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Article Summary

Understanding Opioid Addiction

Opioids are classified as the most lethal and addictive of all intoxicating substances. If you start taking these drugs, there is a high risk that you could soon find yourself struggling with an addiction or an opioid use disorder.

NIDA - the National Institute on Drug Abuse and the CDC - the Centers for Disease Control and Prevention - have both declared that the United States is struggling with an opioid epidemic.

As such, it would be in your best interests to understand how opioids - including heroin, fentanyl, and prescription medications in this class of drugs - work as well as how they cause tolerance, dependence, and addiction to develop. Further, you might want to find out how you can overcome your growing opioid use disorder before it is too late to do anything about it.

What Is An Opioid?

Opioids is an umbrella term that includes all synthetic and natural painkillers that are created from the opium poppy plant, or created from chemicals that resemble the effects of opium.

Opiate, on the other hand, is a related term that refers to the medications that are created from natural opium. For instance, heroin is one such opiate. However, there are other medications that doctors often prescribe for the relief of acute pain.

You might get this prescription if you are suffering pain from dental and medical procedures, toothaches, surgeries, and any other type of injury. The goal of these medications is to relieve any chronic pain that you might be feeling.

However, there are also studies showing that using opioids in the long term - even when they have been legally prescribed - might not be quite as effective as you might assume. Further, this form of medication use might increase your risk of developing tolerance, dependence, and addiction.

Common Opioids

There are some opioids that are better known than others. This is because doctors often prescribe these medications for the treatment of pain. They include but are not limited to:

  • Codeine
  • Fentanyl (Actiq and Sublimaze)
  • Heroin (Diacetylmorphine)
  • Hydrocodone (Lortab and Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Methadone
  • Morphine
  • Opium
  • Oxycodone (Percocet and OxyContin)
  • Oxymorphone
  • Tramadol

Working Mechanism of Opioids

When you take opioids, their molecules will move through your bloodstream and straight to your brain. Once there, they will attach themselves to the opioid receptors found on some brain cells.

As a result, they will trigger a chemical response that is similar to what you would typically experience if you felt intense pleasure due to engaging in some life-reinforcing habits and behaviors. These include drinking fluids, having sex, caring for babies, and eating. This is because these actions are necessary for your survival.

All these survival-based and rewarding activities often cause dopamine to be released in the reward center of your brain. However, opioids are like any other substance of abuse in the sense that they will trigger dopamine release in excess volumes - far and beyond wat you naturally need to stay alive and experience pleasure.

At this point, your brain would have been signaled by the drug and its effects. This means that it will come to relate the use of opioids with these pleasurable effects. As a direct result, you may find yourself taking these drugs in higher doses over the long term just to experience these effects.

Opioid Overdose

However, if you continue using these medications in high doses, you might increase your risk of suffering a drug overdose. When this happens, you may experience the following adverse effects:

  • Blue or purple color to the lips and fingernails
  • Constipation
  • Drowsiness
  • Extremely pale face
  • Gurgling noises
  • Inability to speak
  • Limp body
  • Mental fog
  • Nausea
  • Skin feeling clammy to the touch
  • Slowed breathing
  • Slowed or stopped heartbeat
  • Unconsciousness
  • Vomiting

Opioid Dependence and Addiction

If you continue abusing opioids by taking them for any reason other than your doctor prescribed or using them in ways that are not recommended, you might develop tolerance.

When this happens, you will find yourself needing to take these drugs in higher doses or more regularly than you used to. This is the only way you are going to derive the pleasurable effects that your brain has come to associate with opioids.

Over time, tolerance will be replaced by physical and psychological dependence. This effectively means that your body and brain will no longer be able to function normally unless you use your favorite opioids.

If you suddenly stop taking these substances or significantly reduce the dose that you have become accustomed to, there is a high risk that you could start displaying some negative withdrawal symptoms. When this happens, you could be said to be dependent on opioids.

Addiction, on the other hand, refers to the chronic brain condition that will occur due to ongoing opioid use. Once you develop this condition, you will no longer be able to function normally without the drug. In fact, you may get to a point where you start seeking out opioids almost compulsively and using the substances uncontrollably. This is even though you might already have realized that they have been causing negative outcomes and adverse consequences in your personal and professional life.

The risk of developing tolerance, dependence, and addiction would be increased if you continue abusing these substances or mix them with other intoxicating drugs like alcohol and amphetamines.

But what does drug abuse refer to? Essentially, this will happen when you take opioids in excess, use someone else's batch of medications, or take the drugs in a way that is different than your doctor recommended. Using the medicine for the primary goal of getting intoxicated also amounts to drug abuse.

Signs and Symptoms of Opioid Abuse and Addiction

If you have been exposed to these drugs, you will experience an increase in the release of dopamine in the brain's reward center. However, you might not always be said to be addicted the first time you are exposed to opioids

Even so, your risk of developing tolerance, dependence, and addiction would increase if you have a history of drug abuse and addiction - or someone else in your close family circle has struggled with this condition.

Some of the signs and symptoms that could point out the fact that you have developed an opioid use disorder include but are not limited to:

  • A persistent desire to reduce or control your opioid use but finding that you are consistently unsuccessful in your efforts
  • A strong urge or desire to use these drugs
  • Abdominal cramping
  • Agitation
  • Apathy
  • Bad dreams
  • Coma
  • Constipation
  • Constricted pupils
  • Continued opioid use in spite of the recurrent and persistent personal, social, and professional problems that it causes
  • Continued opioid use in spite of your awareness of the potential and actual problems that it causes
  • Continued use of these drugs in spite of being in situations that might turn out to be dangerous
  • Depressed respiration
  • Depression
  • Drowsiness
  • Dry mouth
  • Failure to continuing fulfilling your obligations and responsibilities at school, work, and home as a result of your ongoing drug abuse
  • Headaches
  • Impaired attention
  • Intense cravings for opioids
  • Loss of libido
  • Menstrual problems
  • Mood swings
  • Nausea
  • Poor judgement
  • Poor memory
  • Problematic mental health
  • Psychological or behavioral changes
  • Sexual dysfunction
  • Skin rashes
  • Slurred speech
  • Spending a great deal of your time, money, energy, and other essential resources looking for, acquiring, and abusing these drugs, as well as trying to recover from their effects
  • Taking opioids in higher doses or for longer than your doctor prescribed or you intended to
  • Weight gain

If you take opioids in high doses, you might suffer severe respiratory depression. This condition could increase your risk of suffering a drug overdose that might also lead to death either through suicide or any other means.

Opioid Withdrawal

If you are already dependent on and addicted to opioids and you suddenly reduce your normal dose or cut the drug out completely, you might suffer some severe withdrawal symptoms. These symptoms might make it difficult for you to stop abusing these drugs. They include but are not limited to:

  • Agitation
  • Anxiety
  • Cold flashes
  • Deep bone pain
  • Diarrhea
  • Fear
  • Fever
  • Flu-like symptoms
  • Goose bumps
  • Insomnia
  • Intense anxiety
  • Involuntary leg movements
  • Irritability
  • Itching
  • Joint pain
  • Mild hypertension
  • Muscle aches
  • Muscle cramps
  • Muscle pain
  • Muscle spasms
  • Panic
  • Paranoia
  • Rapid heart rate
  • Restlessness
  • Runny nose
  • Seizures
  • Shakes
  • Sleep difficulties
  • Stiffness
  • Sweating
  • Tremors
  • Vomiting
  • Yawning

In the long term, opioid withdrawal could give rise to other serious consequences. For instance, your cravings for these drugs, depression, and anxiety might continue for several months - or even years - after you stop taking opioids.

While in recovery from opioid addiction, you might also suffer an increase in your sensitivity to both imagined and real pain. Further, you may find that you are more vulnerable to any painful or stressful event.

Further, you might have a deep desire to get back to normal as well as to escape the dysphoria that arises during your opioid withdrawal. As a result, you might have a high risk of relapse. If you relapse, however, you may suffer a drug overdose that could potentially turn out to be fatal.

Treatment for Opioid Abuse and Addiction

The only way to safely overcome your growing opioid use disorder is by checking into a professional addiction treatment and rehabilitation program. There are many such programs and they offer a wide variety of treatments that might prove useful in helping you achieve a state of full recovery.

For starters, the program will take you through an intense evaluation and assessment. The goal of this process would be to determine the extent, nature, duration, and severity of your opioid use disorder. The evaluation would also try to unearth any other co-occurring medical and mental health disorders that you may also be struggling with.

After the assessment, you will be provided with medically managed detoxification services. These services would be designed to deal with any withdrawal symptoms that you display as your body tries to reduce its dependence to opioids.

Detox is also necessary in ensuring that you stop your physical tolerance and dependence - a condition that would have to be managed before you progress to the next step in your recovery.

Once detox has been deemed successful, the drug rehab program will provide you with a wide variety of evidence based or alternative therapies - or a mix of both. These therapies include individual therapy, group counseling, couples counseling, family therapy, addiction education, aftercare planning, and many more.

Some drug rehabs might also offer dual diagnosis treatment. This would particularly be the case if you have been diagnosed with other conditions like depression, anxiety, sleep disorders, or HIV and hepatitis B and C over and above your opioid use disorder or addiction.

This form of treatment is typically useful in managing both addiction and other co-occurring medical and mental health disorders. This is because you need to manage and deal with all these conditions simultaneously to ensure that they do not lead to a relapse down the road.

The important thing to keep in mind is that it is possible to overcome your opioid use disorder, as well as manage any other co-occurring mental health disorders that you may also be struggling with. You just need to check into a professional drug rehab and treatment program to get started on your recovery journey.

In the long term, achieving a state of sobriety would take some time. For this reason, it is recommended that you make a choice between inpatient and outpatient addiction treatment - or use both of these forms of treatment - and continue following them up with some form of aftercare program. By so doing, you can effectively ensure that you recover from all the conditions that you were struggling with over and above your opioids addiction while reducing your risk of relapse both in the short and in the long term.

CITATIONS

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.947.6292&rep=rep1&type=pdf

https://ghr.nlm.nih.gov/condition/opioid-addiction

https://www.cdc.gov/drugoverdose/epidemic/index.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104618/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385443/

https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf

https://www.webmd.com/mental-health/addiction/painkillers-and-addiction-narcotic-abuse#1

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