Opioid Addiction and Abuse

Last updated on May 14th, 2021

  • What Are Opioids?
  • Are Opioids Addictive?
  • How Do Opioids Work?
  • Opioid Addiction Treatment
  • Find Out If Your Insurance Plan Covers Opioid Rehab

Opioids are a class of drugs sometimes also referred to as narcotics or opiates.1 As medications, opioids have been widely used for their painkilling properties, though at certain doses, their use may also elicit a rewarding, euphoric high.2 While opioids can be addictive, recovery is possible with the right treatment and support. This page will provide insight into different aspects of opioids and their use and answer questions you may have, including:

  • What are opioids?
  • What are the various types of opioids?
  • What is opioid addiction?
  • What are the current opioid addiction statistics?
  • What are some important opioid addiction facts?
  • What makes opioids addictive?
  • How do opioids work?
  • What types of opioid addiction rehab are available?
  • How is opioid addiction medication used in treatment?

What Are Opioids?

Opioids have historically been prescribed to treat medical conditions such as pain, cough, or diarrhea; in addition to these prescription opioids, there are several opioid drugs on the illegal market, including heroin and illicitly manufactured fentanyl.1,3,4 Prescription opioids are available in several forms, including tablets, capsules, skin patches, oral liquids, injectable suspensions, and suppositories. Illicit opioids such as heroin are commonly encountered in powdered form or chunks that can range in color from white to brown or black.1

Depending on the specific type of opioid, dose, and method of use, effects may include:1,5

  • Pain relief.
  • Euphoria.
  • Relaxation.
  • Drowsiness.
  • Confusion.
  • Nausea and vomiting.
  • Constipation.
  • Slowed breathing.
  • Skin itching.
  • Constricted pupils.

Are opioids addictive? Yes, opioids—both illicit and prescription—have reinforcing properties and pronounced abuse potential. Problematic opioid use, whether it involves illegal drugs like heroin or nonmedical misuse of prescription medications like oxycodone, can increase the risk of developing a substance use disorder (SUD), or addiction.

What Is a Substance Use Disorder?

Addiction is a chronic brain disease characterized by overwhelming drug cravings, compulsive drug seeking, and an inability to stop using despite the adverse consequences of such continued substance use.6-10 Treatment professionals may diagnose various types of drug addiction as substance use disorders (SUDs).

An addiction to opioids is diagnosed as an opioid use disorder (OUD).11 Physicians and other treatment professionals make such a diagnosis based on several diagnostic criteria that outline various signs, symptoms, and behavioral changes commonly seen in cases of opioid addiction. Examples of these criteria include:12

  • Using more opioids or using them for a longer period than intended.
  • Being unable to cut back on opioid use despite a persistent desire to do so.
  • Experiencing intense cravings to use opioids.
  • Continuing to use opioids despite the considerable social or interpersonal problems related to their use.
  • Giving up important social, recreational, or work-related activities because of opioid use.
  • Experiencing significant physical or mental health issues related to ongoing opioid use.

People who meet at least 2 (of 11 total) criteria within a 12-month timeframe may be diagnosed with an OUD.

What Are the Differences Among the Various Opioids?

As a drug class that includes a broad range of substances, there are several differences amongst the various opioids. For instance, some opioids are prescription medications, while others are illicit drugs with no recognized medical purpose.1,3,4

Another distinction involves how certain opioids are derived.1 Some opiate alkaloid substances, such as morphine and codeine, can be sourced directly from poppy plants. Synthetic opioids, on the other hand, are created either through semisynthetic processes that modify the starting block opiate precursors, or fully synthetic manufacturing in a lab.1,5,8,13 Regardless of these differences, all opioid agonist drugs have somewhat similar pharmacological mechanisms of action, as well as a recognized potential for abuse.

Common Opioids

There are several types of opioid drugs, both prescription and illicit. Some of the more common opioids include:1,3-5,13-15

  • Heroin.
  • Fentanyl (Actiq, Duragesic, Sublimaze).
  • Hydrocodone (Vicodin, Norco).
  • Oxycodone (OxyContin, Percocet).
  • Codeine.
  • Morphine.
  • Hydromorphone (Dilaudid).
  • Methadone.

Fentanyl is a synthetic opioid that is extremely potent.1,4,8,15 While pharmaceutical formulations of fentanyl remain Schedule II prescription medications, it is increasingly being diverted or illicitly manufactured for nonmedical use and has contributed to a number of overdose deaths.1,8 Fentanyl is sometimes added to heroin or other drugs to deliver a more powerful high.8

Heroin is an illicit opioid that has no accepted medical use in the United States.8 It is derived from morphine and has a similar chemical structure and mechanism of action as other prescription opioids. Some people who abuse prescription opioids may switch to heroin if it costs less and is easier to access.8,15,16 Heroin is highly addictive and can lead to opioid addiction and dependence.8,15


Are Opioids Addictive?

Opioids are highly addictive drugs.3,5,16 While specific causes of opioid addiction aren’t clearly understood, there are some risk factors that can make you more likely to develop an issue with opioid addiction or abuse. These risk factors include:3,5-9

  • Exposure to abuse or trauma.
  • Genetic predisposition to SUDs.
  • High levels of stressors.
  • The presence of co-occurring mental health issues such as anxiety or depression.
  • Use of substances that started at an early age.
  • Use of opioids for extended periods of time, even if prescribed by a doctor.
  • Use of very strong opioids, which are more likely to cause euphoria or a “high.”

Statistics from a 2019 survey of Americans age 12 and over showed that in the last year:14

  • 6 million people had an OUD.
  • 4 million people had an addiction to prescription pain medication.
  • 438,000 people had an addiction to heroin (more than double the number in 2002).

In the US, there were 70,630 deaths due to drug overdoses in 2019.17 Opioids were involved in 49,860 (70.6%) of these deaths.17 Nearly 73% of these deaths involved some type of synthetic opioid, such as fentanyl.17

Why Are Opioids So Addictive?

Opioids are very addictive for a few reasons. When opioids are used, they relieve pain and can provide feelings of euphoria and relaxation, making it more likely that you’ll want to continue taking them.8,9,13,16 Long-term effects of opioid addiction include changes in the brain that may affect judgment, behavior, and ability to make decisions and cope with stress, which can make it additionally difficult to stop using.9,16

Certain problematic patterns of opioid use may also make the development of an opioid use disorder more likely. Misuse includes any illicit use but may also involve taking prescription opioids in larger doses than prescribed, taking them more often than prescribed, taking them when they haven’t been prescribed to you, or using them differently than how they were prescribed, such as by crushing pills and then snorting or injecting them.1,2

Physical dependence can develop with continued use, no matter how opioids are used. When dependence develops, withdrawal symptoms may arise when use is stopped. These occur as a result of the body and brain becoming used to the presence of opioids in the system and relying on them to function normally.8 Opioid withdrawal can be extremely unpleasant, making it that much more challenging to stop using opioids without help.2,3,12

Physical dependence commonly occurs alongside tolerance.8 Tolerance develops as you become less sensitive to the effects of opioids and need to take larger amounts to achieve pain relief or a high.8,9 Although tolerance may also develop when opioids are taken regularly for long periods of time as prescribed by a doctor, its presence can be another sign of addiction, as the increased opioid use that it prompts can escalate the development of compulsive patterns of use.7

Addiction is a disease that affects your thoughts and behaviors, leading to compulsive opioid use even after it has caused negative consequences in at least 1 area of your life.4,7 Dependence and tolerance are included in the diagnostic criteria for addiction, but they do not alone explain why opioids are so addictive.7,12 For instance, while tolerance and dependence may subside after you stop using opioids, addiction is a larger matter to address. Issues like ongoing cravings as well as unhealthy thoughts and behaviors surrounding opioids and their use may require additional treatment attention to best promote long-term recovery.1



How Do Opioids Work?

There are opioid receptors located throughout the brain and body which opioids bind to and activate.3,13,16 Opioids interfere with the processing of pain signals between the brain and body, leading to pain relief when taken.3,13,16 Opioid use is also accompanied by an increased release of dopamine, stimulating the pleasure centers of the brain, resulting in a rewarding euphoria.8,9,13 This also reinforces the behavior of using the substance, making you want to continue taking opioids to continue feeling the pleasurable effects.8,9,13


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Opioid Addiction Treatment

Many people recover from opioid addiction with the help of professional rehabilitation.10 Treatment options can include:7,10,13,16

  • Inpatient/residential treatment settings provide intensive levels of treatment and around-the-clock support while you live at the facility. Though treatment times vary from person to person, inpatient care often lasts for around a month, while some residential treatment models may last for longer periods of time.
  • Outpatient treatment programs can provide a similar range of therapeutic services to inpatient/residential, though on a relatively less intensive basis. When appropriate to your treatment needs, outpatient programs allow you to live at home and attend scheduled sessions at a clinic. Outpatient programs can themselves vary in intensity, with partial hospitalization and intensive outpatient options providing the most intensive levels of outpatient care.
  • Behavioral therapies will likely comprise much of the treatment plans for both inpatient and outpatient treatment programs. A combination of different behavioral approaches can help to increase motivation toward sobriety and staying in treatment, improving relapse prevention skills, developing positive coping skills, building healthier relationships, practicing healthy hobbies, and making better decisions. Therapy can be provided in both group and individual sessions, with group sessions allowing for feedback and peer support, and individual sessions offering greater privacy to discuss more private issues.
  • Co-occurring disorder treatment, where mental illness and OUD are treated simultaneously using therapy and medication as needed for best results.

To provide individualized treatment to meet your unique needs, there are a wide variety of opioid treatment programs throughout the country.7 These include private rehab programs as well as state and local treatment programs, all designed to offer care and services to help you recover from an OUD.

What Is Medication-Assisted Treatment (MAT)?

MAT involves the use of a medication along with counseling and social support as part of a comprehensive opioid treatment strategy.4,11,18,19 Opioid agonist medications, such as buprenorphine and methadone, can be used to help manage withdrawal symptoms and cravings during detox.4,7,10,11 Once you are finished with detox, you may continue to take maintenance medications to manage cravings and help reduce the risk of relapse.7,18 Some combination of methadone, buprenorphine, and/or naltrexone can be used in the longer-term to reduce cravings and block the effects of any additional opioids that are ingested, which decreases relapse risks and promotes recovery.7,10,11,16


Find Out If Your Insurance Plan Covers Opioid Rehab

American Addiction Centers provides comprehensive rehabilitation services for those seeking recovery from addiction and substance abuse, including opioid addiction and abuse. To find out if your insurance covers treatment at an American Addiction Centers facility, click here or fill out the form below. Your information is kept 100% confidential.


Sources

  1. Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide.
  2. National Institute on Drug Abuse. (2020). Misuse of prescription drugs research report.
  3. National Institute on Drug Abuse. Opioids.
  4. U.S. National Library of Medicine. (2021). Opioid misuse and addiction.
  5. National Institute on Drug Abuse. (2020). Commonly used drugs charts.
  6. U.S. National Library of Medicine. (2021). Substance use disorder.
  7. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).
  8. National Institute on Drug Abuse. (2018). Media guide.
  9. National Institute on Drug Abuse. (2018). DrugFacts: Understanding drug use and addiction.
  10. National Institute on Drug Abuse. (2019). DrugFacts: Treatment approaches for drug addiction.
  11. Substance Abuse and Mental Health Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.
  12. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (fifth ed.). Arlington, VA: American Psychiatric Publishing.
  13. National Institute on Drug Abuse. (2020). DrugFacts: Prescription opioids.
  14. Substance Abuse and Mental Health Services Administration. (2020). Key substance abuse and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  15. U.S. Department of Health and Human Services. (2020). What are opioids?
  16. National Institute on Drug Abuse. (2019). DrugFacts: Heroin.
  17. Centers for Disease Control and Prevention. (2021). Opioid overdose.
  18. Substance Abuse and Mental Health Services Administration. (2021). Medication-assisted treatment (MAT).
  19. U.S. Department of Health and Human Services. (2020). How do medications treat opioid addiction?

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