Opioid Addiction: Signs, Symptoms, & Treatments

What Is Opioid Addiction?

Opioid addiction occurs when individuals develop problematic and compulsive patterns of substance misuse, resulting in uncontrollable urges to use opioids despite adverse consequences.

Whether acquired through prescription or illegally, opioids are highly addictive because they bind to opioid receptors and activate reward systems in the brain. Over time, the body adapts to the positive side effects of opioids, like pain reduction and pleasure, and a person continues using the substances to experience these desired effects.

Opioid Addiction Vs. Opioid Dependence

While many use opioid addiction and dependence interchangeably, these are different experiences. Dependence is a medical term describing the body adapting to a substance or medications, like opioids. A person will likely experience opioid withdrawal symptoms when they stop taking the opioid due to this dependence.

On the other hand, opioid addiction encompasses both physical and psychological reliance on opioids that interferes with functioning. A person addicted to these substances continues using despite negative impacts on their health, relationships, and overall well-being.

Signs of Opioid Addiction

Signs of opioid abuse depend on the individual and addiction severity. Anyone can struggle with opioid addiction, and spotting problematic substance use in a person can be challenging. Many individuals appear functional and completely normal despite their opioid misuse. Typically, noticeable signs become more readily apparent when individuals stop using (or go into withdrawal).

Below are common signs of opioid addiction:¹

• Financial difficulties due to opioid abuse
• Experiencing opioid withdrawal
• Weight loss
• Sleep disturbances
• Decline in self-care
• Self-isolation
• Stealing from loved ones to pay for opioids

Symptoms of Opioid Addiction

Symptoms of opioid addiction vary in intensity according to potency, dose, frequency of use, and physiological tolerance. Common physical manifestations include constipation, nausea, reduced sex drive, sensitivity to pain, shallow breathing, and slurred speech.²

Individuals taking prescription opioids for pain management will experience similar tolerance and opioid dependence as those struggling with addiction.³ However, symptoms of opioid addiction include the behavioral aspects of compulsive misuse, such as failure to cease consumption, intense cravings to use, and continuing use despite known consequences.

According to the DSM 5, symptoms of opioid addiction include:⁴

• Taking opioids in larger amounts or for longer than prescribed
• Wanting to cut down or stop using opioids but being unable to do so
• Spending an excessive amount of time getting, using, or recovering from opioid use
• Cravings and urges to use opioids
• Not fulfilling daily life obligations at work, home, school, and elsewhere due to opioids
• Continuing to use despite associated issues
• Giving up important social, occupational, or recreational activities due to use.
• Using opioids repeatedly in potentially harmful situations
• Continuing to use, even when one is aware of having a physical or mental condition worsened or caused by opioids
• Needing more opioids than prescribed to feel the desired effect (often referred to as “chasing the dragon”)
• Development of withdrawal symptoms, which may be relieved by taking more of the substance

Opioid Addiction Causes & Risk Factors

Like any addiction, research suggests that genetic and environmental factors affect the development of opioid addiction. Some individuals may be genetically predisposed to abuse due to a family history of addiction or pre-existing mental health conditions, like substance use disorder.

Opioid addiction risk factors may include:^2,5

• Genetic vulnerability: People with a family history of substance misuse or addiction may be more likely to develop opioid addiction.
• Engaging with others who misuse opioids: Social influence can be a potent risk factor for opioid misuse. Those surrounded by people who misuse opioids may feel pressured to engage or experiment. They may also begin to see substance abuse as normal behavior, contributing to further consumption.
• Ease of access: Individuals with easy access to opioids may be more likely to become addicted. Ease of access increases the risk of problematic misuse, even for those taking prescription opioids.
• Experiencing chronic pain: Individuals may take prescription opioids for chronic pain. Sometimes, people may take more than prescribed to experience desired effects due to increased tolerance. Over time, this may contribute to misuse and addiction.
• Struggling with grief and loss: Grief and loss can trigger or exacerbate mental health conditions, increasing the risk of opioid misuse and addiction as a coping mechanism.
• Experiencing trauma: Similar to loss, some may use opioids to cope with traumatic experiences or events.
• A diagnosable mental health disorder or condition: Mental health conditions, such as depression or anxiety, can contribute to opioid misuse and addiction as individuals may use opioids to self-medicate or alleviate their symptoms.
• Having an addictive personality: Some people may have a personality more prone to addiction, making them more susceptible to opioid addiction.

Opioid Withdrawal Symptoms

Opioid withdrawal occurs when a person cuts back or ceases consumption. The symptoms of opioid withdrawal can be uncomfortable and potentially dangerous, including nausea, vomiting, and diarrhea. These symptoms and duration can vary depending on addiction severity and amount of opioid use.

The effects of opioids on the body and brain are numerous, and the positive characteristics of these medications can benefit individuals with chronic pain. However, opioids can result in physical dependence and withdrawal, and medical intervention may be necessary to ensure safety and comfort.

Below are common opioid withdrawal symptoms:¹

• Sweating or chills
• Increased anxiety
• Irritability
• Muscle pain
• Insomnia or sleep disturbances
• Abdominal pain
• Nausea
• Vomiting

Opioid Overdose Symptoms

One of the many dangers of opioids is the possibility of overdose. An overdose occurs when an individual consumes more opioids than their body can tolerate. Individuals who relapse after a recovery effort, detox, or incarceration are at a heightened risk because their tolerance to opioids decreases with abstinence.

Fortunately, Narcan (naloxone) can help reverse an opioid overdose. If you or anyone you know struggles with opioid addiction or abuse, acquire and learn to use a Narcan kit to reduce the likelihood of a fatal overdose.

Symptoms of an opioid overdose may include:

• Clammy and pale skin
• Limp body
• Blue or purple fingernails
• Vomiting or gurgling
• Loss of consciousness or ability to speak
• Slowed or stopped breathing
• Death

Treatment of Opioid Addiction

Treatment of opioid addiction should be tailored to the individual and offer a holistic approach. The intensity and duration of treatment will depend on the severity of the addiction and available resources. Significant efforts to remain abstinent and maintain recovery are pivotal for successful outcomes.

Medication-Assisted Treatment (MAT)

Given the intense cravings and withdrawal symptoms individuals with opioid addiction experience, many physicians may recommend medication-assisted treatment (MAT). MAT combines medication with therapy to help curb cravings and reduce withdrawal symptoms.

Below are medications used for treating opioid addiction:

• Methadone: Methadone is a synthetic opioid agonist that reduces cravings and withdrawal symptoms. Side effects of methadone may vary, and individuals should use the medication with discretion according to prescriber recommendations.
• Buprenorphine: Buprenorphine is a partial opioid agonist that activates the same brain receptors as methadone but to a lesser degree.⁶ Like methadone, buprenorphine can help decrease the risk of misuse and dangerous side effects.
• Naltrexone: Unlike methadone and buprenorphine, naltrexone is an opioid antagonist that prevents the high experienced from opioid use. Naltrexone often comes as a once-monthly injection and helps decrease cravings and the risk of relapse.⁵

Therapy

Therapy for opioid addiction is an essential part of treatment. Cognitive behavioral therapy (CBT) for addiction focuses on how cognitions (thoughts), personal beliefs, and values impact emotions that lead to opioid use. The therapy also focuses on automatic negative thoughts (ANTs) contributing to illogical thinking and irrational behavior. Generally, ANTs contribute toward opioid use and relapse.

Dialectical behavioral therapy (DBT) is similar to CBT but includes an element of mindfulness to help keep individuals focused on the present and aware of their internal and external environment. These skills are particularly beneficial when experiencing a craving.

Inpatient & Rehab Treatment

Inpatient and rehab treatment for opioid addiction typically involve comprehensive and structured programs to help individuals overcome substance misuse. Inpatient treatment includes staying in a facility where individuals receive round-the-clock care and support. These programs often include detoxification to manage withdrawal symptoms and stabilize patients.

Rehab treatment focuses on the underlying causes of addiction and developing coping strategies for long-term recovery. Programs often involve individual and group therapy, medication-assisted treatment, and behavioral therapies.

The effects of opioids on the body can be pervasive and harmful, leading to physical and mental health issues. Inpatient and rehab treatment programs aim to not only address the immediate physical effects of opioid addiction but also promote overall well-being and recovery. Through a combination of medical intervention, therapeutic interventions, and support systems, these treatment programs can help individuals regain control over their lives, develop healthy coping mechanisms, and prevent relapse.

Intensive Outpatient Treatment

Intensive outpatient programs (IOP) allow individuals to live at home while receiving intensive therapy and support. IOP provides individuals with a structured and flexible treatment plan while they fulfill their daily responsibilities at work, school, or with family. These programs typically involve individual counseling, group therapy, psychoeducation, and support groups. The frequency and duration of sessions may vary but are often more frequent than traditional outpatient programs.

The long-term effects of opioid abuse can be devastating and impact various aspects of life. Intensive outpatient treatment aims to address these impacts by providing individuals with ongoing support and therapy as they build the necessary skills for long-term recovery.

Coping With Opioid Addiction

Coping with opioid addiction can take many forms. Regularly attending support groups can provide valuable encouragement, understanding, and accountability. Exploring new hobbies can help fill the void left by drug use and provide a healthy and fulfilling outlet for emotions and time.

Furthermore, distance yourself from “drug buddies” to avoid triggers and temptations that may lead to relapse. Removing any drug paraphernalia from your surroundings can minimize the chances of relapse and create a drug-free environment.

Reflect on your values and aspirations when times get hard. For some individuals, revisiting their spirituality or faith can provide solace, guidance, and a sense of higher purpose. Finally, an optimistic perception of recovery fosters hope, resilience, and belief in your ability to overcome challenges and achieve lasting recovery.

Below are tips for coping and managing symptoms include:

• Regularly attending support groups: Support groups can provide individuals with emotional support, guidance, and accountability from others who understand the challenges of opioid addiction.
• Exploring new hobbies: Exploring new hobbies can help individuals rediscover passions and interests they may have lost during opioid addiction, helping to build a positive identity beyond drug use.
• Distancing from “drug buddies”: Distancing from individuals who use opioids can reduce the likelihood of relapse and create space for healthier relationships with friends, family, and community.
• Removing any drug paraphernalia: Removing any drug paraphernalia can create a drug-free environment and reduce triggers and temptations that may lead to opioid abuse.
• Working toward and achieving a goal: Working toward and achieving a goal can provide individuals with a sense of accomplishment, confidence, and hope for the future.
• Exploring life meaning: Finding a purpose in life can help people stay motivated when struggling.
• Getting in touch with spirituality: Getting in touch with spirituality can provide individuals coping with opioid addiction a sense of purpose, meaning, and connection to something greater than themselves. Spiritual practices and beliefs can also offer a framework for moral values and positive choices.
• Having a support network: Healthy support networks offer emotional support, accountability, and practical assistance in managing opioid addiction and related challenges.
• Identifying triggers and limiting access: Identifying triggers associated with drug use can help individuals stay on track, plan for tempting situations, and avoid relapse.
• Having an optimistic perception of recovery: Maintaining positive perceptions of recovery can help individuals stay motivated, resilient, and hopeful in the face of challenges and setbacks.

Final Thoughts

Coping with opioid addiction is a challenging journey. However, recovery is possible with the right strategies and support. Remember, seeking professional help and guidance is crucial, and a comprehensive treatment approach can provide the tools and resources needed to overcome addiction and build a fulfilling, drug-free life.