Opioid Addiction and Opioid Use Disorder: Symptoms, Treatment, and More

Opioids are a type of pain medication used to treat pain or assist with healing after an injury. However, opioids are also used recreationally without a prescription by people who want to feel the relaxation and pain-free state these drugs can produce. No matter how you use opioids, though, they can lead to opioid use disorder, which is a serious problem in the U.S. Over 2.5 million Americans suffer from opioid addiction.

Read on to learn more about the difference between opioid use and opioid use disorder, as well as symptoms and treatment options. 

What are opioids?

Opioids are a class of drugs that interact with the brain and nervous system to reduce pain and cause euphoria. Opioid analgesics are any opioids that are prescribed by medical professionals to provide relief to patients managing moderate to severe pain. They are commonly used by dentists and physicians to assist patients managing pain from medical procedures that would otherwise be overwhelming. Some commonly prescribed opioids include:

• Hydrocodone/acetaminophen (Vicodin)

• Oxycodone (OxyContin, Percocet)

• Morphine (Kadian, Avinza)

• Codeine 

• Fentanyl (Duragesic)

• Methadone (Methadose)

• Tramadol (Ultram)

Are opiates the same thing as opioids?

Opiates are opioids that are natural and derived from the poppy plant, such as heroin, morphine, and codeine. Opioids and opiates are terms that are often used interchangeably, but the main difference is in how these drugs are manufactured. An opioid can be produced naturally or synthetically (made in a lab.) Some drugs are opioids but not opiates, like fentanyl. Prescription opioids — or opioid analgesics — can be both synthetic or natural.

What is opioid use disorder?

Opioid use disorder is a medical diagnosis found in the Diagnostic and Statistical Manual of Mental Health Disorders, which is what healthcare providers use to diagnose mental health conditions. Opioid use disorder is a type of substance use disorder. When someone has a substance use disorder, they are physically, mentally, or emotionally dependent on drugs or alcohol. They experience problems in their lives as a result of their substance use.

Opioids are highly addictive, and anyone who uses them is at risk for developing an opioid use disorder. Opioid addiction is challenging and can happen to anyone regardless of race, sex, gender, and education, in addition to income level. 

Opioid use disorder symptoms

Knowing the signs of an opioid use disorder can help you determine if you or someone you care about may need additional help. For someone to be diagnosed with an opioid use disorder, at least two of the following symptoms must be present over a 12-month period:

• You take more opioids over time, or take more than you intended.

• You feel you need to stop or cut down how much you use, but you can’t.

• You experience cravings, or a strong desire to use opioids.

• You can’t meet goals or fulfill responsibilities with life roles such as in relationships, at work, or in school.

• You keep using opioids, even though you have negative consequences from them. 

• You use opioids in situations that are risky or dangerous (such as while driving).

• You have tolerance of opioids.

• You experience withdrawal symptoms when you stop taking them.

• You spend long amounts of time using opioids.

• You keep using them despite physical or mental health problems.

It’s important to talk to a doctor or other healthcare professional, like a therapist who specializes in addiction, if you are experiencing any of the symptoms of an opioid use disorder. 

Dependence and withdrawal 

Dependence and addiction often — but not always — occur together, and the differences can sometimes be difficult to identify. Dependence occurs when you are physically dependent on a substance and feel withdrawal symptoms if you stop taking the drug. It is possible to become dependent on opioids even when taking them as prescribed. Opioid withdrawal can be extremely uncomfortable or even dangerous. Talk to a healthcare provider if you think you are experiencing symptoms of opioid withdrawal such as:

• Agitation

• Anxiety

• Muscle aches and pains

• Runny nose

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Chills or sweats

Dependence is a symptom of addiction, but dependence alone does not mean you are addicted. Signs that you are addicted to a drug, or have a substance use disorder, can include dependence and withdrawal symptoms, as well as many other symptoms. 

Is it safe to take prescription opioids?

Opioids can be used safely, but it’s important to understand the risks and not to misuse your medication. Here are some questions to ask your doctor if you are considering taking opioids.

How will this medication help me? 

There might be other, non-addictive options that could provide pain relief without the need to take opioids, like ibuprofen (Advil), massage, or acupuncture.

How long will I need to take this prescription? 

The longer you take opioids, the higher your risk of developing dependence or addiction.

What are the potential side effects of using opioids? 

Remember that opioids are powerful drugs. They impact your ability to make decisions and drive a car, and they can have dangerous side effects if mixed with other substances.

Should I get a prescription for naloxone? 

Naloxone (Narcan), is a drug that can help with an opioid overdose and prevent death. It is available either as an injection (similar to an EpiPen) or a nasal spray that you can give to yourself or to an unconscious person who has overdosed. 

It’s important to remember that naloxone does not completely stop an overdose but can give the person enough time, anywhere from 30 to 90 minutes, to receive the necessary medical assistance they need to survive. 

If you or someone you know has a history of addiction to any substance, especially opioids, talk to your healthcare provider about this life-saving drug. 

Opioid addiction treatment

Opioid addiction can be treated with counseling, medication, and hospitalization — or a combination of these treatments. Treatment can be long or short term, take place in an inpatient or outpatient setting, and may include the use of medication. Read more about the different types of treatment options available to you here, or ask your healthcare provider or therapist for more information.

If you don’t have a healthcare provider or a therapist to talk to, there are other ways to find help for an opioid addiction. To find help in your area, you can reach out to family and friends, clergy, or your insurance company. You can also contact local self-help groups or hotlines by searching for substance abuse treatment in your area. 

If you’re concerned about illegal opioid use, organizations like the National Harm Reduction Coalition can help get you connected to resources near you without fear or worry of legal consequences. 

Medication assisted treatment

Medication-assisted treatment (MAT) is a type of therapy that involves specific medications in combination with counseling to treat opioid use disorder. MAT can last for months or years and requires a doctor to prescribe a medication that blocks the effects of opioids. The medication may need to be taken daily or, in some cases, monthly. MAT can reduce your cravings for opioids, block the drugs from making you feel good, and lessen the effects of withdrawal when you stop taking opioids.

There are currently three medications used in MAT treatments, each with their own risks and benefits: 

• Buprenorphine (Butrans, Buprenex): reduces the high feeling that opioids cause

• Methadone (Methadose): reduces cravings and withdrawal symptoms and blocks or reduces the high you may feel

• Naltrexone (Vivitrol): non-addictive, also used to treat alcoholism; blocks the high that opioids cause and can reduce cravings

Getting treatment is important. Opioid use disorder can lead to overdose, seriously impact your quality of life, and increase the spread of diseases such as HIV or hepatitis. 

Remember that not all healthcare providers work with substance abuse. Don’t be afraid to ask for a referral or find an addiction specialist to join your healthcare team if you feel like you or someone you love may need specialized care.

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Written by:

Cecilia Stonebraker, NCC, LCMHCA, LCAS, CSI

Cecilia Stonebraker, LCAS, LCMHCA, CSI, is a national certified counselor, a licensed clinical addiction specialist, and a couples therapist. She runs a private practice in North Carolina.

Reviewed by:

Emily Guarnotta, PsyD

Emily Guarnotta, PsyD, is a licensed clinical psychologist and certified perinatal mental health professional with over 10 years of clinical experience.

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