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Opioid addiction or abuse

Doctors prescribe opioids to treat strong pain. They're most often used in hospitals or hospices. They're used 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, due to the high they can give.

Sometimes a person is introduced to opioids by someone they know. This might be at a party or another fun 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 who have opioid addictions get opioids from their doctor. 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 suboxone are the only opioids that doctors can legally prescribe to people who are addicted. And 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. The drugs 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.

People can take opioids in different ways. They can be swallowed, inhaled, 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. Methadone relieves withdrawal symptoms but doesn't give a high.

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

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 (yet fatal) overdose.

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

Injecting drugs also has a high rate of infections like hepatitis B and C, and HIV and AIDS.

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

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

While high you could be physically or sexually assaulted.

Withdrawing from an opioid is usually extremely unpleasant. People addicted to opioids tend to use the drug more to avoid the withdrawal effect than to get a high. This is part of the awful downward spiral that opioid addiction can produce.

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.

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

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Written by HealthInfo clinical advisers. Page created November 2018.

Sources

Page reference: 520830

Review key: HIADG-47857