Understanding Opioid Addiction

Opiates, sometimes called opioids, are a class of drug that have been extracted or synthesized from opium poppy seeds, which contain morphine, codeine, and other active ingredients that give opiates their sedating properties. Opiates reduce pain, ease anxiety, and in high enough doses, produce a euphoric effect. Prescription opiate painkillers include Vicodin (hydrocodone with acetaminophen), OxyContin (oxycodone), and morphine. Illegal derivatives include heroin and opium.

Both prescription and illicit opiates are highly addictive. Even those who follow a doctor's guidelines for taking an opiate medication may become physically dependent on it (i.e., they experience withdrawal if they miss a dose or try to quit cold turkey) so dependence alone is not necessarily an indication of an opiate addiction. But with the combination of extremely unpleasant withdrawal symptoms and the euphoric effects these drugs produce, opiates have a high potential for abuse, which can quickly turn into an addiction.

Signs And Symptoms

Opiate addicts generally demonstrate the following behavioral signs:

• Taking more opiates than directed by a physician
• Frequently trying, and failing, to cut back on their drug use
• Making significant sacrifices to obtain more drugs

Physical symptoms of an opioid addiction can include:

• Physical tolerance (increasingly larger doses are necessary to achieve comparable highs)
• Withdrawal when the drug is stopped or decreased (including anxiety, irritability, physical tremors, aches, sensations of hot or cold, or nausea)
• Impaired pain sensations
• Confusion
• Slowed breathing
• Sedation

Diagnosing Opiate Addiction

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines criteria for the diagnosis of substance addiction: physical tolerance, withdrawal symptoms, and failed attempts to stop or decrease the habit.

Opiate Addiction And Other Mental Health Disorders

As mentioned, prescription opiates are often used to treat moderate to severe pain; thus, some opiate addictions originate in legitimate uses of the substance, which the patient later decides to abuse. However, opiate and other addictions are often the result of self-treatment for a range of co-occurring mental health problems including ADHD, Anxiety Disorders, and Mood Disorders.

Treatment

Most conventional treatments of opiate addiction begin with detox, during which the patient is gradually tapered off the opiate while under the care of physicians who can ameliorate the symptoms of withdrawal. However, opiate dependence (especially on heroin) can be too much for many patients to cope with in the short period of time (e.g., days) commonly allotted to detox. For this reason, some recovering opiate addicts may benefit from substitution therapy. As part of this treatment option, the addict substitutes another, less debilitating opioid for the drug that caused the addiction. The new drug (usually methadone or Suboxone) fulfills the person's craving for opiates but does not generate the high, crash, and corresponding self-destructive behavior.

Following detox, rehabilitation (either residential or out-patient) begins. It is important that the program a recovering opiate addict selects also treat any other mental health conditions simultaneously. If you or someone dear to you needs treatment for an opiate addiction with or without a known co-occurring mood disorder, anxiety disorder, or other psychiatric condition, please contact the UCLA Dual Diagnosis Clinic to set up an evaluation with one of our skilled experts.