Every day, thousands of people worldwide take prescription pain medications and become accidentally addicted to opioids.
While opioid addiction is widespread, it’s easy to prevent or treat if you have the correct information.
This article will cover everything you need to know about opioid use disorder, including causes, symptoms, treatment, prevention, and more!
What Are Opioids?
Opioids, often called narcotics, are a powerful class of pain-killing medications usually prescribed for acute or chronic pain. They target the central nervous system and reduce your brain’s ability to perceive pain. Hence, the pain-killing effect.
Opioids can also be prescribed for cough, diarrhea, and medical issues. However, opioid addiction has become alarmingly common, so opioids are only prescribed if the benefits outweigh the risks, such as:
- Trauma such as an accident or injury
- Chronic joint pain
- Severe pain from medical conditions such as cancer
How Do Opioids Work?
Opioids work by binding with your body’s opioid receptors located in different tissues such as the brain, spinal cord, and gastrointestinal tract.
The mu receptor is the most important receptor for pain relief, and it is responsible for the analgesic effects of opioids. Opioids can also produce other effects, such as constipation, euphoria, nausea, respiratory depression (slowed breathing), and vomiting.
Except for euphoria, these side effects are usually undesired. If you take opioids correctly for a short period, you’ll likely experience a mild version of these side effects.
However, with opioid abuse or an opioid overdose, respiratory depression can cause your lungs to stop breathing altogether, leading to death.
Types of Opioids
Opioids are generally classified into three categories based on their origin: natural, semi-synthetic, and synthetic.
Natural Opioids (Opiates)
These opioids are directly extracted from the opium poppy plant and are also called opiates. The most popular opiates include morphine, codeine, and thebaine.
Semi-synthetic opioids are created by chemically modifying natural opioids. Heroin, hydrocodone, and oxycodone are common examples.
Synthetic opioids are entirely artificial and don’t originate from natural sources. Fentanyl, methadone, and buprenorphine are common examples of synthetic opioids.
What is Opioid Use Disorder (OUD)?
Opioid use disorder, or opioid addiction, is a chronic condition characterized by opioid drug abuse. It’s when you continue to misuse opioid drugs despite knowing the negative mental, physical, and socioeconomic impacts they have on you.
Opioid use disorder can have serious consequences on your daily life, affecting your ability to function at school, work, and at home.
Most patients who suffer from this substance use disorder start with prescription opioids. However, once they start taking the prescribed opioids in large doses or for long periods, their mind quickly becomes addicted to the euphoric effect.
This euphoria is what causes opioid dependence and cravings. Your body becomes accustomed to the presence of opioids, and if you try to cut back or stop taking them, you experience unpleasant withdrawal symptoms.
These symptoms are the main reason patients relapse shortly after quitting opioids. The greater and more frequent the symptoms, the more likely you are to start using opioids again unless you get medical help.
The severity of opioid use disorder is determined by the number of symptoms a patient experiences as follows:
- Mild: 2-3 Symptoms
- Moderate: 4-5 Symptoms
- Severe: 6+ Symptoms
How Common Is Opioid Use Disorder?
Opioid use disorder is a common condition that affects millions of people worldwide. According to WHO (World Health Organization) studies, about 39.5 million people used opioids and lived with a drug use disorder in 2021.
Another study showed that approximately 480,000 deaths in 2019 were related to opioid use disorder, and about a quarter were drug overdose deaths.
This has driven many organizations, such as SAMHSA (Substance Abuse and Mental Health Services Administration) and American Addiction Centers, to create specialized programs for treating opioid use disorders.
The DEA (Drug Enforcement Administration) strictly regulates prescription opioid dispensing to try and control the opioid epidemic.
Causes of Opioid Use Disorder
The leading cause of opioid use disorder is opioid misuse, which means taking opioid drugs in a manner your physician didn’t intend.
For example, if you take larger doses than prescribed or continue taking opioids for long periods, you’ll likely develop opioid use disorder.
Studies show that about 75% of patients with opioid use disorder started with a prescription drug. In other words, most cases begin with prescription pain relievers rather than illicit drugs such as heroin.
However, when left untreated, their drug addiction worsens, and many soon turn to heroin, with an extremely high chance of overdose and death.
Who Might Develop Opioid Use Disorder
Anyone taking prescription opioids can develop opioid use disorder, regardless of age, sex, socioeconomic status, or race. However, some people are more likely to develop substance use disorders than others.
Physicians often use a screening tool, such as an opioid risk tool (ORT), to determine how likely a patient is to become addicted before prescribing opioids.
Here are a few factors typically covered in an ORT that make you more likely to become addicted to opioids:
- Personal or family history of illegal drug abuse
- Aged between 16-45 (with the highest risk between 18-29)
- History of mental disorders such as depression, ADD (attention deficit disorder), OCD (obsessive-compulsive disorder), bipolar disorder, or schizophrenia.
- Personal or family history of alcohol or prescription drug abuse
Some studies published by Harvard Medical School also point to a genetic factor. Some genetic traits make you more likely to become addicted to some substances than others.
Another major risk factor for opioid use disorder is your environment. If you live in a high-risk environment full of triggers, stress, or temptations, you’re much more likely to become addicted to opioids.
Symptoms of Opioid Use Disorder
If you or a loved one has been recently prescribed opioid medication, it’s essential to watch for signs and symptoms of opioid addiction. The sooner you identify opioid use disorder, the easier it is to treat it.
The Diagnostic and Statistical Manual of Mental Disorders lists several criteria indicating you might have opioid use disorder. These include:
- Taking opioids in larger quantities or for a longer duration than intended.
- Struggling to reduce or control opioid use despite repeated attempts.
- Spending excessive time obtaining, using, or recovering from the effects of opioids.
- Experiencing intense opioid cravings.
- Opioid use affects your daily activities and interactions at work, school, or home.
- Using opioids in risky situations, such as driving or operating heavy machinery.
- Ignoring the negative impact of opioids on your physical or mental health and continuing to use them anyway.
Opioid Use Disorder Complications
Opioid use disorder can lead to several short-term and long-term complications that affect your physical and mental health, relationships, and overall quality of life.
Some potential complications of OUD include:
- Death: Patients suffering from OUD often experience an opioid overdose which causes their lungs to shut down, resulting in death.
- Lung problems: Prolonged opioid use causes slowed breathing rates and can lead to hypoxia (low blood oxygen), asthma attacks, and lung diseases.
- Infections: Opioid use disorder, especially associated with heroin or injectable opioid use, often leads to blood-borne infections such as hepatitis.
- Poor dental health: Opioid use disorder affects the mouth’s natural bacteria and pH levels, leading to dental problems such as tooth decay, gum disease, mouth infections, and tooth loss.
- Cognitive impairment: Opioid use disorder impairs cognitive function, memory, decision-making abilities, and concentration. This is mainly due to opioids’ suppressive effects on the central nervous system.
- Hormonal imbalances: Prolonged opioid use disrupts hormone levels, leading to changes in menstrual cycles, erectile dysfunction, and infertility.
- Malnutrition: OUD can lead to malnutrition due to a lack of appetite, nausea, vomiting, and altered digestive habits.
- Organ damage: Long-term opioid use can harm organs such as the liver, kidneys, heart, and lungs.
- Pregnancy complications: Pregnant women with OUD are at a higher risk of pregnancy complications, such as miscarriage, premature birth, low birth weight, and neonatal abstinence syndrome (NAS).
- Financial problems: Patients suffering from opioid addiction often have financial issues due to the high cost of illegally acquiring opioids.
Opioid Use Disorder Treatment (Opioid Detox)
The first step in treating OUD is detoxification, which involves managing withdrawal symptoms and cleansing the body of opioids.
Detox is a crucial stage of recovery, as it sets the foundation for further treatment and long-term sobriety. There are several approaches to opioid detox, including behavioral therapy, medication-assisted treatment, and managing withdrawal symptoms.
Opioid Withdrawal Symptoms
When you suffer from opioid use disorder, you’re mentally and physically dependent on opioids. That means your mind craves the euphoric effect of opioids, but your body can’t function correctly without them.
When you try to reduce your opioid intake or cut them out completely, your body’s inability to function manifests as opioid withdrawal syndrome.
Here are the most common opioid withdrawal symptoms you may encounter:
- Anxiety and agitation
- Depression and mood swings
- Extreme tiredness and insomnia
- Muscle aches and pains
- Gastrointestinal problems include nausea, vomiting, diarrhea, abdominal cramping, and stomach upset.
- Sweating, tremors and chills
- Seizures, but only in severe cases of addiction or if you have a seizure disorder
- Severe opioid cravings
These symptoms can vary in intensity and duration, depending on the type of opioid used, the dose, and the length of time you’ve been taking them.
Generally, withdrawal symptoms can start within 12 hours of your last dose and peak within 72 hours.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) is a drug addiction treatment that uses medications to help manage withdrawal symptoms and curb opioid cravings.
It aims to safely and effectively cure your physical dependence while reducing your risk of relapse, which is common with severe withdrawal symptoms.
That’s why most rehab programs try to avoid withdrawal symptoms or help you navigate them with the slightest discomfort, if inevitable.
Opioid treatment programs incorporate different types of addiction medicine for treating various withdrawal symptoms. For example, they might give you another less addictive painkiller to manage pain-related withdrawal symptoms.
MAT is available at most rehab centers and treatment facilities across the country. The SAMHSA Treatment Finder Tool can help you find the closest center to your location.
The American Addiction Centers also have a comprehensive list of detox centers that offer medication-assisted treatment. They have a dedicated 24-hour hotline that answers all your questions about detox, MAT, and more.
Methadone is a synthetic opioid commonly used to treat opioid addiction, especially heroin.
It works similarly to regular opioids, binding to opioid receptors in the brain and causing relaxation and analgesia.
Unlike other opioids, methadone doesn’t give the same high or euphoric feeling, making it less addictive. However, there’s still a slight chance of addiction if misused, which is why methadone dispensing is strictly limited to rehab centers and treatment facilities.
Methadone helps manage chronic or acute pain while reducing cravings and withdrawal symptoms.
Buprenorphine is a partial opioid agonist used to treat opioid addiction. It works by partially binding to opioid receptors in the brain, so it doesn’t cause euphoria.
Unlike methadone, buprenorphine isn’t restricted to rehab centers and treatment facilities because it has little chance of addiction. It can be prescribed and dispensed by physicians at clinics.
Naltrexone is an opioid antagonist that blocks opioid receptors and their euphoric effect.
Healthcare providers usually wait for the opioids to be cleared from your system before giving you naltrexone because it can cause severe withdrawal symptoms when taken with opioids.
Naltrexone can be life-saving in case of an opioid overdose, and it’s recommended to keep an injection of naltrexone handy if you or a loved one is recovering from OUD.
Behavioral therapy is another cornerstone of opioid treatment programs along with MAT.
It involves working with a trained therapist to develop coping mechanisms and strategies for controlling opioid cravings and preventing relapse. While MAT is often limited to a few weeks, behavioral therapy can be extended for months or years to help you remain sober.
Behavioral therapies can be one-on-one, such as individual counseling, or in a group setting.
Opioid Use Disorder Prevention
Despite popular opinion, avoiding opioid prescriptions isn’t the solution to preventing opioid use disorder. Opioid analgesics are indispensable, and in some cases, no other drugs can provide adequate pain relief.
The best way to prevent opioid use disorder is safe opioid prescribing, which means only dispensing a small amount that covers the recommended doses and dosing period.
When coupled with non-pharmacological treatments such as physical therapy and ice packs, you can reach adequate pain relief with minimal opioid use.
Reducing opioid exposure can also help prevent misuse. This means if you or a loved one has a history of drug abuse, it’s better to store prescription opioids safely out of sight to avoid relapse triggers and temptations.
Proper education of loved ones and awareness campaigns also significantly reduce the risk of opioid use disorder.
Whether you’re suffering from opioid use disorder or supporting a loved one, your struggle is temporary.
With guidance and a solid opioid treatment program, you can cut opioids out of your life for good. Book an appointment with our experts today to get started.