Opioid Abuse & Treatment Options
What are Prescription Opioids?
Prescription opioids are commonly prescribed by doctors to treat moderate to severe pain. People may receive them to alleviate pain caused by cancer, injury, or surgery.1
Even though there is a lack of evidence to support their long-term effectiveness for other uses, such as chronic pain caused by noncancer conditions like osteoarthritis, they are frequently prescribed for these conditions, despite the risks associated with opioids.1
Prescription opioids are often misused for their pleasurable effects; anyone who uses opioids has a risk of addiction.1
Opioids are effective at alleviating pain because of how they affect the brain and body. You have opioid receptors in different locations around your body, such as in your brain, spinal cord and organs.2
Opioids attach to and act on these receptors by blocking pain signals and causing a surge in dopamine, a chemical in your brain that plays a role in regulating how you feel pain and pleasure, as well as influencing reward and motivation.2
This surge not only helps with pain relief but is also responsible for pleasurable feelings and helps your body associate taking an opioid with pleasure. The desire to keep feeling good and repeat the experience associated with opioids is a key reason why opioids can be so addictive.
Common Prescription Opioids
Doctors wrote more than 153 million prescriptions (nearly 47 for every 100 persons) for prescription opioids in 2019, making them one of the most widely used medications in the U.S.3 Many types of prescription opioids are commonly used in medical practice. Some of the most common prescription opioids used for pain relief include:4
- Hydrocodone (Vicodin).
- Oxycodone (OxyContin, Percocet, Percodan, Roxicodone).
- Morphine (Duramorph, MS Contin).
- Oxymorphone (Opana).
- Codeine (many brand names).
- Fentanyl (Actiq, Duragesic, Sublimaze).
- Hydromorphone (Dilaudid).
- Meperidine (Demerol).
Heroin and fentanyl are two opioids that can be very dangerous for people who are addicted to prescription opioids.
Heroin is a dangerous, illicit opioid drug that has no accepted medical use in the U.S. People who use prescription opioids risk developing an addiction to heroin.5
Around 4-6% of people addicted to prescription opioids transition to heroin. Additionally, around 80% of people who use heroin started by abusing prescription opioids.5
People may switch to heroin since it’s cheaper and easier to get than prescription opioids but produces similar effects.2
While fentanyl is a prescription medication that is sometimes used in hospital or emergency care settings for severe pain, it’s also associated with illicit use and overdose. It’s a synthetic, man-made opioid that is 50-100 times more potent than morphine, and it is commonly manufactured and sold illegally because it produces effects that are similar to but much stronger than heroin.6
Fentanyl or fentanyl-like substances (i.e., fentanyl analogues) are also frequently mixed with other drugs of abuse, including heroin, illicitly manufactured opioid painkillers, cocaine, and methamphetamine.
The presence of fentanyl is often unknown to the user and is done both to augment the effects of these drugs and because it can be cheaply produced. When a person using fentanyl-laced illicit drugs has no idea of what they are actually taking, it can lead to overdose and death.6
How Can I Identify Opioid Abuse?
Only medical or clinical professionals can diagnose someone with an opioid addiction, also known as opioid use disorder (OUD). However, there are some signs you can look out for that could mean that someone has a problem with misusing opioids. These signs can include:7, 8
Opioid Use Disorder Criteria
An OUD is a clinical diagnosis that means a person is no longer able to control their opioid use despite harmful consequences. A person who receives this diagnosis meets at least 2 of the following criteria over a 12-month period:9
- Using opioids in higher amounts or more frequent doses than you intended.
- Wanting to cut down or stop opioid use yet being unable to do so.
- Spending a lot of time trying to get, use, and recover from the effects of opioids.
- Cravings, meaning strong desires to use opioids.
- Being unable to meet responsibilities at work, home, or school due to your opioid use.
- Continuing to use opioids even though you experience ongoing problems in your relationships and social life that are probably due to opioid use.
- Giving up activities you once enjoyed so you can use opioids.
- Using opioids in physically dangerous situations (where you can cause harm to yourself or others, such as while driving.).
- Continuing to use opioids even though you’ve developed a physical or mental problem that you know is probably due to opioid use.
- Experiencing tolerance, where you need to use higher amounts or more frequent doses of the drug to achieve previous effects.
- Developing withdrawal symptoms when you try to stop using.
Misusing Prescription Medication
Misusing prescription medication means that you use a drug in a way that it’s not intended. This can mean continuing to take a medication when you no longer need it for medical purposes, taking someone else’s prescription (even if you have a legitimate problem that makes you feel it’s necessary), or using the medication to get high.
People may also say that a drug is used for nonmedical purposes when they refer to prescription drug misuse.10
What Are the Side Effects of Prescription Opioids?
Even when taken as directed by your doctor, you can experience unpleasant side effects of opioids. Opioid side effects can include:1
- Dry mouth.
Risks and Effects of Long-Term Opioid Use
With long-term use, prescription opioids can lead to:2, 11
- Tolerance, meaning that your body needs higher and/or more frequent doses to get the desired effects
- Dependence, meaning that your body has adapted to the presence of the drug and you need it to feel normal and to function.
- Increased pain sensitivity.
- An increased risk of falls and fractures (typically in older adults).
- Intestinal blockages, which can result in hospitalization and death.
- Respiratory effects like sleep-disordered breathing, sleep apnea, and hypoxemia (low oxygen levels in the blood). Opioids, particularly if you overdose, can also cause hypoxia, a condition that results when your brain does not receive enough oxygen. This can cause coma, permanent brain damage, and even death.
- Low testosterone levels, which can cause low sex drive, reduced energy, and diminished strength.
- An increased risk of cardiovascular events, such as heart attack and heart failure, when opioids are used over long periods of time.
- Mental health risks like depression.
- Suppressed immune system when used long-term.
Signs and Symptoms of an Opioid Overdose
Anyone who takes prescription opioids is at risk of an unintentional opioid overdose, which could be fatal.12 You may have an increased risk of opioid overdose if you use other substances (including alcohol) with opioids, take high doses of opioids, take more of the drug than you were initially prescribed, take illegal opioids like heroin or fentanyl, are older than 65, or if you have other medical conditions, such as sleep apnea or kidney or liver issues.13
An opioid overdose can cause signs and symptoms such as:13
- Small or pinpoint pupils.
- Losing or complete loss of consciousness.
- Slow, shallow, erratic, or completely stopped breathing.
- Making choking or gurgling sounds.
- A limp body.
- Unresponsiveness or awake, but unable to talk/respond.
- Pale, blue, or cold skin.
- Slow, erratic, or absent pulse (heartbeat).
How Can I Get Help for an Opioid Addiction?
Recovery from opioid addiction is possible. Seeking opioid addiction treatment can help you or a loved one recover from opioid misuse or illicit opioid use. Common therapies and treatments that may be used include medications and/or behavioral therapies.2, 14, 15
Medications are often used to help control cravings, help prevent relapse, and ease unpleasant and uncomfortable withdrawal symptoms. These medications often include:15, 16, 17
- Methadone. This is known as a full opioid agonist, which means that it binds fully to opioid receptors, which helps to suppress withdrawal symptoms and alleviate cravings for opioids.
- Buprenorphine. This is a partial opioid agonist, meaning it partially acts on opioid receptors. It is effective at reducing withdrawal symptoms, cravings for opioids, and risk of opioid overdose.
- Naltrexone is an opioid antagonist, which blocks the effects of opioids, so you won’t experience effects if you use them. It is only used to help prevent relapse in people who have already completed detox.
Behavioral therapy may be used alone or combined with medications (called medication-assisted treatment). It can be done in one-on-one sessions with a counselor/therapist or in a group setting. Types of behavioral therapy include:
- Cognitive-behavioral therapy to help you make changes to the thoughts and behaviors that may have contributed to your addiction.
- Motivational interviewing to help increase your motivation to make positive life changes.
- Contingency management, a rewards-based treatment that involves providing tangible goods and positive reinforcement for behavioral change.
Detoxing from Prescription Opioids
Methadone and buprenorphine may be started during medical detox, which is typically the first step in treating an opioid use disorder. Medical detox from prescription opioids is a beneficial way to help you safely and comfortably stop using opioids and manage your withdrawal symptoms. You’ll receive medical supervision and support as you go through withdrawal.
River Oaks for Prescription Opioid Addiction Treatment
From safe medical detox through to inpatient and outpatient treatment and aftercare planning, River Oaks Treatment Center has many different options when it comes to treatment for prescription opioid addiction. Call our admissions navigators at or explore our treatments and facility below to learn more about us, our personalized treatment plans, and more.