Understanding Opioid Addiction
Learn about opioid addiction and abuse
Opioids are a category of substances that includes heroin and prescription medications like Vicodin, OxyContin, morphine, fentanyl, and many others. As nervous system depressants, opioids work to eliminate an individual’s ability to feel pain while also eliciting feelings of relaxation and euphoria. Due to the pleasurable effects that opioids produce, many individuals find themselves stuck in a pattern of problematic abuse of these substances. While prescription opioids can offer immense relief for individuals who possess a legitimate medical need for them, they can also cause tremendous problems if they are consumed in a manner that is contrary to their prescribed guidelines. Furthermore, many individuals use opioids recreationally, simply to achieve a high.
As individuals continue to abuse opioids, it is more likely that they will begin to experience functional problems in many areas of their lives. The longer that the abuse of opioids continues, the more susceptible these individuals become to developing an addiction to these dangerous substances. Once that type of addiction has developed, it can be exceedingly difficult to overcome without professional intervention. Fortunately, opioid addiction can be overcome with proper treatment.
Statistics
Opioid addiction statistics
he American Psychiatric Association (APA) reports that opioid use disorder affects 0.37% of the adult population. The National Institute on Drug Abuse (NIDA) states that between 26 and 36 million people abuse opioids throughout the world. In the United States, more than two million people struggle with the abuse of opioid-related prescription medications.
Causes and Risk Factors
Causes and risk factors for opioid addiction
The causes and risk factors that have been linked to the onset of opioid use disorder are discussed briefly in the following:
Genetic: According to the APA, genetic factors play a highly significant role in increasing the likelihood that someone will begin abusing and subsequently become addicted to opioids. When a family history of substance abuse exists, whether it is a history of opioid abuse or the abuse of another type of substance, individuals are more likely to engage in similar behaviors than are those who do not the same kind of family history.
Risk Factors:
- Family history of substance abuse and addiction
- Personal history of abusing other types of substances
- Having a novelty-seeking personality
- Being in the company of other individuals who abuse opioids or other types of substances
- Possessing an impulsive temperament
Signs and Symptoms
Signs and symptoms of opioid addiction
The signs and symptoms that may indicate that someone is abusing opioids will vary from one person to the next, but can include the following:
Behavioral symptoms:
- No longer adhering to responsibilities in favor of using opioids
- Declined occupational performance
- Engaging in drug-related crimes
- Continuing to abuse opioids despite having the desire to stop
- Using opioids in situations that are physically hazardous, such as while driving
- Slurred speech
- Withdrawing from family and friends
- No longer engaging in activities that were once seen as enjoyable
Physical symptoms:
- Drowsiness
- Psychomotor agitation and retardation
- Insomnia
- Pupillary constriction
Cognitive symptoms:
- Concentration and attention difficulties
- Suicidal ideation
- Cravings
- Memory impairment
- Impaired judgment
Psychosocial symptoms:
- No longer finding interest in things that one once enjoyed
- Euphoria followed by apathy
- Depression
Effects
Effects of opioid addiction
If an individual remains in a pattern of ongoing opioid abuse, he or she is vulnerable to experiencing any number of negative effects. Examples of such effects can include, but are not limited to, the following:
- Legal problems due to engaging in criminal behavior, including incarceration
- Occupational failure
- Financial strife
- Homelessness
- Destroyed friendships
- Loss of child custody
- Demise of marriages or partnerships
- Cognitive impairment
- Disturbances of reproductive functioning in women
- Erectile dysfunction in men
- Seizures
- Stroke
- Heart attack
- Onset of new, or worsening of current, mental illness symptoms
Dual Diagnosis
Opioid addiction and dual diagnosis
It is not uncommon for individuals who are addicted to opioids to also have other mental health conditions. Clinicians refer to this as dual diagnosis. If you’ve developed opioid use disorder, you may be at increased risk for the following:
- Posttraumatic stress disorder (PTSD)
- Persistent depressive disorder
- Major depressive disorder
- Stimulant use disorder
- Alcohol use disorder
- Other substance use disorders
Failing to get effective care for dual diagnosis can undermine your efforts to achieve successful recovery from opioid addiction. Unfortunately, many people who are addicted to opioids don’t realize they’re also dealing with another condition. This is why it’s so important to get help at a center that can identify and address the full scope of your needs. Comprehensive dual diagnosis programming can put you on the path to a drug-free future.
Withdrawal and Overdose
Effects of opioid withdrawal and overdose
Effects of opioid withdrawal: When an individual abruptly ends his or her use of heroin, he or she is susceptible to experiencing a period of withdrawal as his or her body attempts to readjust to its previous way of functioning. This withdrawal process can be extremely uncomfortable and may include the following symptoms:
- Muscle aching
- Yawning
- Pupil dilation
- Insomnia
- Fever
- Nausea
- Vomiting
- Excessive sweating
- Dysphoric mood (feeling in a constant state of unease)
Effects of opioid overdose: When an individual ingests more of an opioid substance than his or her body can metabolize or excrete, he or she is at risk for experiencing an overdose. Overdosing on any substance can be extremely dangerous, and an opioid overdose is no exception. For this reason, it is imperative that emergency medical attention be sought if an individual displays any of the following symptoms:
- Slurred speech
- Cold, clammy skin
- Seizures
- Extreme confusion
- Labored or shallow breathing
- Severe dizziness
Additional Facts
How are opioids made?
Opioids are a class of drugs that are used to treat pain. Some are naturally derived from the opium poppy plant (morphine and codeine) and are specially classified as opiates, but most of the opioids you see today are either synthetic or semi-synthetic.
- Semi-synthetic opioids are made by changing the chemical structure of opiates.
- Synthetic opioids are made from chemicals without using a naturally occurring opioid as starting material.
The most commonly abused opioid painkillers include oxycodone (Oxycontin), oxymorphone (Opana), hydrocodone (Vicodin), hydromorphone (Dilaudid), and meperidine (Demerol).
How do opioids work?
Opioids work by binding to opioid receptors in the central nervous system. Once attached, they produce the “opioid effect”, which blocks pain, slows breathing, and relaxes the body. Opioids also target the brain’s reward system by increasing the release of dopamine, which is responsible for feelings of pleasure and euphoria as well as their addictive nature.
How do people get high on opioids?
Opioids are abused in a variety of ways, depending on the formulation of the specific opioid. Some drugs can be abused simply by taking more than the prescribed amount, but users also crush the tablets or “cook” them through crude processings and then snort or inject the drugs, which brings a faster high.
Time-release preparations of opioids such as Oxycontin require more complicated process to separate the drug form the coating and other “waxy” components, and the recent development of tamper-resistant opioid formulations have made it much harder to abuse, although determined users will find a way to extract the drug in the form they want it.
What should I not mix with opioids?
Opioids should not be taken with any substances that enhance its effects. This includes alcohol, other opioids, other depressant drugs, and stimulants.
Simultaneous consumption of these substances could cause overdose effects (heart failure and dangerously slowed breathing), liver damage from acetaminophen toxicity, or fatal injury due to adverse effects (impaired judgment and coordination).
What are the short term effects of opioids?
Possible short term effects include
- Pain relief
- Euphoria
- Nausea
- Vomiting
- Dizziness
- Confusion
What are the long-term effects of opioids?
Long term effects of opioids include:
- Constipation
- Tolerance
- Addiction
- Brain changes
What are the overdose effects of opioids?
Overdosing can cause
- Respiratory depression
- Sedation
- Coma
- Death
How long do opioids stay in my system?
The length of time opioids stay in your body depends on the drug in question, dosage, your frequency of use, your body’s mass and metabolism, and how the drugs are taken (snorted, injected, swallowed).
Some drug tests also check for the drug in other places besides urine, such as saliva or hair. On average, opioids can be detected in the urine for three to five days, but a higher dose can stay in the system for longer. In a hair test, drugs can be found up to 90 days later.
How long do the effects of opioids last?
The pain-relieving effects of opiates vary depending on the strength of the drug—a higher dosage means more powerful and longer pain-relief. Generally, a single dose can provide pain relief for four to five hours. (Again, this depends on the half-life of the specific drug). The extended release version of drugs (Oxycontin ER or Fentanyl patches) can provide pain relief for up to 12 hours.
As for the euphoric effects, the first time always lasts the longest—possibly four to five hours, depending on the route of administration and drug of use. As tolerance develops, the effects last shorter and shorter, dropping down to less than one hour.
How many opioids can I take before risking overdose?
Overdose can occur when person takes more than the prescribed amount of medication. There is no set amount, because the maximum dose depends on a person’s tolerance, frequency of use, and personal metabolism, not to mention the dosage and strength of the drug in question.
Also, many painkiller drugs contain acetaminophen–more acetaminophen, in fact, than the actual opiate ingredient. Death from a dangerous overdose of acetaminophen is more likely than overdose from the actual opiate. Taking more than 1000 mg of acetaminophen won’t kill you right away, but chronic use will cause liver damage. Continually taking more than 4000 mg of acetaminophen results in irrevesible liver damage.
For example, Percocet is a combination of the narcotic oxycodone and acetaminophen. The strongest Percocet tablet has 10 mg of oxycodone and to 650 mg of acetaminophen. It may take 40 mg of oxycodone to overdose if you haven’t taken the medication before (approximately 4 pills), but by then, you’d be well over the daily limit for acetaminophen poisoning.
How do I know if I’m addicted to opioids?
A common questionnaire to diagnose an addiction is the CAGE test. If you answer “yes” to 2 questions, you could be addicted.
- Needing more of the opioid to achieve the same effect (tolerance)
- Spending more money or resources than you have to obtain opioids
- Continuing to use opioids despite the problems it causes
- Unable to cut down or stop opioid use
- Depending on opioids to relax or enjoy yourself
- Others have expressed concern about your opioid use
- Feelings of guilt when using opioid
Can opioids kill you?
The minimum lethal dose varies with the drug and how much tolerance you’ve developed. However, just because an opioid might not kill you in 10 minutes doesn’t mean it won’t kill you in the future: any overdose of pills can damage your organs, induce dangerous symptoms such as seizures or comas, wear out your body, and increase your chances of premature death.
