of the substance to achieve the same effect.
- You always have a supply of the substance.
- Money meant for bills or other necessities is instead spent on the substance.
- Excessive amount of time is spent obtaining the substance, using it, and recovering from its effects.
- You develop risky behaviors to get the substance, such as stealing or violence.
- You engage in risky behaviors while under the influence of the substance, such as driving or having unprotected sex.
- The substance is used in spite of the problems it causes or the risk it poses.
- You try and fail to stop using the substance.
- You experience withdrawal symptoms once you stop using the substance.
Your loved one might try to conceal their addiction from you. You may wonder if it’s drug use or something else, such as the effects of a high-pressure job or stressful time in their life.
The following can be indicators of drug addiction:
- Personality changes. Your loved one may experience anxiety, depression, irritation, or mood swings.
- Behavioral changes. These can include acting secretive, aggressive, or violent.
- Changes in appearance. Your loved one has small “pinpoint” pupils, lost or gained weight, or developed poor hygiene habits.
- Health issues. They may have a lack of energy, fatigue, or chronic illnesses related to drug use.
- Social withdrawal. Your loved one may withdraw from friends or family, develop relationship problems, or make new friendships with people who use drugs.
- Poor performance at work or school. They may be disinterested or absent from work or school on a regular basis. They may have poor performance reviews or report cards, be expelled, or lose a job.
- Money or legal problems. Your loved one may ask for money without a rational explanation or steal money from friends or family. They may get in legal trouble.
The first step is to acknowledge any misconceptions you may have about drug use and addiction. It’s important to remember that drug use can change the structure and chemistry of the brain. This makes it very difficult to simply stop.
Learn more about the side effects and risks of substance use disorders, including the signs of intoxication, addiction, and overdose. Investigate potential treatment options to present to your loved one.
Think carefully about how to approach your loved one. You might be considering staging an intervention with other family members or friends.
An intervention might help encourage your loved one to seek help, but there are no guarantees. Interventions can sometimes have the opposite effect, leading to anger or social withdrawal. Sometimes, a nonconfrontational conversation is a better option.
Make sure you’re prepared for every outcome. Your loved one may deny using drugs or refuse to seek help. If that happens, you may find it helpful to seek out additional resources or find a support group for family or friends of people living with addiction.
Asking for help is an important first step. When you — or your loved one — are ready to get treatment, bringing a supportive friend or family member into the fold can help you begin the road to recovery.
Many people start by making a doctor’s appointment. Your doctor can evaluate your overall health by performing a physical exam. They can also discuss treatment options and refer you to a treatment center and answer any questions you have about what’s to come.
Speak to a health professional for a recommendation. You can also search for an addiction treatment center near you. Try the Behavioral Health Treatment Services Locator. It’s a free online tool provided by the Substance Abuse and Mental Health Services Administration.
Symptoms of opioid withdrawal can appear within hours of the last dose. These symptoms can range from mild to severe.
Withdrawal can cause:
- stomach cramps
- muscle aches
- racing heartbeat
- runny nose
Detoxification (detox) is the process of ending opioid use as quickly and safely as possible. This can include medication to ease withdrawal symptoms.
Detox can take anywhere from several days to several weeks. It depends on how severely the substance has been misused.
Before detox begins, your doctor will complete a comprehensive examination. It often includes blood tests and testing for other medical conditions. This information will help your doctor plan your treatment.
When you’re stable — meaning the drug is completely out of your system — your doctor will help you prepare for treatment.
There are a wide variety of treatment options available. Often, more than one treatment is used. Common opioid addiction treatments are listed below.
A psychiatrist, psychologist, or counselor conducts therapy. You can do it on your own, with your family, or in a group.
There are many different types of therapy. Behavioral therapy can help you identify and change negative attitudes and behaviors, particularly those that lead to drug use. You’ll learn how to deal with cravings, avoid drugs, and prevent relapse.
Other therapies for opioid addiction incorporate incentives. These can include cash prizes or vouchers in exchange for drug-free urine samples. The value of the voucher is generally low at first. It may increase the longer you’re drug-free.
Therapy is often intensive during the first weeks and months of treatment. After, you might transition to seeing your therapist less frequently.
Medication is one of the most effective options available to treat opioid addiction.
Maintenance medications ease symptoms of withdrawal without producing a “high.” These medications also reduce the euphoric effects of other opioids. They include:
Naltrexone is another maintenance medication. It makes it impossible for opioid drugs to activate opioid receptors in the brain. As a result, taking opioids doesn’t produce a high. Naltrexone is available in pills and a long-acting injection. The long-acting injection has been found more effective than oral administration.
Studies have shown that all maintenance drugs reduce opioid use. They also reduce other negative outcomes associated with drug use. Maintenance treatment can last from several weeks to several years. Some people choose to take maintenance medications for life.
Although treatment outcomes are comparable to that of other chronic illnesses, addiction requires long-term management. Finding the most effective treatment may also be a process of trial and error.
Treat yourself, or your loved one, with kindness and patience during this time. Don’t be afraid to reach out for help. Your doctor can also help you find support resources in your area.
In some cases, relapse is part of the recovery process. Preventing and managing relapse are important parts of your long-term recovery plan.
The following can help you reduce your risk of relapse in the long term:
- Avoid triggers that make you want to use drugs, including people, places, and objects.
- Build a support network and seek help when you need it.
- Find meaningful work or activities.
- Adopt healthy habits, such as getting enough sleep and frequent exercise.
- Care for yourself, especially when it comes to your mental health.
- Challenge your thinking.
- Develop a healthy self-image.
- Set goals for the future beyond sobriety.
Depending on your situation, reducing your risk of relapse might also include the following: