ALERTS & COVID-19 UPDATES Learn more: COVID-19 Resources; COVID-19 Testing; Vaccine Info; Safe Care; Visitor Policy; Support Us, DPH Attestation & Phase 3 Information

Lahey Health is now part of Beth Israel Lahey Health

by Preda A
(OUD; Opioid Abuse; Opioid Addiction; Opioid Dependence)

Definition

Opioid use disorder (OUD) is when a person keeps using opioids despite the cognitive, behavioral, and physical problems they cause.

Opioids are a class of drugs made from opium. Ones like oxycodone are legal when prescribed by a doctor. Others like heroin are illegal. They are often mixed with other substances, snorted, or used for the wrong reasons, such as to get high or to fall asleep.

Causes

The cause is not known. Things like genetics, the environment, and peer pressure may play a role.

How it Affects the Brain
neurotransmitter
Opioids help release chemicals in the brain that cause joy. Over time, you need more drugs to cause the same release. This leads to misuse.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Things that may raise the risk are:

Symptoms

OUD can lead to:

  • Being unable to stop or limit use
  • Craving the opioid
  • Making a habit of using the opioid even though it causes problems
  • Moving from one doctor to another to get more
  • Rapid increase in the amount of opioids needed
  • Use that gets in the way of doing normal things
  • Using a lot of effort to get more of the opioid

With regular use, the body begins to need the drug to get through the day. A person may get sick when they stop or take less of the opioid. It may result in nausea, vomiting, shaking, and sweating. This can make it harder to stop using.

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked about your use of opioids. A physical exam will be done. This is often enough to make the diagnosis.

Blood, urine, saliva, sweat, and hair may also be tested to look for signs of opioid use.

Treatment

The first step is to stop using opioids. This is also known as detox. The second step is to change behaviors to stop from using the drug again.

It can take some time to recover. Treatment may be given in a rehabilitation program. Many people may need to be treated several times. It may include 1 or more of the following:

Medications

Medicines may be given to ease withdrawal symptoms and lower the risk of using again. Common ones are:

  • Buprenorphine
  • Buprenorphine/Naloxone—a combined drug
  • Methadone
  • Naltrexone

Therapy

Therapy can help a person learn about the issues and lifestyle choices that lead to opioid use. This can help a person learn coping and problem-solving skills. A person can also learn how to replace opioid-use behaviors with healthier choices. Therapy sessions may be 1-on-1 or with a person's family.

Support Groups

Narcotics Anonymous is a 12-step program. It helps to support people who are recovering from OUD.

Prevention

The best way to prevent OUD is not to use opioids.

RESOURCES

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

National Institute on Drug Abuse  https://www.drugabuse.gov 

CANADIAN RESOURCES

Canadian Centre on Substance Abuse  http://www.ccsa.ca 

Centre for Addiction and Mental Health  http://www.camh.ca 

References

Drugs, brains, and behavior: The science of addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction. Accessed September 2, 2020.

Hall W, Doran C, et al. Illicit opiate abuse. National Center for Biotechnology Information website. Available at: http://www.ncbi.nlm.nih.gov/books/NBK11797. Accessed September 2, 2020.

Kosten TR, Baxter LE. Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. Am J Addict. 2019 Jan 31.

Opioid abuse and dependence. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/opioid-abuse-and-dependence . Accessed September 2, 2020.

Opioid addiction. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/opioid-addiction. Accessed September 2, 2020.

Opioid withdrawal. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/opioid-withdrawal . Accessed September 2, 2020.

Treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction. Accessed September 2, 2020.

Types of treatment programs. Principle of drug addiction treatment: A researched-based guide. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs. Accessed September 2, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
  • Review Date: 03/2020
  • Update Date: 02/19/2021