We have heard a lot lately about opioid addiction in America from the news, politics, and just about everywhere you turn. If you, a family member, or a friend have been affected by this disorder, you are all too aware of the great challenges associated with opioid addiction. This article will explore the specifics of what opioid addiction is, why opioids are so addictive, what happens physiologically in opioid dependence and addiction. Other opioid addiction facts and how to get help for an opioid addict, be it yourself or someone you love.
An opioid is a class of narcotic drugs that interact with opioid receptors within the brain and body to help block pain signals and minimize a person’s sensations of pain. These drugs are highly addictive because of the accompanying euphoric effects.
Opioids include synthetic drugs such as fentanyl and methadone, as well as legally prescribed pain relievers like oxycodone (OxyContin, Percocet, Percodan,) hydrocodone, (Vicodin, Lortab, Lorcet,) codeine, morphine, Darvon, Demerol, Dilaudid, and others. An opioid can be natural, synthetic, or semi-synthetic.
Natural opioids are known specifically as opiates, including morphine, codeine, and the illegal drug, heroin. These opiates are directly derived from opium and the natural alkaloids found in the resin of the opium poppy.
Most opioids are consumed in pill form; however, others can be administered through injection or IV, a patch on the skin, or via suppository. While prescription opioids are safe and effective when taken as directed by a doctor, they are often abused and can lead to severe life-threatening addictions.
In recent years, synthetic opioids have been responsible for a large spike in overdose deaths. According to the CDC, more than 36,000 lives were lost because of synthetic opioids in 2019. That is an increase of 16 percent from 2018 and nearly 12 times that of 2013. A large reason for this dramatic increase is the rising presence of illegally made fentanyl, a synthetic opioid with a potency 50-100 times stronger than morphine. Once a person becomes addicted or dependent on the effects of opioids, professional treatment can help restore a healthy and addiction-free life.
Opioid addiction is the compulsive use, despite negative consequences, of one or more of the substances in the opioid class of drugs and, like all addictions, is a disease of the brain. Opioid addiction is centered in the brain’s reward system. The brain develops a dependence on opioids with repetitive use, and addiction occurs when the drug’s euphoric effect is repeated to the point that the brain perceives the drug to be necessary to survival.
The addict, on some level, is convinced they will die without the drug. This driving compulsion is at the core of the opioid addiction crisis.
Why are opioids addictive, and what is opioid addiction like? These drugs are related chemically and interact with the opioid receptors on nerve cells in the body and brain. The body produces naturally occurring opioids called endorphins to regulate pain and pleasure. The receptors in the brain don’t know the difference between natural endorphins and opioid drugs.
Opioid dependence develops when neurons adapt to the repeated exposure to the drug and only function normally when the drug is present. When the drug is removed, several physiologic reactions occur. This is known as “withdrawal.” Nausea, vomiting, diarrhea, body aches, difficulty sleeping, restlessness, anxiety, runny nose and watery eyes, rapid heart rate, and high blood pressure are all withdrawal symptoms.
It can be very uncomfortable, and the dependent person often seeks more opioids to relieve discomfort and to allow them to feel “normal” again. “Tolerance” is the effect of needing higher and higher doses of the substance to achieve the same effect. With heroin or morphine, tolerance to the pain-relieving effects develops rapidly, causing the user to increase the dose. This is also true to some degree of all opioids and can lead to addiction. When opioids are misused for the euphoric effect, and more and/or increasingly stronger drugs are used, addiction develops.
This euphoric effect is one reason why opioids are so addictive. And yes, all opioids are addictive to one degree or another. There is no such thing as nonaddictive opioids. Science is working on developing less-risky opioids like buprenorphine, which is also used to treat opioid addiction. However, buprenorphine still has some addictive properties and is also very costly and often not covered by insurance.
The Diagnostic Statistical Manual, the DSM-5, defines “opioid use disorder” with a lengthy list of criteria and specifiers. The spectrum of opioid use disorder spans a wide range of patterns of use, levels of dependency, and degrees of addictive behaviors.
Anyone who is prescribed opioids for pain, someone with an injury or surgery, even dental work, or other relatively minor procedures or conditions can subject person to fall prey to opioid addiction, given the right circumstances and factors. Opioid addiction after surgery or injury is all too common. Someone with chronic pain or a severe injury is especially at risk. A person starts taking the medication as prescribed, but as tolerance and dependence develop, the person may take more and stronger opioids. If the euphoric effects play on the brain’s reward system, addiction is soon to follow. Illicit use of prescription opioids to get high is common also. Young people, some in high school or even as young as middle school, are common victims of illegal opioid use. Sometimes they start legally by being prescribed medication for pain. They may then move on to buying the drug illegally on the street or take their parent’s or another adult’s medication to get high. Before long, they become hopelessly addicted. The not fully developed brains of the young are even more susceptible to opioid addiction than an adult brain and can pave the way for a life-long struggle with addiction. A family history of addiction or alcoholism can be a predictor of a predisposition to opioid addiction, as can a history of trauma and the early use or abuse of alcohol and other drugs.
We hear about the opioid “epidemic,” but how many people are addicted to opioids? According to the CDC, 91 people die every day in the U.S. from an opioid overdose. The numbers for opioid misuse in 2016 for people ages 12 or older in our country are just as staggering; 11.8 million, 4.4% of the population, based on a SAMHSA study. These opioid epidemic statistics are also probably somewhat underreported, as people often are in denial and hide their addiction until it becomes very progressed. Which are the worst states for opioid addiction? According to a recent study, Washington DC has the worst drug problem in the country. After DC, Vermont, Colorado, Delaware, Rhode Island, Oregon, Connecticut, Arizona, Massachusetts, and Michigan follow in ranking as the top 10 states with the worst drug problem. The same study found West Virginia to have the highest number of opioid overdose deaths in the country per capita, with New Hampshire, Kentucky, Ohio, Rhode Island following, and Alabama having the most opioid prescriptions 100 people. With these opioid addiction statistics, opioid addiction treatment needs to be a priority in the US. New and stronger regulations for prescribing opioids need to be put in place, and less addictive means of pain control and management need to be developed, in addition to better access to treatment and cracking down on illegal trafficking of opioids.
At Crossroads, we understand that seeking help for opioid addiction is a huge and often daunting step. We treat each person seeking treatment with compassion, respect, and confidentiality, regardless of their background.
It is likely that a person requiring treatment for opioid addiction will need to first complete a detoxification process to remove all heroin from their systems and go through the withdrawal process, which can be particularly risky if attempted without medical assistance.
Once this has been completed, there is a wide range of treatment options available. Crossroads does not believe in rigid, restrictive treatment for opioid/ heroin dependence and so are proud to offer a variety of traditional and contemporary treatment options.
The full list of treatment options includes: