What are the Dangers & Treatment for Opioid Addiction?
In This Article
Opioid Addiction
Opioid addiction is also called opioid use disorder (OUD). It occurs after the continuous use or misuse of opioids (narcotics), a group of addictive prescription drugs that relieve intense pain and cause euphoria.
There are specific criteria that form the basis of an OUD diagnosis. People with the disorder may have trouble meeting obligations at work, school, or home.
OUD is an extensive disorder; healthcare specialists must assess many other signs and symptoms to provide proper diagnosis and treatment.
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What are the Symptoms of Opioid Use Disorder?
Symptoms of opioid use disorder include:
- Intense cravings for the drug
- Tolerance for the drug, requiring larger amounts and more frequent doses to achieve the same effect
- Anxiety
- Nervousness
- Depression
- Irritability
- Fatigue
- Sleep problems
- Interpersonal issues
- Neglect of personal hygiene
- Inability to enjoy once-loved activities
- Lack of concentration
- Inability to manage time
- Difficulties with making or keeping commitments
- Neglecting responsibilities
- Lack of judgment
- Reckless or dangerous behavior
DSM-5 Diagnostic Criteria for OUD
OUD is a chronic medical condition. To diagnose opioid addiction, doctors must determine if at least two of the following 11 symptoms have occurred within the last 12 months:
- Using larger amounts of opioids over a longer period than intended
- Failing to cut down or control opioid use without success
- Investing a lot of time obtaining or using the opioid or recovering from its effects
- Craving or having a strong desire to use opioids
- Neglecting work, school, or home responsibilities
- Continued opioid use despite negative social or interpersonal problems
- Avoiding or spending less time engaged in previously enjoyed activities because of opioid use
- Using opioids in hazardous situations
- Continued opioid use despite physical or psychological issues due to drug use
- Developing a tolerance to the drug’s effects and needing more and more to achieve the desired effect
- Experiencing withdrawal symptoms or using opioids to avoid withdrawal symptoms
What Causes Opioid Use Disorder?
Genetic and environmental factors play a role in developing opioid use disorder. In some cases, opioid addiction begins with a doctor’s prescription.
Some prescription opioids tend to take effect quickly and are highly potent. This makes them more addictive.
These drugs are also easy to access. People who mix other mind-altering substances, including alcohol, have a higher risk of developing an addiction.
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How to Spot an Opioid Overdose
Recognizing an opioid overdose can be challenging. It’s always best to assume the worst and seek medical attention, even with legal risks.
Signs of an opioid overdose include:
- Constricted pupils
- Loss of consciousness
- Slow, shallow breathing
- Limp body
- Choking
- Pale, cold, and or blue skin
Responding to an Opioid Overdose
It’s possible to reverse an opioid overdose if you act quickly enough. Victims of overdose are given Naloxone, an FDA-approved “rescue drug” that counteracts the life-threatening effects of an overdose.
In 2018, the US Surgeon General recommended that people at risk of overdose, as well as friends, family, and community members, carry Naloxone to administer if overdose is suspected. Naloxone has no risk of abuse.15
What are the Side Effects of Opioids?
When used as prescribed, opioid drugs can provide short-term pain relief from mild to severe cases. However, when you use them excessively or without a prescription, opioids cause various side effects.
Common side effects of opioids include:
- Severe drowsiness and confusion
- Nausea and vomiting
- Brain fog
- Digestive problems (constipation is the most common)
- Temporary euphoria, followed by extreme lows
- Breathing difficulties
- Heart problems
Severe Side Effects
More serious side effects of opioids include:
- Hypoxia (when too little oxygen reaches the brain)
- Neurological effects
- Permanent brain damage
- Dependence and addiction
- Coma
- Death
According to the US Department of Health and Human Services, more than 760,000 people have died since 1999 from a drug overdose. In 2020, an opioid was a factor in about 75% of drug overdose deaths.13
According to the Centers for Disease Control and Prevention, the age-adjusted rate of deaths involving synthetic opioids (other than methadone) increased by more than 1000 percent between 2013 and 2019.14
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What are the Symptoms of Opioid Withdrawal?
You’ll experience withdrawal symptoms if you have developed physical dependence on opioids due to OUD and suddenly stop taking the drug. This is because opioids affect the receptors of various nerve cells in the body.
The following opioid withdrawal symptoms may occur after stopping use abruptly:
- Muscle aches
- Trouble sleeping
- Diarrhea and vomiting
- Cold flashes with goosebumps
- Uncontrollable leg movements
- Extremely intense cravings for the drug
- Flu-like symptoms
- Body shakes
- Sweating
- Agitation
- Anxiety
- Runny nose
If you or someone you know is addicted to opioids, experts recommend detoxing at a professional treatment center. Don’t quit 'cold turkey,' as withdrawal symptoms can be severe and life-threatening.
How Do You Treat Opioid Use Disorder?
The only way to treat opioid use disorder is through a multi-faceted approach. This includes taking behavioral therapy, medication, and support groups.
- Behavioral therapies: These programs can help you change your attitude towards opioids and help you develop coping strategies for cravings and stressors that can lead to relapse.
- Medication: When you receive these medications under medical supervision, they can help reduce cravings and other withdrawal symptoms.
- Support groups: Support groups such as Narcotics Anonymous or SMART Recovery provide a nonjudgmental environment where you can talk openly about your addiction and learn from others in the same situation.
Treatment of opioid use disorder is an ongoing process that requires commitment and discipline. Finding the right treatment plan is essential for long-term success.
What are the Types of Opioids?
Opioids refer to natural, semi-synthetic, and fully synthetic opioids. There are many different types of opioids, some available through a prescription while others are entirely illegal.
All opioid types have addictive properties. Below are these different types:
Natural Opioids (Opiates)
Natural opioids, or opiates, don’t contain artificial substances and come from naturally occurring substances. Some plants, like the opium poppy, can produce nitrogen-containing chemical compounds. Natural opioids include morphine and codeine.
Prescription Opioids
Physicians prescribe these opioids to treat moderate to severe pain. However, these substances can be highly addictive when misused.
Some of the more well-known prescription opioids with a high risk for misuse and addiction include:
- Morphine
- Codeine
- Methadone
- Oxycodone (oxycontin)
- Hydrocodone
- Fentanyl
- Hydromorphone
- Buprenorphine
Illegal (Illicit) Opioids
Illicit opioids are a variety of drugs, including heroin, that are common for recreational or nonmedical use. These substances are highly illegal, with varying intensity and combination of effects. This is because illicit opioids are typically synthetic or semi-synthetic opioids.
Semi-Synthetic Opioids
These are lab-made opioids, which are mixtures of synthetic and natural opioids. It includes heroin and oxycodone.
Synthetic Opioids
This class of opioids is fully artificial and doesn’t contain natural opiates. Some examples include fentanyl, methadone, and tramadol.
What Are the Different Kinds of Opioids?
The most common opioids that lead to abuse, dependence, and addiction include:
- Opiates: Users widely abuse natural opioids like Oxycontin, Percocet, and Vicodin, according to NIH
- Heroin: Morphine-derived, highly addictive, and can cause severe long-term effects
- Analgesics: Prescription or OTC pain relievers, which misuse can lead to side effects and addiction
- Codeine: For pain and cough, which misuse can result in tolerance, addiction, and overdose
- Vicoprofen: Combines ibuprofen and hydrocodone, with high addiction risk and severe withdrawal symptoms
- Methadone: Treats pain and narcotic drug addictions and poses risks of overdose and long-term side effects
- Opium or Opana: Illegal with high addiction potential, and can cause severe symptoms and death.
- Fentanyl: Synthetic opioid, a potent painkiller, and has risks of tolerance, dependence, and addiction
- Dilaudid: Treats severe pain with high potential for abuse and respiratory depression
- Suboxone: Treats opioid addictions with rare overdose potential
- Demerol: Short-term for moderate to severe pain; high doses can cause respiratory distress
- Tramadol: Pain reliever, which poses a risk of dependence and respiratory depression
- Hydrocodone: For severe pain and as a cough suppressant with a risk of overdose
- Vicodin: Treats moderate pain, which high doses or combination with alcohol can be fatal
- Morphine: For moderate to severe pain; risk of overdose and withdrawal
- Oxycodone: Powerful painkiller with high risk of addiction and dependence
- Propoxyphene: Mild pain reliever with risk of addiction and overdose
- Percocet: Can release excessive dopamine and lead to euphoria, with risk of misuse and dependence
- Norco: Treats pain and suppresses cough with high risk of addiction
- Lortab: Pain reliever with risks of respiratory depression and liver failure, with high abuse potential
How Long Do Opioids Stay in Your System?
How long opioids stay in your system depends on the type of drug you misuse or abuse:
| Drug Name | Urine Test | Saliva Test | Blood Test | Hair Text |
| Codeine | 3 days | 4 days | 24 hours | Up to 90 days |
| Heroin | 2 days | Up to 36 hours | 5 hours to 2 days | Up to 90 days |
| Fentanyl | 1 to 3 days | 3 days | 5 to 48 hours | Up to 90 days |
| Oxycodone | 3 to 4 days | 2 days | Up to 24 hours | Up to 90 days |
| Methadone | 6 to 12 days | 30 minutes to a few days | 6 hours | Up to 90 days |
| Morphine | 4 days | 4 days | Up to 3 days | Up to 90 days |
| Buprenorphine | 1 to 2 days | 3 days | 2 days | Up to 90 days |
Summary
Opioids are powerful prescription drugs that reduce pain. However, they also have a high potential for abuse, addiction, overdose, and death.
Seek immediate medical help if you or someone you know is experiencing an opioid overdose. Likewise, seek medical help if you or someone you know has developed an opioid addiction.
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- Moeller et al. “Clinical Interpretation of Urine Drug Test: What Clinicians Need to Know About Urine Drug Screens.” Mayo Clinic Proceedings, 2017.
- “Prescription Opioids DrugFacts.” National Institute on Drug Abuse, 2021.
- U.S. National Library of Medicine. “Opioids and Opioid Use Disorder (OUD)” MedlinePlus, 2023.
- “Opioid Testing.” Testing, 2022.
- “Heroin Drug Facts.” National Institute on Drug Abuse, 2022.
- “Fentanyl Drug Facts.” National Institute on Drug Abuse, 2021.
- “More FAQs about Opioids.” National Institute on Drug Abuse, 2023.
- “Effective Treatments for Opioid Addiction.” National Institute on Drug Abuse, 2016.
- U.S. National Library of Medicine. “Opiate and Opioid Withdrawal.” MedlinePlus, 2022.
- “Opioid Use Disorder.” American Psychiatric Association, 2022.
- “Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, 2019.
- “The ASAM National Practice Guideline 2020 Focused Update.” American Society of Addiction Medicine, 2020.
- “Opioid Facts and Statistics.” U.S. Department of Health and Human Services, 2018.
- “Trends in Drug Abuse.” National Institute on Drug Abuse, 2023.
- “Overdose Prevention Strategy.” U.S. Department of Health and Human Services.
