By Elizabeth Ossip, LCSW, CAP, ICADC

We have heard a lot lately about opioid addiction in America from the news, politics, and just about everywhere you turn. If you, a family member, or a friend have been affected by this disorder, you are all too aware of the great challenges associated with opioid addiction. This article will explore the specifics of what opioid addiction is, why opioids are so addictive, what happens physiologically in opioid dependence and addiction. Other opioid addiction facts and how to get help for an opioid addict, be it yourself or someone you love.

What are opioids and opiates?

An opioid is a class of narcotic drugs that interact with opioid receptors within the brain and body to help block pain signals and minimize a person’s sensations of pain. These drugs are highly addictive because of the accompanying euphoric effects.

Opioids include synthetic drugs such as fentanyl and methadone, as well as legally prescribed pain relievers like oxycodone (OxyContin, Percocet, Percodan,) hydrocodone, (Vicodin, Lortab, Lorcet,) codeine, morphine, Darvon, Demerol, Dilaudid, and others. An opioid can be natural, synthetic, or semi-synthetic.

Natural opioids are known specifically as opiates, including morphine, codeine, and the illegal drug, heroin. These opiates are directly derived from opium and the natural alkaloids found in the resin of the opium poppy.

Most opioids are consumed in pill form, however others can be administered through injection or IV, a patch on the skin, or via suppository. While prescription opioids are safe and effective when taken as directed by a doctor, they are often abused and can lead to severe life-threatening addictions.

In recent years, synthetic opioids have been responsible for a large spike in overdose deaths. According to the CDC, more than 36,000 lives were lost as a result of synthetic opioids in 2019. That is an increase of 16 percent from 2018 and nearly 12 times that of 2013. A large reason for this dramatic increase is the rising presence of illegally made fentanyl, a synthetic opioid with a potency 50-100 times stronger than morphine. Once a person becomes addicted or dependent on the effects of opioids, professional treatment can help restore a healthy and addiction-free life.

woman sits by Florida beach thinking about opiate rehab

What does opioid addiction look like?

Opioid addiction is the compulsive use, despite negative consequences, of one or more of the substances in the opioid class of drugs and, like all addictions, is a disease of the brain. Opioid addiction is centered in the brain’s reward system. The brain develops a dependence on opioids with repetitive use, and addiction occurs when the drug’s euphoric effect is repeated to the point that the brain perceives the drug to be necessary to survival.

The addict, on some level, is convinced they will die without the drug. This driving compulsion is at the core of the opioid addiction crisis.

Why are opioids addictive, and what is opioid addiction like? These drugs are related chemically and interact with the opioid receptors on nerve cells in the body and brain. The body produces naturally occurring opioids called endorphins to regulate pain and pleasure. The receptors in the brain don’t know the difference between natural endorphins and opioid drugs.

Opioid dependence develops when neurons adapt to the repeated exposure to the drug and only function normally when the drug is present. When the drug is removed, several physiologic reactions occur. This is known as “withdrawal.” Nausea, vomiting, diarrhea, body aches, difficulty sleeping, restlessness, anxiety, runny nose and watery eyes, rapid heart rate, and high blood pressure are all withdrawal symptoms.

It can be very uncomfortable, and the dependent person often seeks more opioids to relieve discomfort and to allow them to feel “normal” again. “Tolerance” is the effect of needing higher and higher doses of the substance to achieve the same effect. With heroin or morphine, tolerance to the pain-relieving effects develops rapidly, causing the user to increase the dose. This is also true to some degree of all opioids and can lead to addiction. When opioids are misused for the euphoric effect, and more and/or increasingly stronger drugs are used, addiction develops.

This euphoric effect is one reason why opioids are so addictive. And yes, all opioids are addictive to one degree or another. There is no such thing as nonaddictive opioids. Science is working on developing less-risky opioids like buprenorphine, which is also used to treat opioid addiction. However, buprenorphine still has some addictive properties and is also very costly and often not covered by insurance.

Symptoms of an opioid addiction include:

  • A loss of control of the use of an opioid substance
  • Strong cravings or drug-seeking behavior
  • New financial struggles
  • Social isolation from friends and family
  • Inability to focus on work or school
  • Health issues and poor hygiene
  • Drowsiness and changes in sleeping patterns
  • Loss of weight or appetite
  • Loss of interest in previously enjoyed hobbies and activities
  • Decreased physical activity
  • Stealing to help fund one’s addiction

The Diagnostic Statistical Manual, the DSM-5, defines “opioid use disorder” with a lengthy list of criteria and specifiers. The spectrum of opioid use disorder spans a wide range of patterns of use, levels of dependency, and degrees of addictive behaviors.

couple talk about treatment options for opioid addiction

How do you get addicted to opioids?

When opioids are prescribed for pain relief, they are generally safe if taken for a short time and only as prescribed by a doctor, but if taken for extended periods and misused; not taken per the prescription, regular use can lead to dependence, tolerance, addiction, overdose, and death. Because of the possible euphoric effect opioids can produce, they are easily misused.

Many people ask, how long does it take to get addicted to opiates? Everyone is different; many factors can bear on how long it takes to form an addiction. With repetitive and excessive use, it does not take very long to develop a dependence. In just a few continuous days of using heroin, some withdrawal symptoms may be experienced upon stopping the use of the drug.

When using opioids to experience euphoria, to get “high,” addiction can develop quickly. The use of other substances like alcohol and a person’s predisposition to addiction can cause more rapid development of dependence and a