How Does Opioid Addiction Start?

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The opioid epidemic now claims more than 40,000 lives each year. It's a truly startling number, and for many people, opioid addiction begins with a legitimate injury or surgery. They're then prescribed an opioid for the pain, and ultimately because of how that drug affects their brain and body, it can lead to dependence and addiction.

It's important for people to have an understanding of the risks of opioids and be their own health care advocates if they deal with pain from an accident or injury. There is a place for the use of opioid medications in the healthcare industry, but in many cases, people can deal with their pain in different ways.

The following offers an overview of what opioids are, how they work, and how that, in turn, can lead to opioid dependence and addiction.

What Are Opioids?

Opioids are a class of drugs, also known as narcotics. There are prescription opioids, which include pain medications like oxycodone and hydrocodone, and heroin is also an opioid, although it's illegal and has no medical uses in the U.S.

There are naturally-derived opioids that come from the poppy plant and also synthetic opioids such as fentanyl. Fentanyl is similar to morphine, yet it's anywhere from 50 to 100 times stronger.

Opioids help relieve pain in a couple of ways. First, they change how pain signals are sent from the body and the brain. Opioids also change the emotional response to pain, which is where the risk of addiction can stem from.

There are many different specific types of opioids, although most work in the same way. These drugs can be taken orally in pill or liquid form, as a skin patch, or as a tablet or film dissolved under the tongue or inside the cheek.

There are both short- and long-acting opioids, and sometimes opioid medications are combined with another medicine, such as acetaminophen, to boost their pain-fighting ability.

Why Do Doctors Prescribe Opioids?

Doctors prescribe opioids for different types of pain, but in recent years with the ongoing opioid epidemic, there have been more stringent guidelines put in place for how doctors can prescribe these drugs.

For example, according to the Centers for Disease Control and Prevention, the recommendation is that doctors try nonopioid approaches for situations with chronic pain, such as physical therapy.

There have also been monitoring programs put in place in many states to make sure that opioids are being prescribed safely and responsibly, but even so, that risk of addiction still exists.

How Do Opioids Work?

Opioids are unique in how they bind to certain receptors in the brain and body-these are the opioid receptors. We have opioid receptors throughout our brain and spinal cord, as well as our gut.

When someone first takes opioids, it slows down the processes of the central nervous system. This is why general side effects can include drowsiness, nausea, and constipation.

Unfortunately, this slowdown of the central nervous system is also what can lead to an overdose. When someone takes a higher dose of opioids than what their brain and body can handle, their central nervous system becomes overwhelmed. That person may then stop breathing, or their breathing may slow to a dangerously low level, which is an opioid overdose.

Using opioids with other central nervous system depressants such as benzodiazepines can further increase the risk of an overdose.

That overdose risk is why opioids claim tens of thousands of lives each year.

Some people may experience feelings of euphoria or a pleasant sense of well-being when they're on opioids as well. This can be known as high. This happens because the brain releases feel-good chemicals called neurotransmitters in response to the presence of opioids. Those feel-good chemicals are a big part of why opioids are addictive.

Why Are Opioids Addictive?

When you take opioids, even as prescribed by a doctor, there's a trigger of endorphins, which are those feel-good brain chemicals mentioned above. You may experience pleasurable feelings because of the way in which opioids activate reward centers in your brain.

You feel good, and then, when the drug wears off you might want that feeling back again.

That desire to feel the positive effects of opioids, even if you don't realize what's happening at a conscious level, can lead to opioid addiction. Eventually, the brain isn't able to produce it's own feel-good brain chemicals anymore without opioids, and that's the addiction cycle.

Your brain is driving you to continue using opioids, even if there are negative consequences related to your use of the drugs.

Along with addiction, dependence can form as well. Opioid dependence means quite literally your brain and body depend on the presence of the drugs.

If you're dependent on opioids and you stop using them suddenly, you may go through withdrawal. Opioid withdrawal can range from mild to severe.

Some people who become addicted to prescription opioids then go on to use more powerful opioids-in fact, a large portion of people addicted to heroin report that they started using prescription opioids first.

Individual factors can play a role in opioid addiction, as well. Some people are more likely to develop an addiction, and it's difficult for doctors or researchers to pinpoint why this is. There may be physical and mental reasons, as well as environmental factors that make one person more likely to get addicted to opioids than another.

If you are prescribed opioids by your doctor, be proactive about asking why he or she feels that's the right treatment approach for you. You might also ask why your doctor has chosen the number of pills they have, and why they've chosen a particular length of time to treat you with opioids.

These aren't bad questions to ask, and they can save you from developing an addiction.

You can also talk with your doctor about other options that are available for pain management outside of opioids. You are an active participant in your healthcare decisions, so partner with your doctor to understand why medicines are being prescribed, what the benefits versus the risks are, and what other options may exist.

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