Opioid Addiction: What Is It and What to Do About It

Opioid addiction is a substance use disorder that can significantly impact a person's health and have social and economic consequences. A person with opioid use disorder may strongly desire to take opioid drugs even if they are not medically required.

Opioids can take the form of prescription medications used for pain relief but can also be found on the street in forms such as heroin.

Learn more about opioids, why they are prescribed, risk factors for addiction, diagnosis of a substance use disorder, and treatment options.

Commonly Used Opioids

Opioids are often used as painkillers. They work by blocking pain signals between the brain and the body.

Common forms of opioids include:

• Oxycontin (oxycodone)
• Codeine
• Belbuca (buprenorphine)
• Methadose (methadone)
• Ultram (tramadol)
• Heroin
  

Conditions That Merit Opioid Prescriptions

There are several circumstances in which opioids might be prescribed for pain management. These include:

Cancer or Other Chronic Conditions

Opioids may be prescribed to manage moderate to severe pain related to cancer. Prescribed drugs may include fentanyl, codeine, morphine, methadone, or hydromorphone.

Opioids may also be prescribed alongside non-opioid drugs like nonsteroidal anti-inflammatory drugs (NSAIDs). It is rare to become addicted to opioids when taken appropriately to treat cancer pain.

In some cases, opioids may also be prescribed for people with chronic conditions or chronic pain like chronic back pain or chronic headaches.

Surgeries

Opioids are highly effective forms of pain relief. They may be prescribed to treat pain following surgery. Opioids like morphine, fentanyl, and oxycodone may be used for major surgeries like knee replacement.

Serious Injuries

An example of acute pain is a pain that comes on suddenly, like from an injury. Opioids may be used in this instance for a serious injury like a broken bone or a bad burn.

Dental Procedures

Some dental procedures like tooth extraction or dental surgery can cause pain. In this instance, a dentist may prescribe opioids like hydrocodone, codeine, or oxycodone for pain management.

Codeine

Codeine may be used to treat mild to moderate forms of pain. In some cases, it may be used to reduce coughing.

Fentanyl

Fentanyl is typically used in the treatment of breakthrough pain, which is pain that appears suddenly despite consistent treatment with other forms of medication. This may occur in people with cancer.

Hydrocodone and Oxycodone

Hydrocodone and oxycodone are used to treat pain in people who require 24/7 pain management. Oxycodone may be used for moderate to severe pain. Hydrocodone is used to treat severe pain. These drugs are available as extended-release medications that can provide pain management over a long period.

Hydromorphone and Oxymorphone

Hydromorphone and oxymorphone are used to treat severe pain in people who are expected to need pain management for a long period.

Methadone

Methadone is used for long-term treatment of severe pain. It may also be used in those addicted to opiate medications.

Morphine

Morphine is used to treat moderate to severe pain when pain can't be treated using other pain medications.

Tramadol

Tramadol is an opioid used for the treatment of ongoing, 24/7 pain. It is used for moderate to severe forms of pain.

Consequences of Opioid Addiction

Opioid use disorder can have short and long-term consequences, affecting the individual and their family.

Short and Long-Term Consequences of Opioid Addiction

Consequences of opioid use disorder may include:

• Behavioral changes
• Isolation from family and friends
• Changing friends or mixing with new groups
• Neglecting personal hygiene
• Loss of interest in activities
• Breaking the law
• Mood swings
• Financial difficulties
  

Signs of Opioid Addiction

Signs opioid use disorder of this may include:

• Taking more than the required amount of opioids
• Taking opioids for longer than was intended
• Trouble cutting down on or controlling the use of opioids
• Having a strong desire to continue using opioids
• Spending a significant amount of time accessing opioids
• Stopping or reducing other activities due to opioids
• Difficulties with work, school, or home-related obligations
• Continued use of opioids despite problems with relationships or social interactions
• Using opioids in dangerous contexts
• Continued use opioids despite physical or psychological problems that worsen due to opioid use
• Needing a higher amount of opioids to achieve the same effect
• Withdrawal symptoms
• Using opioids to relieve withdrawal symptoms

Signs of Opioid Overdose

Those with opioid use disorder may experience an opioid overdose. Signs of this include:

• Inability to speak
• Shallow breathing that is slow
• Feeling extremely sleepy
• Snoring
• Gurgling sounds
• Dark-colored lips
• Skin turning blue
  

Incidence of Opioid Addiction in the US

The United States is in the midst of an opioid epidemic. The most recently available data suggest that roughly 1.6 million people in the United States live with an opioid use disorder. More than 10 million people in the United States misuse prescription opioids.

White people and males have the highest rates of opioid misuse and deaths from overdose. But there are disparities in access to treatment for minority populations, people of low income, and females.

Deaths from overdose are rising faster for non-Hispanic Black people and American Indians than other demographic groups. Pregnant people may be denied treatment or be afraid of legal consequences of seeking care.

What Causes Opioid Addiction?

Genetic, environmental, and lifestyle factors are all believed to contribute to opioid use disorder.

Risk Factors for Opioid Addiction

Several risk factors may make a person more susceptible to an opioid use disorder.

These may include:

• Current substance abuse
• Past substance abuse
• Younger age
• Social environment that encourages the misuse of opioids
• Family environment that encourages the misuse of opioids
• Untreated psychiatric disorder
  

Causes of Opioid Addiction

Numerous factors can contribute to opioid use disorder. These include:

• Lifestyle
• Environment
• Genetics

Experiencing childhood neglect or abuse or living in poverty or a rural place are factors that have been associated with opioid addiction. Having easy access to opioids is another factor, as are certain personality traits like being impulsive or sensation-seeking.

Variations in certain genes are also believed to play a role in addiction.

Inheritance

Those with a family member who has an addiction are at higher risk of addiction. This may be due to shared genes, lifestyle, or environmental factors.

Opioid Addiction Treatment, Diagnosis, and Prevention

There are several options in the prevention, diagnosis and treatment of opioid addiction.

Opioid Addiction Treatment

Treatment for opioid use disorder often involves medication alongside counseling or behavioral therapy.

Medication options used to treat opioid addiction include the following, with costs for treatment in a certified opioid treatment program estimated in a 2016 report:

• Vivitrol (naltrexone): This stops feelings of euphoria from opioids. Costs in 2016 were estimated at $1,176.50 per month, $14,112 per year.
• Methadone: This drug reduces craving in those with an addiction and helps prevent withdrawal symptoms. A treatment program usually requires daily visits and includes psychosocial and medical support services. Costs in 2016 were estimated at $126 per week, $6,552 per year.
• Subutex, Suboxone (buprenorphine): This helps reduce or completely stop withdrawal symptoms and reduces cravings in people with addiction. A program using buprenorphine would involve twice-weekly visits. Costs in 2016 were estimated at $115 per week,$5,980 per year.

Diagnosis: When to See a Healthcare Provider

If you or a loved one are displaying signs of an opioid use disorder, don't hesitate to reach out to a healthcare provider. They will be able to refer you to a specialist in addiction medicine and advise what steps you should take.

Can Opioid Addiction Be Prevented?

Talk with a healthcare provider about non-opioid treatments if you need pain management. If opioids are the most appropriate choice, discuss how to use these drugs safely.

How to Help Someone With Opioid Addiction

When trying to help a loved one experiencing opioid addiction, it is important to reassure the person it is possible to manage opioid use disorder. Consider reminding them that it may take a few attempts to identify the best management approach.

In some cases, a person with an addiction may refuse help. In this case, it is advised not to try an "intervention" or confrontational approach. This can be dangerous and lead to violence.

Instead, encourage the person with an addiction to speak with a healthcare provider.

Summary

Opioid addiction can seriously affect a person's health, relationships, finances, and living circumstances.

There are legitimate reasons for prescribing opioids, including pain management for cancer, surgery, or injury. Opioids may also be obtained illicitly as street drugs like heroin.

Some people, like those with untreated psychiatric disorders or those with a current or past history of substance use, are more at risk for developing opioid addiction.

Those with an opioid addiction may display signs like taking more opioids than is required or taking opioids for longer than intended, having difficulties with work, school, or family obligations due to opioids, or withdrawing from friends and family. Opioid addiction can be treated with medications and therapy.

A Word From Verywell

Opioid use disorder can be challenging for both the individual and those around them. If you or someone you know is displaying signs of opioid addiction, do not hesitate to reach out to a healthcare provider. They will be able to provide support, as well as a referral to an addiction specialist.