Opioid medications that are properly prescribed by a doctor can be very useful for treating pain. However, both legally prescribed and illegal opioid medications can easily lead to opioid addiction. Opioid use disorder (ODU) is on the rise in the United States.
From 2019 to 2020, the number of drug overdose deaths in the United States increased by nearly 30% (and has quintupled since 1999)—and opioid-related death rates increased by 38%. Of the 91,799 drug overdose deaths in 2020, nearly 75% involved an opioid.
For people who are concerned about their personal opioid use—or a loved one’s use of opioids—this post provides vital information about opioid use and the basics of opioid addiction. It introduces the most frequently abused opioids, describes the symptoms of an opioid use disorder, and discusses treatment options.
What are Opioids?
Opioids—also known as narcotics—are a class of drugs that are used to reduce pain.
Some opioid drugs (such as morphine) are found naturally in the opium poppy plant. Others (such as fentanyl) are synthetic or semi-synthetic chemicals—produced in labs by scientists. All opioid drugs interact with the opioid receptors on nerve cells in the human brain and body, to reduce the intensity of pain signals.
Prescription opioids are typically safe when prescribed by a doctor and taken for a short time. However, because opioids produce feelings of euphoria as well as relieve pain, they can be misused and potentially be addictive.
Examples of opioids include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers that can be legally prescribed by a doctor, such as hydrocodone (Vicodin®), oxycodone (OxyContin®), codeine, morphine, and others.
The Most Commonly Abused Opioids
When used correctly and under the direction of a medical doctor, prescription pain medicines such as opioids can be very useful—for instance, to help manage chronic pain or for people recovering from surgery. However, the misuse of prescription opioids creates a serious risk of dependence, addiction, and overdose.
Among the various opioids, two of the most often abused are heroin and fentanyl.
Heroin—a highly addictive drug made from morphine—is an illegal opioid, which means that any “use” is an “abuse.” In the United States, 36 people die every day from an overdose death involving heroin.
Fentanyl is a synthetic opioid pain reliever that is up to 50 times stronger than heroin and 100 times more potent than morphine. Fentanyl is approved for the treatment of severe pain, for instance, in advanced-stage cancer patients. However, the use of illegally produced and distributed fentanyl has been on the rise and is a major contributor to the epidemic of opioid addiction.
Controlled Substances Act
The U.S. Controlled Substances Act (CSA) places all substances that are in some way regulated under federal laws into one of five categories called “schedules.” This placement of each drug into a particular category is based on its medical use, its actual or relative potential for abuse, its risk to public health, and its safety or dependence liability. Schedule 1 drugs are considered the most dangerous, and schedule 5 is the least dangerous.
• Schedule 1: Drugs with no current medical use with high potential for abuse and/or addiction.
• Schedule 2: Drugs with some medically acceptable uses but with a high potential for abuse and addiction. These drugs can be obtained through prescription.
• Schedule 3: Drugs with low to moderate potential for abuse and addiction but less dangerous than Schedule 1 or 2. These drugs can be obtained through prescription but generally are not available over the counter.
• Schedule 4: Drugs with viable medical use and low probability of use or misuse.
• Schedule 5: Drugs with low potential for abuse (lower than Schedule 4).
Chemical and Brand Names of Commonly Abused Opioids
The chemical and brand names of CSA Schedule 1, Schedule 2, and Schedule 3 opioids/narcotics—i.e., those that are considered to be most dangerous—are as follows. These are the opioids that people become addicted to most often.
Heroin is considered a Schedule 1 narcotic based on the guidelines from the CSA.
Schedule 2 opioids include:
• Fentanyl (Actiq®, Duragesic®)
• Hydromorphone (Dilaudid®)
• Meperidine (Demerol®)
• Methadone (Dolophine®)
• Morphine (MS Contin®)
• Oxycodone (Percocet®, Percodan®, Oxycontin® and Roxicodone®)
• Oxymorphone (Opana®)
Schedule 3 opioids include:
• Buprenorphine (Subutex®)
• Buprenorphine/Naloxone (Suboxone®)
• Codeine (Tylenol 3®)
• Hydrocodone (Lorcet®, Norco® and Vicodin®)
The Dangers of Opioid Abuse
Misusing opioid medications can lead to opioid addiction—an opioid use disorder (OUD). The dangers of opioid abuse include physical and psychological side effects such as mental fog, drowsiness, nausea, and constipation. Opioids can also cause slowed breathing, which may lead to death in the case of an overdose.
People with mental illnesses may rely on alcohol, opioids, or other drugs to temporarily relieve their symptoms. But drugs and alcohol adversely affect the nervous system and increase the risk of creating or worsening a mental health disorder. It’s also common for substance abuse disorders (including OUD) to co-occur with mental health conditions, particularly serious mental illnesses such as bipolar disorder, depression, schizophrenia, eating disorders, PTSD, and other forms of trauma.
Opioid addiction affects people of all ages, genders, classes, races, and religions. The artificially created feelings of euphoria associated with opioids may be used to mask not only physical but also mental and emotional pain. But the drugs, of course, do not address the root cause of a person’s suffering or dysfunction. The need to take them again and again to maintain the euphoric effect perpetuates the cycle of addiction.
People with a family history of substance abuse should refrain from using opioids due to how addictive they are. Genetic and environmental factors can influence a person’s likelihood of abusing these substances.
Signs of Opioid Abuse & Addiction
Opioid use disorder (OUD) is a type of substance use disorder (SUD) that’s characterized by the compulsive use of opioid drugs even when the individual wants to stop and when using the drugs has obvious negative effects on their physical and emotional well-being.
The basic signs and symptoms of opioid use disorder include craving for the drug, risky use, and withdrawal symptoms if the opioid is discontinued.
In the early stages of an opioid use disorder, a person may take an opioid because of its pleasurable effect. Over time, the pleasant sensations diminish. When this happens, the individuals may increase the frequency and dose of opioids to restore and maintain the euphoric feelings. As the addiction progresses, the drug is taken to avoid withdrawal symptoms.
Symptoms of Opioid Use Disorder
The major symptoms of opioid use disorder (OUD) include:
Cravings: Overwhelming physical and emotional urges to take the drug, even when there’s an understanding of the potential negative effects on well-being.
Physical dependence: A physiological change happens when a person uses a substance. When they stop taking the opioids, they experience withdrawal symptoms such as restlessness, cravings, sweating, irritability, anxiety, nausea, or diarrhea.
Risky use: Increasingly unhealthy or risky use of opioids. The individual is unable to control their use of opioids, and actions associated with getting and using opioids increasingly interfere with their daily life, causing problems with health, safety, financial security, or personal relationships.
Secondary signs and symptoms: Other side effects and indications of opioid use disorder may include:
• Weight loss
• Disrupted sleep patterns
• Frequent flu-like symptoms
• Decreased libido
• Lack of personal hygiene
• Changes in exercise habits
• Isolation from friends or family members
• Stealing from family members, friends, or colleagues
• Experiencing new financial difficulties
If a person is experiencing any of these symptoms of opioid addiction, they should seek professional help.
Treatment for Opioid Abuse
Treatment for opioid use disorder generally includes a combination of counseling/psychotherapy and medications such as methadone, buprenorphine, or naltrexone to help ease cravings and support the detox and withdrawal process. In emergencies, naloxone can be used to treat an opioid overdose.
People recovering from opioid addiction may do so in a hospital, a residential treatment center, an outpatient facility—or a combination of these settings.
The first part of treatment for opioid addiction is detox―fully eliminating opioids from the person’s body. When there is a physical dependence on opioids, an individual may experience withdrawal symptoms for 6-24 hours. In some cases, withdrawal symptoms may increase in severity for up to 72 hours before they begin to taper off.
Once the opioids are out of the person’s system, counseling and behavior therapy become the focus of rehabilitation. This is intended to discover the underlying thoughts, feelings, and behaviors associated with opioid abuse. Once the psychological root cause of the addiction has been uncovered, the person can develop new habits and strategies to avoid relapse and create a healthier life.
Opioid Addiction Recovery at New Method Wellness
New Method Wellness is a dual diagnosis residential addiction treatment center with on-site drug and alcohol detox facilities, specializing in treating opioid and other substance abuse addiction and underlying mental health issues. Every client at New Method Wellness is paired with two therapists from a multidisciplinary team of licensed clinicians and addiction professionals. This ensures the individualized high-quality care that our clients deserve.
To learn more about our leading-edge addiction treatment program—and how we can help you or a loved one recover from an opioid or other drug addiction—contact us today.