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Opiod dependence

Opioid medication can help bring relief for people with severe and long-term pain. However, there is a risk of addiction, dependence or abuse of opioid drugs.

Opioids, also known as narcotics, may be prescribed to ease moderate to severe pain. They are often given to people recovering from operations, severe injuries or to ease the pain of terminal illnesses, and in certain conditions where relief of chronic pain is necessary.

Opioid abuse occurs when people use narcotics to seek feelings of well-being, in addition to or separate from, the narcotic's pain-relieving properties.

Morphine and other drugs derived from the opium poppy are called opiates.

Drugs such as heroin and methadone are called semi-synthetic drugs.

The most commonly abused opioid is heroin. Other opioids include methadone, pethidine, morphine, codeine, hydromorphone, fentanyl, hydrocodone and oxycodone.

A doctor will recommend the lowest possible dose to tackle pain.

The difference between dependence and addiction

Adequate pain control is the goal for the medical use of opioid analgesics. Patients and doctors should therefore not allow fear of addiction to interfere with using opioids for effective pain relief.

Differentiating dependence from addiction is important.

People receiving maintenance opioid therapy for long periods of time may need the dose to be increased over time as tolerance to the drug can build up. Stopping treatment abruptly can cause withdrawal symptoms. This is dependence.

Addiction is elevated opioid use (abuse) that becomes compulsive and self-destructive. A person may try to get the drug for reasons other than pain relief.

If circumstances allow, the dose for people using opioids over an extended period of time for medical purposes is slowly reduced over a few weeks to prevent withdrawal symptoms. People who are weaned off opioids and are pain-free rarely return to opioids or become abusers of opioids. Opioid use for short-term medical conditions does not usually require weaning.

Opioid abuse causes

Opioids produce their effect by stimulating opioid receptors in the central nervous system and surrounding tissues.

The abuse of opioids is a result of the euphoria and sedation that narcotics produce within the central nervous system. Abusers of intravenously injected heroin describe the effects as a 'rush' or orgasmic feeling. This may be followed by feelings of elation, relaxation, sedation or sleep.

Narcotic abuse symptoms

Narcotics users can develop tolerance and psychological and physical dependence to the drugs when they take them over an extended period.

Tolerance means there is a reduced response to the drug so that higher doses are required.

Psychological dependence means a person uses the drug for their personal satisfaction irrespective of health risks.

Physical dependence means there will be withdrawal symptoms after stopping use of the drug.

Signs of addiction include:

  • Loss of control over medication use
  • More frequent use of the medication during the day
  • Taking pain medication for other reasons besides pain, such as when depressed
  • Taking medication that was prescribed for another person.

Signs and symptoms of opioid abuse:

  • Loss of feeling of pain
  • Sedation
  • Euphoria
  • Shallow breathing
  • Small pupils, bloodshot eyes
  • Nausea, vomiting
  • Itching skin
  • Flushed skin
  • Constipation
  • Slurred speech
  • Confusion
  • Poor judgement
  • Needle marks on the skin.

WebMD Medical Reference

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