What Is Opioid Use Disorder?

Medically reviewed by Erika Prouty, PharmD

Opioid use disorder occurs when an individual misuses or overuses certain medications or illegal drugs that are designed to relieve pain or cause feelings of euphoria or being "high."

More than 2.1 million Americans experience opioid use disorder. Deaths from opioid misuse have increased sharply in the last 20 years; over 68,000 people died from opioid overdose in 2020 alone.

Opioid use disorder is a complex condition that can be difficult to treat. This article will explain the symptoms and treatment options for opioid use disorder. It will also provide suggestions for coping with opioid use disorder or assisting a loved one who struggles with opioid misuse.

What Are Opioids?

Opioids are found in prescription pain medications and illegal street drugs like heroin. While prescription pain medications can be helpful for the short-term management of moderate to severe pain, they carry a high risk for addiction. They can also cause serious side effects or even death when used incorrectly.

Opioids block pain signals between the brain and the body and can cause people to feel relaxed, happy, or "high." Side effects include slowed breathing, constipation, nausea, confusion, and drowsiness.

Common opioid medications include:

• OxyContin (oxycodone)

• Hysingla ER (hydrocodone)

• Duramorph (morphine)

• Dilaudid (hydromorphone)

• Fentora (fentanyl)

• Methadose (methadone)

• Demerol (meperidine)

• Conzip (tramadol)

Opioids are sometimes combined with other medications, including Tylenol (acetaminophen) and Advil (ibuprofen). Common brand names for these combination medications include Vicodin (hydrocodone containing acetaminophen) and Percocet (oxycodone containing acetaminophen).

Symptoms of Opioid Use Disorder

Opioid use disorder occurs when someone misuses opioids. This might mean that someone uses more than prescribed or experiences withdrawal if they stop taking the drug.

Healthcare providers look for the following signs of opioid misuse.

• Continued use even when it impacts physical or psychological health

• Continued use that results in social and interpersonal consequences

• Avoiding social or recreational activities

• Struggling to fulfill work or school responsibilities

• Spending a lot of time finding opioids or recovering from their use

• Taking more drugs than intended

• Experiencing cravings for the drug

• Unable to decrease or stop using the drug

• Tolerance, where more of the drug is needed to achieve the same effect

• Using the drug in dangerous situations

• Experiencing withdrawal symptoms when they do not take the drug

When someone overuses opioids, they may have symptoms like confusion, increased sleepiness, nausea, euphoria, constipation, narrowed or "pinpoint" pupils, and decreased pain.

If someone uses more than intended, their breathing and heart rate can slow to dangerously low levels. They may become unresponsive or stop breathing.

Withdrawal

Long-term opioid use causes substantial changes to the brain and other organs. When an individual suddenly stops using opioids, they can experience a range of symptoms. In fact, research shows that opioid withdrawal symptoms can be so severe that some people continue to use opioids primarily to avoid withdrawal symptoms.

These symptoms may include:

• Abdominal cramps

• Cravings

• Agitation

• Diarrhea

• Anxiety

• Increased blood pressure

• Dilated pupils

• Sneezing

• Sweating

• Increased heart rate

• Muscle pain

• Runny nose

• Trouble sleeping

• Goosebumps

• Sweating

• Tearing

• Shakiness
  

Substance Misuse Explained

There are a lot of terms used when discussing substance misuse.

• Opioid use disorder occurs when an individual takes opioid drugs in a way that is not prescribed for a medical condition.

• Addiction occurs when someone continues to use drugs despite negative physical and social consequences.

• Dependence is a term for when someone experiences withdrawal symptoms if they stop taking a drug.

• Tolerance occurs when someone needs more of the drug to have the same effect.

Learn More: Substance Use Disorder vs. Dependency: What Are the Differences?

Treatment for Opioid Use Disorder

Opioid use disorder often occurs in combination with other conditions like alcohol misuse. This can make it more challenging to treat. Opioid use disorder is considered a chronic relapsing condition, which means that individuals may require multiple rounds of treatment and are at risk of misusing opioids in the future.

Treatment for opioid use disorder typically involves a combination of medication and therapy. This is called medication-assisted treatment (MAT). MAT has a much higher rate of success compared to therapy alone.

Takeaway

Medication-assisted treatment, or MAT, is the most effective treatment for opioid use disorder. This approach combines therapy and certain medications that reduce cravings and withdrawal symptoms.

Therapy for Opioid Use Disorder

Some individuals are treated on an outpatient basis through their primary care provider or through a specialized addiction treatment center. Others benefit from inpatient support.

Research shows that counseling helps people stay engaged in therapy and reduces the risk of relapse.

Therapy can include cognitive behavioral therapy, family therapy, or 12-step programs, among others. It's very important that individuals have a support network of family, friends, and trained counselors to support them in their recovery and prevent relapse.

Medications Used for Opioid Use Disorder

Medications can reduce cravings and minimize withdrawal symptoms. Common medications include Methadose (methadone) and Belbuca or Brixadi (buprenorphine). These medications can be useful during the early stages of treatment to reduce withdrawal symptoms. However, these medications must be used under the supervision of a healthcare provider as they carry their own risk of side effects, dependence, and withdrawal.

Some medications, like Vivitrol (naltrexone), prevent opioids from binding to the cells that cause euphoria, meaning that if a person uses opioids while taking those medications, they will not experience a "high." This can break the positive association between opioid use and euphoria.

Naltrexone does not cause euphoria and has no risk of addiction. It is most effective in later stages of recovery after someone has stopped using opioids. Suboxone is a medication that combines naltrexone and buprenorphine as part of a structured detoxification program.

New formulations of naltrexone and buprenorphine allow you to receive medications just once a month through an injection. This minimizes the risk that you will forget or skip a pill.

Learn More: How Prescription Drug Addiction Is Treated

How to Help a Loved One

It can be incredibly difficult to watch a loved one experience opioid use disorder. Remember that opioid use disorder is a medical condition that requires treatment and support from trained professionals.

It's important to call for medical help if you find a loved one unresponsive or difficult to rouse and you suspect opioid use. There are also medications that can reverse an overdose, including Narcan (naloxone). This can be found over the counter in some states.

Narcan will not hurt someone if they have not used opioids. It can be administered as a nasal spray or as a shot. In March 2023, the FDA approved Narcan Nasal Spray as an over-the-counter (OTC) emergency treatment for opioid overdose.

An Overdose Requires Medical Attention

Even if you have Narcan at home, it's still important to call 911 if you suspect an overdose. Narcan can wear off while opioids are still in the body, meaning the person is still at risk of overdose for several hours after Narcan is given.

Coping

Opioid use disorder is a challenging condition, but help is available. Many people are able to achieve abstinence through therapy, medication, and support from loved ones.

You can minimize the risk of developing opioid use disorder by taking medications exactly as prescribed. It's also important to stop taking pain medications when they are no longer needed. Remember to never take medication that has been prescribed for someone else.

Opioid use disorder can lead to serious consequences like addiction or even death. Reach out for help if you suspect an opioid use disorder so that you or a loved one can get help.

SAMHSA Helpline

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Summary

Opioid use disorder occurs when an individual misuses opioid drugs. Addiction occurs when someone keeps using those drugs despite negative social or physical consequences. Treatment usually involves both medication and therapy. You can help a loved one living with an opioid use disorder by encouraging them to speak to their healthcare provider or seek help from an addiction counselor.

A Word From Verywell

If you struggle with opioid misuse, then you should know that help is available. The good news is recovery is possible through professional support and medication. Treatment for opioid use disorder has evolved significantly in response to the current opioid epidemic, which means many treatment options are available to minimize withdrawal and help you sustain long-term recovery.

Read Next: What Is Prescription Drug Addiction?

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