Extensive use of opioids alter the chemistry in the brain and change the drug tolerance. This effect causes the person to require a larger dose to achieve the same effect. If opioids are taken regularly for duration of time there is a high chance of physical dependence developing. When a person stops using drugs their body reacts with withdrawal, psychological and physical symptoms (such as anxiety, diarrhea, and/or muscle cramping). Addiction and dependence are not the same thing. Everyone who takes opioids for an extended duration of time become dependent, a percentage of people experience the obsessive, constant need for the drug that characterizes addiction. Addiction is not normal, it is a disease. Opioid addiction causes the person’s body and mind to seem unable to function without using the drug. Addiction causes people to obsessively search for the drug, even when the drug use causes relationship, behavior, and health problems.

Drug tolerance occurs when opioids change the chemistry in the brain and body, thus causing the dose of the drug to have to be increased to achieve the same effect. When opioids are not used for a period of time the drug tolerance will begin to lower. If the prescription is needed again the former higher dose will not be needed. A higher dose can be too much for the body to take and cause adverse reactions. If medications have been stopped for a period of time and then resumed, you will need to talk with your medical team about dosage.

Opioid dependence is the reaction your body has due to taking a drug for an extended period of time. The reaction the body has causes withdrawal symptoms when the drug is stopped being used. Symptoms of withdrawal can be mild or severe, and may include:

• chills

• depression

• diarrhea

• fatigue

• insomnia

• nausea or vomiting

• pain

• shaking 

• sweating

• leg pain, restless legs

• agitation

If opioid use has been used for a long time, work with your medical team. If prescription opioids are the cause of your withdrawal your medical team can help avoid symptoms of withdrawal by gradually lowering the dose until the medication is no longer needed. If illegal opioids are the root cause of your withdrawal symptoms your medical team can help with a Medicated Assisted Treatment (MAT).

Opioid addiction is categorized as a compulsive, powerful urge to use opioid drugs, even if they are not medically required. Often, adversely impacting their personal and professional lives, people who become addicted prioritize using and getting opioids over any other activity in their life. Addiction effects everyone differently and it is not known why or how some people are more likely to develop an addiction than others.

Opioid drugs alter the chemical balance in the brain by producing artificial endorphins. As well as blocking pain, endorphins create a sense of pleasure. Extensive use of opioids can cause the brain to rely on the artificial endorphins created by the drug. Once the brain starts relying on these artificial endorphins, it may stop producing endorphins on its own with prolonged used. 

Opioid addiction may cause an overwhelming desire for the drug or feel as if they cannot control the urge to use the drug. Using opioids without your medical team’s consent, buying medications off the street without a prescription, even when the drug is causing the person detriment, can be a sign of addiction. The detriment addicted people may cause may be to their health, work, school, financial, legal, and relationships with friends and family. Due to the person’s change in behavior and symptoms, friends and family may recognize and realize the signs of an addiction problem before the person who is addicted does.

The first step in making a successful recovery is acknowledging that there is a problem with opioids. The signs and symptoms of opioid addiction may be behavioral, physical, and/or psychological. A strong sign of substance abuse is not being able to stop using the drug. Another sign is not being able to stop from using more than the recommended amount.

Signs and symptoms of opioid abuse include:

• abandoning responsibilities

• anxiety attacks

• constipation

• depression

• drowsiness

• euphoria (feeling high)

• irritability

• lowered motivation

• mood swings

• nausea, vomiting

• physical agitation

• poor coordination

• poor decision making

• shallow or slow breathing rate

• sleeping more or less than normal

• slurred speech

Life-threatening health problems can be caused by opioid addiction especially the risk of overdose. An overdose is triggered by a high dose of opioids causing breathing to slow or stop, leading to unconsciousness and death if the overdose is not treated immediately. Both legal and illegal opioids carry a risk of overdose if a person takes too much of the drug, or if opioids are combined with other drugs (particularly tranquilizers called benzodiazepines).

 If someone is suspect to have overdosed on opioids, call 9-1-1 immediately. In some states, a prescription nasal spray called naloxone (Narcan) is available to keep on hand in case of an opioid overdose. Talk to your professional medical team to see if you might need this medicine.

Symptoms of an overdose include:

• constricted (small) pupils

• loss of consciousness (passing out)

• unresponsive (can’t wake)

• slow, erratic (irregular) breathing, or no breathing at all

• slow, erratic pulse, or no pulse

• vomiting

Opioid addiction can be diagnosed by your professional medical team or a medical health professional. Diagnosis will include a medical assessment. It also often includes testing for mental health disorders.

Some people are able to safely use opioids without becoming addicted, unfortunately many are not and they have a high potential for addiction. If opioids are used for long-term pain management the risk is very high. Research shows that using them for more than a month can make you dependent on them. Using opioids for no longer than a week drastically lowers the possibility of addiction.

Opiate addiction treatment is highly personal and looks different for every person. However the goal of the treatment remains the same: stop dependence on the opiate, manage addiction, and provide the emotional support to prevent relapse and enable coping mechanisms to manage cravings. Treatment for addiction is not easy. Your body will go through a myriad of withdrawal symptoms that are uncomfortable. While medications can help minimize the symptoms, they are still present. Medication Assisted Treatment (MAT) the use of buprenorphine, methadone, and naltrexone are tools that are utilized with good effect to minimize cravings, mediate withdrawal symptoms, and prevent relapse. 

Methadone and Buprenorphine (suboxone, zubsolv, bunavail, subutex) can help minimize withdrawal symptoms by targeting the same areas of the brain, enabling a slow wean of the opiates, and minimize the withdrawal symptoms. If used correctly, they will not make you feel high. However these medications are not without risk. They can be addictive as well. They also can be addictive. Because of this, these medications are monitored closely for side effects. These medications will require heart monitoring, lab monitoring and extensive provider management.   These medications will also cause withdrawal symptoms is stopped abruptly, so weaning off of these medications should be planned you’re your medical provider. 

Natrexone (Vivitrol, Revia) is a medication that is used after you have been weaned off of the opiates (including methadone and buprenorphine) completely. This medication is used to prevent a relapse and to maintain recovery. This medication helps minimize the cravings for opiates as well as prevents any effect of opiates if you try to take them. It should also be mentioned that using naltrexone can also initiate a sudden and severe withdrawal (precipitated withdrawal) if given before all opiates are detoxed out of your system, or if you try to use opiates while on naltrexone treatment. 

While Medication Assisted Treatment (MAT) can aid you in your detox from and maintenance of your recovery from opiates, the treatment for addiction is not in medications, but in the behavioral therapy.   There is always an emotional and behavioral aspect to addiction that is not fixed with medications alone. Behavioral therapy with Psychologists, Psychiatrists, counselors, case managers and group therapy such as Narcotics Anonymous (NA) or Families Against Narcotics (FAN) is a necessary part of maintaining recovery progress. These behavioral therapies will aid your development in alternate, and healthy, coping mechanisms to deal with cravings, heal relationships with family and friends, hand maneuver your way through legal ramifications of your addiction. 

If you believe you might be addicted to opioids, know that there is help for you. The first step in fighting addiction is realizing that you control your life and your own actions.

These following steps will help your fight with your addiction:

REDEEM yourself 

- Get Control. Take control of your behavior and pledge to fight your addiction.

MOTIVATE today, to be better than yesterday 

- Get Help from your Medical Professionals. Your biggest ally can be your Medical Team pushing you to be a better you. They may be able to help ease your cravings for the addictive drug(s) by prescribing medicine. Discussing your problems and your drug use with your Medical Team is extremely helpful in your fight. 

COMMIT to the change you want 

- Get Support. Many organizations, such as Friends Against Narcotics and Narcotics Anonymous, are committed to your success of overcoming addiction. They are dedicated to offer you the support and tools needed to end your addiction. Friends and family are also a great component of support to help you move on with your life.