Treating Opioid Addiction Introduction

This section is devoted to enhancing understanding of opioid addiction and presenting the latest findings for improved and effective treatment. It covers the many new initiatives under way by government, medical and research communities to help reverse the opioid addiction problem.

Understanding opioid addiction

What are opioids?

Opioids are a class of drugs that include the illegal drug heroin, man-made drugs such as fentanyl, and prescription pain relievers. They work in two ways: 1) by lowering the number of pain signals your body sends to your brain and 2) by changing how your brain responds to pain. They also produce feelings of pleasure and connection, called euphoria or a “high”.

Opioid drugs include: opium, codeine, fentanyl, heroin, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, paregoric, sufentanil, and tramadol.

Prescription opioids work best for short-term pain of three days or less. Doctors most often use them to relieve the immediate pain from surgeries, injuries, and dental procedures. If you are living with chronic long-lasting pain, many other treatments are available including other safer medications and non-drug therapies such as acupuncture, chiropractic, meditation, massage, guided imagery, physical therapy, and gentle exercise such as swimming and tai chi. Even eating a healthy diet and taking certain supplements can improve your brain chemistry and reduce the experience of pain.

Opioid addiction risk factors

Many factors increase the risk of becoming addicted to opioids.

  1. Taking them longer than 3-4 days
  2. Taking opioids in ways that are different from how they were prescribed, such as crushing a pill so that it can be snorted or injected
  3. Taking more than your prescribed dose or taking it more often than prescribed
  4. Having a family history or personal history of substance abuse
  5. Other factors such as unemployment, heavy life stress, depression or anxiety

Why are opioids so addictive?

Endorphins are natural chemicals in the brain that relieve pain and also produce feelings of pleasure, happiness, and connection with others. Opioid drugs change your brain by creating artificial endorphins. These can block pain and also produce a “high” that makes you feel good. Too much opioid use can cause your brain to rely on the artificial endorphins for these good feelings. Once your brain does this, it can even stop producing its own endorphins. The longer you use opioids, the more likely this is to happen.

Symptoms of opioid addiction

Opioids effect how you feel physically and emotionally and what actions you take. Physically you may feel sleepy or have shallow breathing, slurred speech, constipation, or nausea and vomiting. Emotionally you may feel anxious, irritable, or have mood swings from sad to very happy. You may be sleeping more or less than normal or making poor decisions in your life. Overall, you may feel less able to handle your daily life and responsibilities.

Clear signs of addiction are not being able to stop using the substance, decrease the amount taken, or stop yourself from using more than the prescribed amount. Signs also include spending a lot of time getting, using, or recovering from the drug.

Symptoms of opioid overdose

An opioid overdose is a medical emergency and you should immediately call 911.

Symptoms include: passing out, slow irregular breathing or not breathing at all, slow or no pulse, vomiting, and constricted pupils in the eyes.

Long term effects: drug tolerance and drug dependence

Increasing the dosage of opioids over time changes the brain so that it works more or less normally when the drugs are present and abnormally when they are not. Two results of this change are opioid tolerance and opioid dependence.

What is opioid tolerance?

As with any drug, over time your body gets used to its effects and you may need higher doses to get the same effect.

What is opioid dependence?

After taking an opioid for just a month, it changes the way your brain and body work. If you develop tolerance to the drug you need higher and higher doses to reach the same effect. When you try to stop using the drug you experience symptoms of withdrawal from that drug. This can lead to daily drug use to avoid these unpleasant symptoms.

To stop using an opioid and avoid withdrawal symptoms gradually lower the dose you take over time. Your doctor can help you do this in the right way. Your doctor can also prescribe certain medicines to help relieve withdrawal symptoms when you stop using opioids. This will help control your cravings. These medicines include methadone (often used to treat heroin addiction), buprenorphine, naltrexone, and others.

How do I know if I’m addicted?

You may be addicted if you crave the drug, can’t control the urge to take the drug, or if the drug has been prescribed, you continue to use it after your doctor has stopped prescribing it. Another sign may be that the drug is causing problems in your life including relationships with family or friends, poor health, difficulty with school or work, or trouble with the law.

Updated February 20, 2019