Understanding Addiction

There are a few terms to be familiar with around opioid use and risks. The first is opioid misuse, which refers to taking the medication in a way other than the way it was intended by the prescriber.1 For example, this can mean taking additional doses intentionally or unintentionally, or changing the way it is taken (eg, crushing the pills). Opioid misuse can lead to harmful events, such as an opioid overdose.1 If you are not clear on the instructions for opioid use, it is important to clarify with your doctor, or ask your doctor to communicate the instructions with a caregiver or family member.

Addiction is defined as chronic and compulsive drug seeking and use despite knowledge of the negative consequences.2 People can become addicted to drugs for a variety of reasons, such as having a family history of addiction or mental illness, biological factors and genetics, social or economic situations, among other factors. It’s important to remember addiction is a disease with measurable changes in the brain and it requires treatment.2

Opioid use disorder

Opioid addiction, also known as opioid use disorder (OUD), can start after chronic use of opioids where a person develops tolerance to the medication and requires higher doses to achieve pain relief or euphoria, or to avoid symptoms of withdrawal.3 OUD can also start with opioid misuse, such as crushing opioid pills to snort or inject, or taking more than the prescribed dose.4 A person might be at a higher risk of opioid addiction due to biological or environmental factors, but anyone taking opioids can become addicted.4 OUD can lead to cycles of severe withdrawal and relapse, behavioral changes, mental health disorders, lowered quality of life, and greater risk of a fatal overdose.4

Signs of OUD include intense physical and psychological cravings, difficulty fulfilling work or social obligations, greater tolerance to the medication, time spent seeking additional prescriptions, and taking higher doses or more pills.6

Discussing the risks of opioids with your doctor prior to starting treatment can help you stay informed on relevant signs and symptoms of addiction and an overdose. It is important to note that physical dependence and withdrawal can be normal responses to opioid use, and it does not always indicate addiction.7 Severe withdrawal symptoms include muscle aches, diarrhea, runny nose, nerve excitability, and chills.6 If you are experiencing any side effects or withdrawal symptoms, communicating this clearly with your doctor is important so an alternate therapy can be pursued.

If you think you might have an OUD, or a family member or loved one tells you that you might, it is vital to seek treatment. Your doctor or another healthcare professional can prescribe effective medications for opioid-use disorder, including methadone, buprenorphine, and naltrexone.8 These medications help people safely recover from an OUD by blocking or reducing effects of the opioid treatment. Your doctor may also refer you to an addiction specialist or treatment center for more resources and support, or if they are unable to provide treatment for the OUD. An addiction specialist can also work with your regular doctor to form a treatment plan for your recovery.9

Signs of an opioid overdose are unconsciousness or inability to waken, discolored skin, small “pinpoint” pupils, slow breathing and heart rate, or gurgling noises.11 Carrying naloxone, a life-saving medication for opioid overdose, is suggested for anyone using narcotics, and is especially important if you are prescribed a high-dose of opioids, if you have an OUD, or are at-risk for misuse or addiction, or if you know someone who is.12,13 Your doctor can prescribe naloxone, or they are often available over-the-counter. Let your family and loved ones know where it is stored at home in the event of an overdose. It does not require any special training, and comes as a nasal spray or injectable.12

How to use naloxone spray12

How to use injectable naloxone12

References

  1. Hauk L. Management of chronic pain and opioid misuse: A position paper from the AAFP. Am Fam Physician. 2017;95:458-459.
  2. National Institute on Drug Abuse (NIDA). Drug misuse and addiction. July 2011. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction
  3. Johns Hopkins Medicine. Opioid use disorder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/opioid-use-disorder
  4. Mayo Clinic. How opioid use disorder occurs. July 20, 2024. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
  5. What are the signs of opiate addiction? Pines recovery life. November 1, 2018. https://pinesrecoverylife.com/detox-blog/what-are-the-signs-of-opiate-addiction
  6. Dydyk AM, et al. Opioid Use Disorder. StatPearls. Last updated January 17, 2024. https://www.ncbi.nlm.nih.gov/books/NBK553166/
  7. Hospital for Special Surgery (HSS). Opioids: Understanding addiction versus dependence. Last updated July 5, 2023. https://www.hss.edu/conditions_understanding-addiction-versus-dependence.asp
  8. National Institute on Drug Abuse (NIDA). Medications to treat opioid use disorder. Last updated June 2018. https://irp.nida.nih.gov/wp-content/uploads/2019/12/NIDA-Medications-to-treat-opioid-use-disorder_2018.pdf
  9. Dowell D, Haegerich TM, Chou R. CDC Guideline for prescribing opioids for chronic pain–United States, 2016. JAMA. 2016;315:1624-1645.
  10. Fraser Health Authority. Recognizing an overdose. August 25, 2015. https://www.fraserhealth.ca/health-topics-a-to-z/mental-health-and-substance-use/overdose-prevention-and-response/recognizing-an-overdose
  11. Centers for Disease Control and Prevention (CDC). What to do if you think someone is overdosing. April 2, 2024. https://www.cdc.gov/stop-overdose/response/index.html
  12. Centers for Disease Control and Prevention (CDC). Lifesaving naloxone. April 2, 2024. https://www.cdc.gov/stop-overdose/caring/naloxone.html
  13. US Davis Health. Why you should carry naloxone (Narcan) to combat opioid overdoses. August 2, 2023. https://health.ucdavis.edu/blog/cultivating-health/why-you-should-carry-naloxone-narcan-to-combat-opioid-overdoses/2023/08

All URLs accessed August 23, 2024.

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