How Opioid Painkillers Become Addictive

Medically Reviewed By William C. Lloyd III, MD, FACS
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Every year doctors write more than 200 million prescriptions for opioid painkillers, which have become one of the leading types of abused prescription drugs. Many different types of medications fall within the opioid category—including hydrocodone, oxycodone, morphine and codeine—and are prescribed for pain relief. But used improperly, these drugs can have devastating effects, including death. If you use any type of prescription painkillers, be aware of the potential to become addicted and the resulting consequences.

Why are opioid painkillers used?

Doctors prescribe opioids to manage many levels of pain. Codeine, for example, is used to treat mild to moderate pain, and is usually prescribed only after over-the-counter pain relievers have not been effective. Morphine, on the other hand, is used to relieve severe pain, such as after surgery. These medicines reduce a person’s perception of pain, but they also have side effects, such as drowsiness, nausea and constipation.

How do people become addicted to opioids?

When taken as prescribed, opioids simply provide pain relief and rarely result in addiction. Science has provided new insights regarding the effects of opioids and how dependence develops. Experts know for a fact that some people experience a euphoric response to these drugs, which can sometimes lead to abuse. For example, the illegal drug heroin is an opioid processed from morphine and is highly addictive due to its euphoric effects, often called a “rush.” Legally prescribed opioids can also be abused for the same effects.

It’s not only taking too much of a drug that can cause physical dependence or addiction, but also changing the method in which the drug is taken. For example, some medications intended for oral use may be snorted or injected to intensify the euphoric feelings the drugs create. Misusing opioids in any way can lead to overdose and other serious complications, including death.

Addiction isn’t the same as physical dependence. Someone who has become physically dependent on a medication will experience withdrawal symptoms if the drug is abruptly stopped. These people might also develop a higher tolerance for the medication, resulting in the need for increased dosage to control their symptoms. On the other hand, someone who is addicted to a drug will be compulsive about using the medication, without regard to the medical risks.

What are the dangers of opioid overdose?

An overdose can cause slowed breathing, called depressed respiration, which reduces the amount of oxygen that gets to the brain. This condition is called hypoxia and can cause coma or permanent brain damage. Even one large dose of an opioid can result in death. Researchers are still studying the long-term effects on brain function after an opioid overdose. Studies have already shown heroin addiction can cause deterioration of the brain’s white matter.

How can you help someone with an opioid addiction?

If you suspect someone you know has become addicted to opioid painkillers, there are ways you can help. To best help your friend or loved one, show concern without judgment and encourage him or her to seek treatment. Be careful not to enable addictive behaviors, such as helping him or her buy the drugs.

Another possibility is enlisting other supportive friends or family members to hold an intervention, which is a meeting designed to help the addicted person acknowledge the problem and seek treatment. Your loved one might be in denial and not recognize the negative effects of his or her addiction. A face-to-face meeting with people who care could help your loved one get back on track. If you choose to try this method of assistance, make sure to invite people who can support one another along with your loved one. You might even consider including an addictions counselor or professional interventionist, especially if your loved one has a history of mental illness or violence.

While these methods offer long-term help in overcoming an addiction, you might be faced with an emergency situation if your loved one has an opioid overdose. A medication called naloxone can reverse the effects of an opioid overdose and is now available without a prescription in many drugstores. Available in both injection and nasal spray (sold under the name Narcan) forms, naloxone can be used to treat an overdose patient even before medical responders arrive. Talk to your doctor for more information about naloxone and whether it would be a good idea to keep some on hand.

Opioid addictions make up more than 5 million cases of all drug addictions in the United States, but these addictions can be overcome. It won’t be easy: The addicted person must first acknowledge the problem and seek treatment, and then face withdrawal symptoms, which can include severe aches, muscle spasms, restlessness, vomiting, diarrhea, insomnia and depression. However, with treatment and support, recovery from opioid addiction is possible. And if you use opioids for pain relief, be certain to use them exactly as prescribed to avoid addiction and its devastating effects.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 7
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. What are some of the commonly abused prescription drugs? National Institute on Drug Abuse.
  3. What is heroin and how is it used? National Institute on Drug Abuse.
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  5. How to Help an Opiate Addict.
  6. Intervention – Tips and Guidelines. National Council on Alcoholism and Drug Dependence.