Doctors prescribe opioid medication to treat pain and sometimes for other health problems such as severe coughing. The medication comes in a pill, a liquid, or a wafer. It also comes in a patch worn on the skin. Examples of prescribed opioid medications include:
an ingredient in some cough syrups and in one Tylenol® product
Vicodin®, Lortab®, or Lorcet®
Percocet®, OxyContin®, or Percodan®
MSContin®, MSIR®, Avinza®, or Kadian® Propoxyphene—Darvocet® or Darvon®
an opioid used for opioid maintenance therapy
Opioid medications are sometimes misused to self-medicate or to get a good feeling, called a “rush” or “high.” People misuse medications by taking their own prescriptions improperly, stealing medications, going to multiple doctors to get extra, or buying them from drug dealers. Sometimes to get high, they drink a large amount of liquid medicine or crush a lot of pills to ingest, snort, or inject. Additionally, some people seek a high from heroin, an illegal opioid that can be smoked, snorted, or injected.
A person who takes opioids can become tolerant to them. This means that more of the drug is needed to obtain its effects. It is also possible to become dependent on opioids— to feel sick if there are no opioids in the body. This sickness is called withdrawal.
Tolerance and dependence are common side effects of prescribed opioid medication. If tolerance is a problem, doctors may adjust the person’s dose or change the medication.
Tolerance and dependence also occur in people who misuse medications or take heroin. Over time, such people often begin to feel uncomfortable without the opioid. They need to take it just to feel normal.
People who have become dependent on opioid medication but are ready to stop taking it can taper off (take less and less) to avoid withdrawal. This should be done under a doctor’s care.
Addiction is a disease that results when the opioid has made changes to the brain. A person using medication properly is not likely to get addicted, but this sometimes happens. Addiction usually occurs through misuse. Some people are at higher risk of addiction because of their genes, temperament, or personal situation. The signs of addiction are:
It is not usually possible to taper off an addiction. More help is needed because the cravings are so strong and the fear of withdrawal is so great.
Opioids affect the brain to increase pleasant feelings and reduce pain. They get their name from opium, a drug made from the poppy plant. Opioid medications are prescribed to treat pain and sometimes for other health problems such as severe coughing. Heroin is an illegal opioid that is smoked, snorted, or injected to get a good feeling, often called a “rush” or “high.”
People also sometimes seek this feeling by taking large doses of prescription opioids. Opioids also slow down breathing and heartbeat, sometimes causing death.
If you take opioids all the time, you can become tolerant to them. This means that more of the drug is needed to obtain its effects. It is also possible to become dependent on opioids. This means that if you stop taking them, you will feel sick. This sickness is called withdrawal. Dependence is not the same as addiction, but sometimes dependence leads to addiction. The signs of addiction are:
Tolerance and dependence are common side effects of prescribed opioid medication that can be managed under a doctor’s care. Tolerance and dependence also are side effects from misuse of opioids. Addiction is not likely to develop in a person using medication properly, but this sometimes happens. Addiction usually occurs through misuse. Some people are at higher risk of addiction because of their genes, temperament, or personal situation.
Not everyone who uses opioids gets addicted. However, it is difficult to stop using opioids after you have become addicted because the cravings are so strong and the fear of withdrawal is so great.
Opioid addiction is a chronic disease, like heart disease or diabetes. A chronic disease is a medical condition for life. It cannot be cured, but it can be managed. A person with addiction can regain a healthy, productive life. But if you are like most people, you cannot walk away from addiction on your own.
Treatment—the care of medical professionals and substance abuse treatment providers—can help. Treatment helps you give up the problem drug. It helps you get through withdrawal and cope with cravings. Treatment also helps you change addictive thinking into non-addictive, healthful patterns. It can help you move away from other harmful behaviors, too, such as drinking alcohol or abusing other drugs besides the problem opioid.
Just as important, treatment helps you address life issues you might have that are tied to the addiction, such as feelings of low self-worth, a bad situation at work or home, or spending time with people who use drugs. In short, treatment helps you move into a healthy, addiction-free lifestyle—into a way of living referred to as recovery.
Many people in treatment relapse one or more times before getting better and remaining drug free. Each relapse is a setback, but it does not mean failure. People who relapse can continue with treatment and achieve full recovery. A person can prevent relapse by staying away from triggers, such as avoiding former drug-use hangouts and staying away from friends who use drugs. Another way to prevent relapse is to guard against impatience or overconfidence. A person who makes these statements (or even thinks them) might need to return to an earlier goal for recovery:
– This treatment isn’t working!
– I thought I wasn’t supposed to feel cravings.
– I’m cured! I can control it if I only use with my friends.
– There’s no way I can relapse!
– I can stay away from drugs by myself.
– When I got high, I had so much fun! I never had problems.
Drug treatment patients are protected by special federal confidentiality regulations. No one will be told you are in treatment or what you talk about in treatment, except for these certain situations:
Information about a client often is shared within a treatment team in the clinic
You may consent in writing that your information be shared under certain specified conditions—for example, to forward your records to another doctor or clinic.
If your doctor or counselor has reason to think you might hurt yourself or others, he or she must inform others.
If you are facing trial, the court may subpoena your treatment records.
If you test positive for HIV and other communicable diseases, these facts will be shared with public health officials. In certain states, your intimate partners at risk for these diseases may be told that they have been exposed.