The road to opioid addiction is slippery.
If you’ve ever had major surgery, or dealt with severe pain, a doctor may have prescribed you a type of opioid. These types of drugs are some of the best medications for managing pain, but they’re meant to be a short-term solution. When you take opioids for long periods of time, you might develop a tolerance, a dependence, and eventually an addiction. Opioid addiction is known as an opioid use disorder.
When You Start Using Opioids
Let’s say you start off taking your medication only when it is absolutely necessary. For example, a surgeon may tell you to take a dose as needed after a major procedure. They may tell you that if you take one dose at 8 a.m., you need to wait a certain number of hours before you take the next one.
If you take more than prescribed, or continue taking them after your prescription ends, you may run into trouble. Opioids cause a dopamine spike that eases pain and creates a sense of pleasure. Over time, this basically rewires the brain to expect opioids in your system. This is known as an opioid dependence.
When You Stop Using Opioids
Once dependence occurs, quitting opioids can be extremely unpleasant. Similar to how coffee drinkers have headaches if they skip their morning cup, people with an opioid dependence will have unpleasant withdrawal symptoms if they stop using opioids.
Signs of opioid withdrawal include:
- Runny nose
- Stomach pain
Opioid withdrawal can be intense, and it often encourages people to use again. For this reason, opioid dependence is often the first step on the way to opioid use disorder, unless the person gets treatment. Opioid use disorder occurs when the strong desire to keep using opioids is impairing function and daily life. They may lose their job or relationships, struggle with money, and even commit crimes in order to keep taking opioids.
Risk Factors for Opioid Addiction
A common misconception is that opioid misuse is the individual’s fault for not being “strong enough.” Worse, some people mistakenly believe that opioid addiction is just “bad people doing bad things.”
In reality, experts consider opioid use disorder a brain disease. There are different factors that can put someone at risk for opioid use disorder. These can include:
- Chronic stress
- Mental illness
- Family history
- Tobacco use
- Environmental exposure
Getting Help for Opioid Misuse
The earlier you get help, the easier it will be to stop misusing opioids. That might mean talking to your doctor as soon as you feel tempted to continue taking opioids after your prescription ends. This may help prevent you from developing a tolerance or dependence.
If you’re concerned about taking a prescribed opioid, the best thing to do is talk to your doctor. They can help answer your questions and make a plan for taking the opioid safely.
Dr. Avery is the director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital.
- The Science of Addiction. Baltimore, MD: John Hopkins Medicine. (Accessed April 27, 2021)
- Opioid Use Disorder. Washington, DC: American Psychiatric Association. (Accessed April 27, 2021)
- Strategies to Prevent Opioid Misuse, Abuse, and Diversion That May Also Reduce the Associated Costs. Bethesda, MD: NCBI. (Accessed April 27, 2021)
- Opiate and opioid withdrawal. Bethesda, MD: MedlinePlus. (Accessed April 27, 2021)