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Opioid addiction or abuse

Waranga, whakamanioro rānei i te whakaporehu

Important

Opioid addiction is very dangerous. When someone uses opioids, they often use uncertain quantities and may use forms that aren't pure. They may also mix opioids with other drugs.

Injecting, smoking or snorting opioids can cause an accidental overdose and death.

If you think you or someone else may have overdosed, call an ambulance on 111.

Doctors prescribe opioids to treat strong pain. They're most often used in hospitals or hospices, after operations or when a person has a terminal illness like cancer. In these cases, taking opioids is completely appropriate.

People can also use opioids as drugs of abuse because they can give a feeling of pleasure.

Sometimes a person is introduced to opioids in a social situation. Other times they step up to opioids after getting comfortable using a less dangerous drug. They can also get hooked after using opioids for pain relief. However they started, if a person misuses opioids, they're likely to become addicted to them.

Some people with opioid addictions get opioids from their doctor under false pretences. This is called drug-seeking. Other people get them through a friend or by buying them on the street.

Buying or selling opioids is illegal. So is prescribing opioids for a person who is addicted. Methadone and buprenorphine and naloxone are the only opioids that doctors can legally prescribe to people who are addicted. These must be prescribed via the Opioid Substitution Treatment programme.

There are many different types of opioids. The most common ones are oxycodone, codeine, DHC, heroin, fentanyl, pethidine, morphine and methadone. When a person is in pain, these drugs stop them experiencing the pain. They work by blocking the pain message in their brains. When they're not in pain, the opioids give them a feeling of pleasure, or a high.

Opioids can be swallowed, sniffed (snorted), smoked, injected or applied as patches. Different ways of taking the drugs give different effects. For example, injecting or snorting gives an intense high. Swallowing tablets like morphine give a less intense high.

Opioids are very addictive. If they aren't managed carefully, the person taking them rapidly starts to develop a tolerance and to crave more. They find they cannot quit or reduce the amount they're taking and get bad withdrawal symptoms if they try.

People often make increasingly extreme efforts to get the drug. This often results in crime, poverty and physical injury. It also often leads to loss of relationships and loss of employment.

You have a higher risk of having an accident while driving. Driving while high is dangerous and illegal. You could lose your licence or face a criminal conviction.

While high you could be physically or sexually assaulted.

If you inject drugs, you have a high risk of contracting blood-borne diseases like hepatitis B and C, and HIV and AIDS.

Withdrawing from an opioid is usually extremely unpleasant. People addicted to opioids tend to use the drug to avoid the withdrawal symptoms rather than to get a high.

It can be very hard to get control of an opioid addiction. It usually involves very intensive support by a drug service. Sometimes a person might have to have a stay at a residential facility to get off the drug. Your general practice team can help by suggesting support groups and referring to specialist withdrawal services.

After treatment to safely withdraw from opioids, you may need ongoing opioid substitution treatment with drugs such as methadone or buprenorphine and naloxone.

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Written by HealthInfo clinical advisers. Last reviewed June 2023.

Sources

Page reference: 520830

Review key: HIADG-47857