Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made in a laboratory using the same chemical structure. A few common prescription opioids are:
Opioids may be prescribed to reduce acute, severe pain, and the pain that follows surgery. Like all medications, they have side effects. They may cause drowsiness, shallow breathing, and constipation. Because they also can produce temporary changes in mood, including feelings of euphoria, people sometimes misuse them. Opioids are strong, and can be very addictive. Even a single dose may be enough to cause serious health problems, or even death by overdose.
Fentanyl is a synthetic opioid prescribed to treat severe pain. It is 50 times more powerful than heroin. Fentanyl that is illegally made and distributed is on the rise, and is a leading cause of overdose deaths in the United States.
Heroin is an illegal, highly addictive opioid, prepared from morphine. Typically injected, heroin can also be smoked or snorted. Heroin is especially dangerous because it is often mixed with other drugs, including fentanyl, which increases the risk of overdose. In addition, when people inject heroin, they are at risk of serious, long-term viral infections such as HIV, hepatitis C, and hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart. When people overdose on heroin, their breathing often slows or stops. This can decrease the amount of oxygen that reaches the brain and cause death, coma, or permanent brain damage.
Prescription opioids can be useful in treating acute pain.
If you are prescribed an opioid, the best approach is to try the lowest possible dose in the smallest quantity. Opioids should be used for only as long as necessary. Generally, for acute pain, that means one to three days. Rarely are opioids needed for more than seven days.
Before taking an opioid medication for chronic pain:
Opioids pose a risk to all patients of unintentional overdose and addiction, although some people might be at higher risk than others (see below). As many as 1 out of 4 people receiving long-term opioid therapy struggles with opioid use disorder. Nationally, there is an overdose death every 20 minutes.
The use of prescription opioids also carries with it possible side effects, even when taken as directed.
Misuse is when someone takes a prescription drug in higher amounts or for a longer time than recommended; uses someone else’s medication; or uses opioids to get high.
About 25% of people who misuse opioids become dependent.
Anyone who takes prescription opioids can become addicted, though some have a higher risk. You may also develop tolerance — meaning that over time you might need higher doses to relieve your pain, putting you at higher risk for a potentially fatal overdose. You can also develop physical dependence — meaning you have withdrawal symptoms when the medication is stopped.
Teenagers and older adults have higher-than-average risks of becoming addicted. Those who suffered from childhood abuse, survivors of rape, and veterans with post-traumatic stress disorder are particularly susceptible to substance use problems. There is also an increased risk of addiction for individuals with a psychological disorder.
Not everyone who uses prescription painkillers does or will use heroin. However, about 3 out of 4 new heroin users report abusing painkillers prior.
There is evidence that heroin use is increasing as prescription painkillers become less freely available. Nationally, deaths from heroin have tripled in the last five years. More Virginians die every year from overdoses than in automobile accidents, and nationally there is an overdose death every 20 minutes.
Opioids can cause physical dependence — meaning that when someone stops taking them, they might experience withdrawal symptoms. Withdrawal can be physically painful but is usually not life-threatening.
Early opioid withdrawal symptoms include:
Late withdrawal symptoms include:
There is no guaranteed protection against substance misuse, but there are protective factors, often that start in childhood, including strong family bonds. These factors reduce the chances that someone will develop an addiction from using drugs or alcohol.
Work to build a trusting relationship with this person, so that you are able to regularly discuss the risks of substance use and they know they have support. Be aware of risk factors like a family history of addiction, a mental health condition, an impulsive or risk-taking personality, or a history of trauma.
Do not dispose of prescription medications in the toilet or sink, where they can contaminate waterways and harm fish and other wildlife.
Here’s how you can safely get rid of unused medications:
Twelve-step support groups are a form of peer support. They are the most widely available mutual support groups for people trying to break the cycle of addiction and those in recovery.
Although they are not professional treatment, 12-step groups can complement and extend the effects of professional treatment.
Professional treatment involves a structured program over time that includes credentialed counseling for substance abuse and is often accompanied by the closely supervised use of prescribed medication. This can occur in a treatment facility for inpatient or outpatient clients.
Treating withdrawal is not the same as treating addiction.
Detox is a process of managing the acute physical symptoms of withdrawal and can be medically managed in an inpatient facility or hospital. It may also occur on an outpatient basis. Detox is a short-term process, usually lasting less than a week.
Treatment addresses the biological, psychological, and social aspects of addiction. It lasts longer than detox: Research shows that most people who are addicted to drugs need at least three months in treatment to reduce or stop their drug use.
Depending on the type of treatment, detox may be the first step. But detox alone with no follow-up is not treatment.
Used properly, medications do not create addiction; furthermore, they are just one part of the process.
Medications allow an addicted person to regain a normal state of mind, free of drug-induced highs and lows. They free the person from constantly thinking about the drug and reduce problems of withdrawal and craving. These changes can give the person the chance to focus on the lifestyle changes that lead back to healthy living.
In addition to medication, to recover from opioid addiction, most people need some form of counseling and support from friends, family, or other members of the recovery community.