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Opioid Addiction

What is Opioid Addiction?

There are many reasons why people may first take an opioid drug. Maybe a doctor prescribed them for pain control after a surgery. Perhaps a co-worker handed you some pills to help you get through the day at work. Both socially and recreationally, there are many different opportunities which may arise giving you the chance to experiment with opioids for the feelings they can produce. Opioid use can easily and rapidly become a habit, and many who experiment will begin taking opioids daily to produce euphoria, to help ease through the work day, or to calm painful emotions.

There are many disturbing symptoms that opioid drugs relieve, including physical pain, emotional distress, and mental turmoil. Once the effects of an opioid drug are enjoyed for any personal purposes aside from the relief of physical pain, it is likely that for more frequent urges to use will occur. There are some risks, though, of the regular use of opioids for the purpose of relieving such symptoms. These risks of course are becoming physically dependent on opioids and opioid addiction. The use of opioids can start to rapidly spiral out of control once either of these conditions arise.

The core feature of addiction is a powerful, lingering, and unexplainable compulsion to use an opioid drug that will alter your mental state and feelings. Addiction is mostly fueled by using opioids for their desirable personal effects. The fact that opioids can induce a rapid onset of euphoria makes the risk of addiction particularly strong. An opioid addict seeks to avoid the pain of daily life and achieve a detached state of peace and serenity. Opioid use provides a fast and easy path from many of the strains of daily life.

Using a drug out of free choice is not the same as addiction. Even those who are abusing drugs are not necessarily addicted, although drug abuse is still problematic. A key feature to addiction that is reported by many users in deep addiction is a compulsion to use that really has no rational sense to it. This compulsion to use also often has little to do with any reasons why they may have began using drugs in the first place. Users with serious addictions often know they should stop using or have intentions to stop using. Continuing to use while at the same time really wishing not to do so is another one of the main features of addiction.

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Dependence vs. Addiction

Physical dependence on opioid drugs is not the same thing as opioid addiction. If someone is physically dependent on opioid drugs does not necessarily mean they have an addiction to opioids. Physical dependance is indicated by the need to take greater amounts of a drug for the same effect or from withdrawal symptoms when you stop taking the drug. Psychological dependance to opioids can also develop and it is defined as a habit of using opioids as emotional self treatment. With habitual use of opioids for emotional reasons, both physical dependance and addiction are likely to occur.

There are some people who take opioids daily for several years to treat a chronic pain condition. These chronic pain patients would all be physically dependent, since if they ceased taking their opioid medication they would experience withdrawal symptoms. Addiction, however, is a neurobiological disease that is characterized by one or more of the following behaviors: poor control over or compulsive drug use, continued use despite negative consequences, and cravings for the drug. Chronic pain patients who take opioids daily for several years and who follow the instructions for their use are unlikely to be addicted.

Tolerance

This need to take greater and greater doses is also known as tolerance. Users who being taking a certain dose of opioids daily will eventually find that that dose no longer provides them with the feelings and effects that they are seeking. In order to achieve the same effects they must increase their dosage. Over time, the same thing will happen and this new dose will again not be able to provide the user with the same strength of effects. This will lead to the user increasing their dosage once again, and this cycle may be repeated several more times. At the height of their use, some users may end up taking doses that are over 100 times greater than the amount they used when they first started.

Also tied in with tolerance and dependence are the withdrawal symptoms. As a user's tolerance increases, the effects of withdrawal also become stronger and more pronounced. In general, how the longer that a user has abused opioids and the higher the dose they are taking means withdrawal symptoms will be more severe. You can find more information about opioid withdrawal symptoms here.



References
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington DC: American Psychiatric Association. 2000. [Link]
  • Lindesmith AR. (1968) Addiction and Opiates. druglibrary.eu [PDF]
  • Colleau SM, Joranson D. Tolerance, physical dependence and addiction: Definitions, clinical relevance and misconceptions. WHO Cancer Pain Release 1998; 11(3). whocancerpain.wisc.edu [Link]



Related Pages

Signs of Opioid Addiction
There are many ways to recognize opioid addiction. If you or a loved one is addicted to opiates, knowing these signs can help identify when the use of opiates has become abusive.
Opioid Dependence
Read about how prolonged opioid abuse leads to physical and psychological dependence, and what that means for the user.
Opioid Abuse
Prescription opioid abuse is a growing problem in North America, leading to distress in personal, social, and job-related responsibilities, and often resulting in opioid dependence & addiction.
Opioid Withdrawal
Opioid withdrawal refers to the symptoms that can occur after stopping or reducing intake of opioid drugs in opioid-dependent persons. Find out what the symptoms of withdrawal are and how long they last.
Updated August 30, 2016