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Opioid Abuse
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Opioid Abuse

En Español (Spanish Version)

Definition

Opioid abuse occurs when the compulsive use of opioids harms a person’s health or social functioning, or when a person is addicted to or dependent on opioids. Addiction and dependence means having a physical need for continued use of a drug (dependence) versus a psychological drive (addiction) for continued use of a drug. Addiction and dependence may occur simultaneously.

Opioids are a class of drugs made from opium, as well as synthetic or semi-synthetic drugs that resemble these opium-based drugs. Opioids include heroin, morphine, codeine, hydrocodone, oxycodone, and fentanyl. Opioid drugs are also often referred to as narcotic drugs or narcotics.

This condition can be treated. Talk to your doctor if you think you are abusing opioids.

Causes

Opioids produce a quick, intense feeling of pleasure (euphoria), followed by a sense of well-being and calm drowsiness. When opioids are used repeatedly, your brain is likely to become dependent on them. Opioids are a highly addictive type of drug.

Chemical Release in Brain

neurotransmitter

Opioids stimulate the release of "euphoric" chemicals in the brain. Over time, more drug is required to produce the same release, leading to opioid abuse.

© 2008 Nucleus Medical Art, Inc.

Risk Factors

The following factors increase your chances of developing opioid abuse. If you have any of these risk factors, tell your doctor:

  • Age: 20-29

Symptoms

The symptoms below are associated with opioid abuse. If you experience any one of them, see your physician.

  • Tolerance—need to sequentially increase dosage to have the same drug effect
  • Withdrawal (see below)—adverse symptoms occur when the drug is not taken
  • Increasing amounts of time spent drug-seeking
  • Interference of drug or drug-seeking behavior with social, occupational, or school functioning
  • Continued use of drugs despite obvious social, legal, occupational, or interpersonal problems stemming from drug use
  • Desire or efforts made to decrease or stop drug use

Opioid withdrawal symptoms:

  • Aching
  • Fever
  • Sweating
  • Chills
  • Craving
  • Diarrhea, nausea, vomiting
  • Sleeplessness
  • Pain, muscle aches
  • Goose pimples
  • Uncontrollable shivering, tremors
  • Restlessness
  • Tearing eyes, runny nose
  • Yawning

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she will ask you specific questions about your opioid use, such as how long you have been using opioids and how often you use them. Urine drug screens or serum drug tests may be performed to verify the presence of opioid drugs in your system.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Rehabilitation Programs

In rehabilitation programs, people with opioid abuse stay in a controlled environment for 6-12 months, during which they learn to become reintegrated into society. It may be necessary to be in a medical detoxification center initially, where the side effects of drug withdrawal can be safely managed.

Support Groups

Similar in format to Alcoholics Anonymous, Narcotics Anonymous is a twelve-step type program that has a good record for supporting individuals who are recovering from addiction to opioid drugs.

Behavioral Therapy

Behavioral therapies to help people quit are designed to modify people’s attitudes and behaviors related to opioid abuse, and learn how to avoid and cope with situations in which they are most likely to use drugs.

Medications

The medications methadone, Subutex (buprenorphine hydrochloride), and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) have been shown to be effective in the treatment of opioid addiction by interfering with some of the symptoms of withdrawal. They cannot cure opioid addiction by themselves, but are useful adjuncts to other forms of treatment (such as psychotherapy, group therapy, and/or behavioral therapy), They are also useful because in some instances they allow an individual to undergo withdrawal from opioids as an outpatient, rather than requiring inpatient treatment.

Prevention

The best way to prevent opioid abuse is to never use opioids, since they can be highly addictive. More practically speaking, closely following the medical directions given when opioids (narcotic) drugs are prescribed to treat pain can prevent the onset of opioid abuse.

RESOURCES:

American Council for Drug Education
http://www.acde.org

National Institute on Drug Abuse
http://www.nida.nih.gov

Partnership for a Drug-Free America
http://www.drugfree.org

CANADIAN RESOURCES:

Canadian Centre on Substance Abuse
http://www.ccsa.ca

The Council on Drug Abuse
http://drugabuse.ca

References:

Meehan, WJ, Adelman SA. Opioid abuse. Emedicine website. Available at: http://www.emedicine.com/med/topic1673.htm . Accessed November 6, 2006.

Mind over matter: opiates. National Institute on Drug Abuse website. Available at: http://teens.drugabuse.gov/mom/mom_opi1.asp . Accessed October 3, 2006.

Nature, causes, and health consequences of illicit opioid use. National Center for Biotechnology Information website. Available at: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=dcp2.section.7003 . Accessed October 4, 2006.

NIDA InfoFacts: treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: http://www.drugabuse.gov/Infofacts/treatmeth.html. Accessed October 3, 2006.

Purcell TB. Factitious disorders and malingering. Rosen’s Emergency Medicine: Concepts and Clinical Practice . 6th edition. Philadelphia, PA: Mosby; 2006.



Last reviewed February 2008 by Rosalyn Carson-Dewitt, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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