Opioid addiction progresses quickly and intensely. Many individuals start out abusing opioids in order to feel their effects a little more strongly or just to have fun. They tell themselves that this is a one-time thing or that they will not let themselves become addicted to the drug. Over time, opioids act on a person’s brain so that the individual craves them. The person will start to want them all the time, to think about them and how to get more constantly, to be willing to do anything to get another fix. This is when addiction sets in.
The progression of opioid addiction is just as fast as it is dangerous, which both depend on how often a person is abusing opioids and how high their doses are. However, these can both change over time and, with higher and more frequent doses, the person is only more likely to become addicted.
The Potential of Opioid Addiction
According to Harvard Medical School, “Opiates are outranked only by alcohol as humanity’s oldest, most widespread, and most persistent drug problem.” They are incredibly addictive when abused, extremely likely to cause both dependence and tolerance (and may even cause these in individuals who don’t abuse them), and have the potential of causing harm to people who take them nonmedically. Any time you take opioids without a doctor’s prescription, in higher doses than prescribed, or more frequently than prescribed, you are abusing them.
Abuse is what leads to opioid addiction. Usually, someone who takes their medication as directed will not become addicted. But the progression of addiction is fast, so it is important to realize how possible it is to go from a non-addicted individual to an addicted one and to use opioids as safely as possible.
Opioids and the Brain
Opioids act on the brain in such a way that they actually come to change the way it works over time. According to the NIDA, “Heroin [as well as other opioids] produces euphoria or pleasurable feelings and can be a positive reinforcer by interacting with the reward pathway in the brain.” When opioids are abused, they create these feelings and can actually change the reward pathway, making it so that they are a feeling that the brain begins to constantly and consistently want.
If an individual is taking their medication as prescribed, this can lead to some of the issues below. But once the individual deviates from their prescription, they open themselves up for the possibility of addiction. In addition, anyone who abuses opioids (prescription or illicit) is also open to the possibility of addiction as these drugs are intensely habit-forming.
When someone becomes dependent on opioids, they will not feel normal without them. This occurs in both individuals who abuse opioids and those who do not. After someone has been taking opioids consistently for a while, it occurs. Sometimes this process takes a month, sometimes more than one. According to the NLM, “The time it takes to become physically dependent varies with each individual.”
The issues commonly associated with dependence on opioids are:
- Withdrawal symptoms that include muscle pains and aches, flu symptoms (runny nose and the like), vomiting, and diarrhea. These symptoms can be incredibly painful and intense.
- The inability to get through a difficult work day, meeting, or issue without the use of opioids
- The desire to take opioids often
- A discomfort or anxiety when unable to take opioids right away
- An inability to feel like oneself when unable to take opioids
Some people might even start to ignore the other things that used to be important in their lives in favor of taking opioids. This kind of behavior can be incredibly dangerous and often leads to addiction.
Dependency and tolerance are commonly experienced around the same time by individuals who have been taking opioids for a prolonged length of time. Tolerance may be noticeable first or dependency might, but either way, they will both usually occur after a certain amount of time.
A person who becomes tolerant to opioids will want to take more of them than they have been previously, and this feeling will be difficult to ignore. According to the NIDA, tolerance occurs when “a higher dose is required to achieve the same effect” that the original dose used to achieve. The individual will not feel the same pain-reducing effects that they once did or the same euphoric effects when taking the same dose.
It can be incredibly difficult for someone not to take more opioids at this point. But this is also what leads to addiction.
Actions Resulting from Dependence and Tolerance
Someone who becomes tolerant to and dependent on opioids is not necessarily addicted. Their actions are what will lead them into full-blown addiction at this point. If the individual decides to talk to their doctor about their issues with opioids or attend treatment for opioid detox and possible counseling, there is a potential that their opioid problems will not progress any further. However, the actions below will cause it to do the opposite.
- The individual decides to take more opioids than they were originally taking in order to combat tolerance. They realize they have to take more and more in order to do so and begin to constantly up their dosage.
- The individual takes more opioids because they feel that they need them.
- The individual starts breaking the law in order to get or abuse more opioid drugs. This can include stealing or faking prescriptions, doctor shopping, buying opioids illegally, or committing other crimes to get more of the drug.
- The individual becomes extremely secretive and does not want to discuss their drug use with anyone. They start hiding it from family members and friends, lying about where they go and trying to conceal all signs of their drug use.
- The individual’s drug use becomes more important to them than other aspects of their life.
The progression of opioid addiction has completed when a person gets to a point where they cannot stop abusing the drug, even if they want to. They feel helpless and even extreme problems caused by their drug abuse will not make them able to stop. This is the most common progression of opioid addiction.