Addiction

Also referred to as prescription narcotics, opioid prescription painkillers are a close relative of heroin and affect the brain in similar ways. When opioids attach to certain proteins in the brain and body called opioid receptors, they can block the feeling of pain, but they can also induce euphoria (a feeling of being “high”). Opioid prescription painkillers are typically prescribed for the management of pain associated with an injury, surgical and dental procedures, or cancer.

Below are some common street names for prescription opioid painkillers. All of these drugs can be habit-forming or addictive, and lead to a substance abuse problem.

Could you be opioid dependent or addicted? Take this quiz and see.

Addiction to prescription opioid painkillers or heroin is a treatable medical condition caused in part by the changes in the chemistry of the brain that can result from opioid drug use. Opioid dependence or addiction can be a side effect of taking opioids a doctor prescribed for pain, or of recreational drug use of prescription pain medicines or heroin. It doesn’t matter how you become dependent or addicted: once drug addiction develops, it is a disease that requires treatment.

People who become opioid dependent or addicted to opioid drugs move along a path that can look like this:

1. Appropriate medical or recreational use of prescription painkillers or other opioid drugs
2. Relief of pain, with heightened feelings of pleasure or being high
3. Repeated drug use that becomes a habit
4. Changes in the brain
5. Drug cravings and withdrawal symptoms (see below) when the drug is absent
6. Inappropriate drug use to control withdrawal symptoms or to seek pleasure
7. Drug dependence or addiction

Withdrawal symptoms: Once addicted, many people fear withdrawal symptoms, which can be intense and unpleasant. According to the National Institutes of Health, withdrawal symptoms can include agitation, anxiety, muscle aches, insomnia, runny nose, sweating, yawning, abdominal cramping, diarrhea, dilated pupils, goose bumps, nausea, and vomiting. With medication-assisted treatment or other forms of rehabilitation, however, many of these withdrawal symptoms may be suppressed and recovery can be achieved.

If you are opioid dependent or dealing with addiction, you're not alone. Many others have struggled to overcome addiction and rebuild their lives. There are treatment options that can work.

Opioid dependence or addiction can be treated in private drug rehab facilities, outpatient drug addiction programs, detox centers, or methadone clinics. For some patients, medication-assisted treatment in the privacy of a doctor's office and at home can be a viable alternative to treatment in a methadone clinic or other types of rehab facilities.

In some cases, family members and friends may intervene—or stage an intervention—to encourage a person struggling with addiction to take positive action to stop taking drugs.

Counseling is an important part of any medication—assisted treatment for drug addiction. In counseling—also known as talk therapy—you can learn how to recognize events that can trigger the use of opioid painkillers. You can also learn practical ways to cope with events, circumstances, or social situations that you associate with your past drug use.

There are many kinds of counseling available, from private one-on-one therapy with a trained professional to group counseling. Support groups can also make a great addition to therapy with a trained professional. Many people with drug habits they want to break find self-help 12-step programs with a group of peers to be especially helpful. Some of the organizations people fighting addiction find most helpful as they work toward recovery include Narcotics Anonymous.

Yes. Addiction or dependence on opioids—prescription pain medications and heroin—has been defined as a long-term brain disease by the World Health Organization and the National Institute on Drug Abuse.

People who are addicted to drugs experience withdrawal symptoms and intense cravings for the drug when its effects wear off. These symptoms and cravings often lead to increased drug use—even when continued use of prescription painkillers or heroin threatens both the person with the addiction and those around him or her.

Once someone becomes dependent, it is difficult to stop the cycle of addiction. Often a person with an opiate addiction will manage to quit “cold turkey” for a period of time, only to relapse or “slip” later, sometimes again and again. The tendency to relapse into drug abuse is part of what makes drug addiction a chronic condition. Without help, for some people addiction lasts a lifetime.

There are signs and symptoms that may indicate a person is struggling with drug addiction. This short quiz may help you decide if you or someone you care about needs to seek treatment.

Addiction to drugs has several things in common with long-term, chronic illnesses, such as diabetes and asthma:

• Addiction can be successfully managed, but not "cured" per se
• Both medication and changes in behavior can be helpful (like diet and exercise in diabetes management)
• Addiction has a genetic basis—that is, it may run in families
• People can have periods of time when they are symptom-free, as well as periods of time when they have symptoms
• Treatment may be covered by your medical insurance plan

Addiction to opioids is considered a chronic illness with good reason. Because the changes in the brain that result from opioid dependence may be slow to heal, cravings can still make you want to “get high” and withdrawal symptoms can continue to drive substance abuse. Many people need to stay on some form of long-term rehab in order to manage their recovery and lead a healthier life.

For some, it begins with a prescription for painkillers after surgery or a sports injury. People who become dependent in this way are often surprised to find themselves addicted and dealing with powerful drug cravings because they got their medication legally, for what began as a legitimate need.

For other people, opioid drug misuse begins as recreation—the crushing and snorting of painkillers or the injection or snorting of heroin to get high—usually with the mistaken belief that casual drug use can be controlled.

Unfortunately, no matter how you get hooked on opioid drugs, addiction to prescription pain medication or heroin has both physical and psychological consequences.

When you take painkillers or heroin, your brain adapts to the effects of the painkilling drug over time. This increased tolerance is part of physical dependence, and means you need more and more of the substance to get the same pleasurable feelings or high—or even just to feel normal.

Emotions and behavior also play a critical role—which is why counseling is such an important part of treatment.

Psychological dependence or reliance on drugs (continued drug use for reasons other than drug tolerance and withdrawal—for example to experience the drug’s pleasurable effects or high) helps to reinforce the addiction cycle by leading to intense drug cravings. These cravings, in turn, can drive dependent or addicted individuals to take risks to obtain their drug of choice, regardless of the impact on themselves or those around them. The intense drug cravings that go with drug addiction can lead to risky behaviors like crushing and snorting drugs, searching for cheap drugs online to buy without a prescription, searching for ways to get high, or trying to beat a urine test.

People with substance abuse or opioid drug misuse problems may spend more and more time in compulsive drug-seeking behaviors, seeking new ways to get high, neglecting their loved ones and their jobs or school, even breaking the law.

Opioid dependence or addiction is more common than many people think. Men and women of all ages, races, ethnic groups, and educational levels can become dependent or hooked on opioid prescription painkillers or heroin.

Think you may be opioid dependent or addicted? Talk with a doctor near you who is certified to treat opioid dependence.

Some people do succeed in stopping cold turkey—that is, quit on their own without treatment or help. But many others don’t. According to NIDA, the National Institute on Drug Abuse, nearly all opioid-dependent people believe at first that they can stop using drugs on their own.

The reasons so many find they can’t—and end up engaging in risky behavior to continue their drug use, jeopardizing their personal goals and chancing an overdose—have to do with the powerful physical, biological, and psychological forces underpinning this chronic disease. Very simply, long-term addiction can result in changes in the brain that may remain long after a person stops using drugs. Addiction also affects the way you feel and the way you act, which is why counseling can help people who are recovering from addiction learn to deal with their feelings and change their behavior.

While a decision to commit to treatment can be hard to make and harder to live up to, engaging actively in drug rehabilitation can benefit even those dealing with the most severe cases of addiction.

For people dealing with opioid dependence or drug addiction—including those in recovery—a trigger is a situation, a person, a memory, or a feeling that triggers the urge to use drugs. Stressful situations are a common trigger, but each person has his or her own factors that trigger substance abuse behaviors.

There is no way to know ahead of time what details the brain has stored from any particular situation. But whatever they are, when those circumstances are encountered in the future, they can trigger memories of the good feelings produced by opioid misuse in the past, and, often, a desire—in the form of drug cravings or urges—to recreate that experience.

The technical term for these memories is “conditioned associations,” but most people familiar with opioid dependence refer to them as triggers.

Opioid dependence is a complex medical condition. Most people looking to recover or “kick the habit” of opioid painkiller misuse or heroin use should expect to need help, whether in the form of a doctor, counselor, drug rehabilitation clinic, methadone clinic, private rehab center, 12-step program, or a combination of these. There are even online discussion groups and chats you can join.

Ironically, just asking for help may make you feel stronger and more in control as you take a concrete step to overcome your addiction. Talk with your doctor or a counselor about your concerns—or find a trained, certified doctor who can treat addictions in the privacy of his or her office.

Think you or someone you care about may be addicted? Take a quiz to see if it makes sense to consider seeking treatment.