Opioids fall under a class of drugs that include prescription pain relievers such as oxycodone, hydrocodone, codeine, and morphine. There are also synthetic opioids like fentanyl and illicit opioids such as heroin. Regular use of opioids, whether prescribed for pain or taken illicitly can lead to dependence. Opioid dependence develops when a person builds a tolerance to opioids, needs higher dosages to experience any effects, and when they experience withdrawal when they stop taking them.
Opioids alter a person’s brain chemistry, creating artificial endorphins that illicit feelings of wellbeing and euphoria. As a person continues to take opioids (either for pain management or illicitly), the brain stops producing these endorphins naturally. When this occurs, the only way a person can feel “good” is by using the opioids they are accustomed to using.
At this stage, when a person stops taking opioids they begin to feel sick. Once a person has become dependent on opioids and they try to quit, they will experience withdrawal symptoms. Many people who are addicted to opioids take them not to get high, but to feel “normal” and avoid the negative symptoms of withdrawal that occur when a person has developed a tolerance to them.
There are physical, psychological, and behavioural signs of opioid dependence. The clearest sign a person has developed a dependency to opioids is the inability to stop using them. Another sign of opioid dependence is not being able stop after taking the recommended dosage.
Other signs of opioid dependence include:
Withdrawal from opioids can differ in dependent individuals depending on the type of opioid they are accustomed to taking, as well as how long they have been using and the size of the dosage they are accustomed to. Common signs of opioid withdrawal include:
Opioids are typically considered some of the hardest drugs to detox from. Withdrawal symptoms can last 7-10 days, but some symptoms will last longer. Some people experience symptoms of withdrawal for up to a month or longer.
Due to the nature of how opioids work in the brain, overcoming opioid dependence is best managed through professional drug addiction treatment. A full treatment plan for opioid addiction will include detox, therapy and counselling, various treatment modalities designed to help people overcome addiction such as behavioural therapy, and an aftercare programme that will help a person maintain their sobriety after treatment is over.
There are several different treatment options available. Most people with a dependence on opioids find that inpatient or residential treatment is beneficial in treating their dependency problem. Treatment typically lasts 4 weeks (28 days), with extended treatment plans available for those who need them.
While many people try to stop using opioids on their own, the mechanisms of addiction are often too powerful for them to sustain sobriety. After experiencing withdrawal, many people dependent on opioids make sure they always have enough in their system to avoid the uncomfortable withdrawal symptoms associated with it.
Not everyone who uses opioids for pain management will develop an addiction to them. Some people are more prone to addiction including those with a genetic disposition, behavioural problems, environmental factors, and other conditions such as depression and anxiety.
While withdrawal symptoms from opioid withdrawal can be extremely unpleasant, detoxing from opioids is not life threatening. Because symptoms can be so difficult however, opioid dependence typically requires professional help through the detox period.
Opiate Withdrawal Timelines, Symptoms and Treatment, American Addiction Centers