Key takeaways:
An opioid addiction can affect many different areas of a person’s life, including their relationships, finances, and health.
When talking to a person about their opioid addiction, approach them in a private setting and express your concerns with compassion.
A person who is addicted to opioids is at high risk for an overdose. Getting trained to administer naloxone can help you intervene if you witness an overdose.
Opioids include heroin and fentanyl, as well as prescription medications like morphine, oxycodone, and hydrocodone.
An opioid addiction is the common term for what is known medically as opioid use disorder. It’s a health condition in which someone keeps using opioids despite negative consequences. Their use may cause problems in their life, such as with their relationships, their job, or with money.
If someone you know has an opioid addiction, there are ways that you can talk to them and encourage them to get help.
Watching a family member or friend struggle with an opioid addiction can be very stressful and scary. You may be wondering about the best way to approach them about the problem.
There is no one “right” way of helping a person with an opioid addiction. But there are ways that will increase the chance that they will consider changing.
Don’t be discouraged if they don’t listen at first. Even if they resist your efforts initially, you may plant a seed that will grow over time.
If a loved one is dealing with an opioid addiction, you can help by:
Talking to them about your concerns: Approach your loved one privately and explain why you are concerned about them and their safety. Be direct, but avoid blaming or shaming them. Remembering that there is a biological basis to addiction can help you avoid stigmatizing them.
Showing compassion: Remember that your loved one is likely not using opioids to hurt you. Whether they started because of physical pain or to self-medicate for emotional pain, they usually feel like they cannot stop. Imagine yourself in their shoes and have compassion for how difficult this is for them.
Offering to help them find treatment: It’s very difficult to recover from an opioid addiction on your own. And relapse is likely without ongoing treatment. Treatment can help your loved one detox, get to the root of why they use substances, and develop healthier coping skills. Educate yourself on treatment options (see below) and bring these up to your loved one gently. If they resist, respect their decision and remind them that help is available if they need it.
Taking care of yourself: You cannot support someone if you are burned out or very anxious. Practice self-care and consider therapy or support groups if you are struggling with your loved one’s addiction. Al-Anon and Nar-Anon are two popular groups for family and friends of people who use alcohol or drugs.
You can also help someone with an opioid addiction by getting and learning how to administer naloxone. Naloxone (Narcan) is a medication that reverses the effects of an opioid overdose.
If someone shows signs of an opioid overdose, administering naloxone while you wait for emergency medical attention can help prevent death or severe brain damage. For more information about how to get naloxone, visit Get Naloxone Now. There are also places where you can get naloxone for free.
Symptoms of an opioid use disorder can be physical, mental, and social and include:
Taking more opioids than planned or for longer than planned
Difficulty or inability to cut back on them
Taking opioids in physically dangerous situations
Spending less time engaging in social or recreational activities due to drug use
Having difficulty fulfilling one’s responsibilities due to opioid use
Experiencing cravings for opioids
Spending excessive time getting, using, or recovering from the effects of opioids
Continuing to take opioids even though they contribute to physical or emotional problems
Continuing to take opioids even though they contribute to relationship problems (with loved ones, friends, colleagues, etc.)
Developing tolerance (requiring more opioids to feel the same effects over time)
Going through withdrawal (symptoms that begin after stopping or cutting back on opioid use)
Professionals will diagnose an opioid use disorder if a person has at least either tolerance or withdrawal and one of the other listed symptoms.
As a family member or friend, you cannot diagnose someone you care about with an addiction. That said, if you notice these signs, you can start them down the road of getting help.
People may use substances like opioids for any number of reasons, including to:
Relieve physical pain
Self-medicate negative emotions
Cope with stress
Appear cool and interesting to others
Although the estimates vary widely, we know that some portion of people who use opioids will develop an addiction.
An opioid addiction is rarely caused by one single factor. Biological and environmental factors typically both play a role in whether or not a person who uses opioids goes on to develop an addiction:
Biological factors refer to a person’s genetics, developmental stage, biological sex, and ethnicity. Genetics explain around 40% to 60% of a person’s risk of addiction.
Environmental factors refer to one’s surroundings, such as family, peers, school, and community. People who grow up in relatively poor or traumatic environments or those where drug use is present are usually at greater risk.
Factors that increase the likelihood of developing an opioid use disorder are:
Using substances in the past or currently
Having a co-occurring mental health condition
Starting to use opioids or other substances before 25 years old
Having family or peers that encourage opioid use
Smoking, snorting, or injecting opioids
As you might imagine, the more risk factors a person has, the greater their likelihood of developing an addiction.
If your loved one is struggling with an opioid addiction, it’s important to encourage (but not force) them to get help. Opioid addiction is typically treated with a combination of therapy and medication.
Therapy can help a person understand and slowly change their addictive behaviors and improve their coping and life skills. Common therapies used to treat addictions are:
Cognitive behavioral therapy (CBT): CBT helps a person recognize how their thoughts, feelings, and behaviors are connected. It teaches them how to cope with their negative thoughts and feelings.
Motivational interviewing: This type of therapy supports motivation to change. It explores and works through a person’s conflicting feelings about their substance use.
Motivational incentives: This therapy, also known as contingency management, uses positive reinforcement to reward abstinence and other recovery-related behaviors. For example, someone could get a reward for attending treatment and support groups and submitting a drug-free urine or breathalyzer test.
Medications for opioid addiction are also an important part of a treatment plan. Medications can help reduce opioid use, criminal behavior, and the risk of an overdose. They also improve the chance that a person stays in treatment and remains employed.
Some common medications used to treat opioid addiction are:
Methadone: Methadone is a synthetic opioid that prevents other opioids from causing a high. Methadone can also help manage withdrawal symptoms and reduce cravings. By law, methadone for opioid use disorder must be prescribed in a licensed opioid treatment program, or “methadone clinic.”
Buprenorphine: Buprenorphine is another opioid that helps relieve withdrawal symptoms and cravings. It’s prescribed in a doctor’s office, unlike methadone. Suboxone is a medication that contains both buprenorphine and naloxone and is designed to not be misused to get high. If you try to crush, snort, or inject Suboxone, the naloxone will be released and result in withdrawal symptoms.
Naltrexone: Naltrexone (Vivitrol) is an opioid blocker that prevents opioids from activating the parts of the brain where they usually function. In other words, if a person takes an opioid while on naltrexone, they will not experience the usual euphoric effects. Vivitrol is an extended-release injectable form of naltrexone that works for several weeks.
If someone you know is experiencing opioid withdrawal, then they may benefit from medical treatment.
People who use opioids may develop physical and/or psychological dependence on them. If a person who is dependent on opioids suddenly stops taking them, they can go through withdrawal. They may also develop tolerance for opioids. This is where the body gets used to opioids and needs more to feel the same effects.
Common opioid withdrawal symptoms include:
Gastrointestinal symptoms, like nausea, vomiting, cramps, and diarrhea
Runny nose
Sweating
Goosebumps
Tearfulness
Anxiety
Muscle aches
Sleeping problems
People who experience opioid withdrawal — especially repeatedly — are at high risk for relapse. Withdrawal symptoms are uncomfortable, and they may cause someone to want to use opioids to get rid of the symptoms. Getting medical help by going to a detox program or a provider who can treat withdrawal symptoms can decrease the risk of relapse.
Opioid overdose is another condition that requires medical help. An overdose can happen when a person takes more opioids than their body can handle. This causes their breathing and heart rate to slow down and possibly stop.
If someone you know is taking opioids, it’s important to know the signs of an opioid overdose and what to do. It could help save a life.
Warning signs of an opioid overdose include:
Pale, clammy skin
Vomiting
Gurgling noises
Blue or purple lips and fingernails
Unresponsive
Breathing that is slow (less than 12 breaths per minute) or stops completely
Heart rate that is slow (less than 50 to 60 beats per minute) or stops completely
An opioid overdose is a medical emergency. If you notice any signs of an opioid overdose, call 911 right away. Administer naloxone, if it’s available. An opioid overdose is life-threatening. But it may be treatable if emergency medical attention arrives quickly.
Opioid addiction is a serious health condition that is often very difficult to treat.
If someone you know is developing or already has an opioid addiction, you can help by talking to them about it non-judgmentally. Let them know about treatment options, including medications and therapy. You should also consider getting naloxone in case you witness an opioid overdose.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988.
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If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.