Opioids are both addictive drugs and powerful painkillers. They can create euphoric effects in the short term. This is why people may seek them out without a prescription. However, as people take potent opioids for longer periods, they start to become chemically dependent. This means they’ll start to have withdrawal symptoms when they stop taking opioids.
A psychological dependence on opioids, which may affect multiple areas of a person’s life, is known as opioid use disorder (OUD). It’s not only a matter of behavior and control. There is some evidence that certain people have a genetic predisposition to OUD.
Learning about the science of opioids and addiction can help you make well-informed decisions that support the life you want to live. In this blog post, we’ll talk about how opioid painkillers work and why they are so addictive.
What are opioids?
Opioids are prescription medications and other types of drugs that interact with the brain’s opioid receptors. Some are derived from the opium poppy plant and some are semisynthetic or fully synthetic. They’re used to treat postsurgical pain, severe pain due to trauma or disease, and symptoms like coughing and diarrhea. Prescription opioids and illicit substances are chemically similar. Both are used (by some people) recreationally for their euphoric effects, which can lead to addiction. Withdrawal from potent opioids is very uncomfortable. Maintaining an opioid addiction can make people act impulsively. This may create financial hardship and threaten a person’s relationships. It comes with many risks, including a high risk of death by overdose.
How do different types of opioids work?
The one thing that all opioids have in common is that they bind to opioid receptors in the brain and body. This disrupts the brain’s awareness of pain and creates euphoric effects. When these receptors get accustomed to a lot of stimulation, the person becomes chemically dependent on opioids. They will start to feel negative effects or withdrawal symptoms when opioid levels in their bodies decrease. Some activate these receptors to different degrees, and others don’t activate them at all.
Opioids may be delivered orally, via a skin patch, under the tongue, or by injection. Some are helpful in reducing withdrawal symptoms in OUD and preventing overdose. Buprenorphine and methadone activate opioid receptors without creating as much of a high, so they are used for this purpose.
There are three types of opioids:
- Full agonists — Full agonists bind to opioid receptors in the brain and activate them. Some examples are heroin, oxycodone, fentanyl, and methadone.
- Partial agonists — Some medications used to treat OUD are partial agonists that activate opioid receptors to a lesser degree. Buprenorphine is a partial opioid agonist.
- Opioid antagonists — Opioid antagonists bind to receptors without activating them. Medications like naloxone or Narcan are in this category. This type of medication acts fast, so it blocks partial and full agonists. It has the effect of temporarily reversing overdose.
What are the effects of opioids on the brain and body?
The primary effects of opioid agonists are relieving pain and creating different levels of euphoria. They may also induce light sleep and relieve cough and diarrhea. Opioids can cause side effects such as nausea and constipation. At high, unmonitored doses, they can cause central nervous system depression, which can be fatal. This is when breathing slows or stops, depriving the brain of oxygen. Opioid antagonists block the effects of other opioids to reverse overdose.
People typically develop a tolerance for opioids over time. In other words, they need higher doses to feel the same effects. As a person’s tolerance for opioids increases and they develop a chemical dependence, they may feel unable to stop. Withdrawal effects are a long-term consequence of opioid use that ultimately keeps people addicted. In some cases, people can also become sensitized to opioids with repeated use. This is sometimes called “reverse tolerance.”
The following are some potential effects of opioids:
- Pain relief
- Drowsiness or sleepiness
- Confusion
- Nausea
- Vomiting
- Constipation
- Euphoria
- Relaxation
- Slowed breathing
What makes opioids so addictive?
Like other addictive substances, opioids create both positive and negative reinforcement. They have immediate, short-term positive effects, and people can become dependent very quickly. The combination of euphoria or sensitization to opioids and the effects of withdrawal are what keep people addicted. To ease withdrawal symptoms during recovery from OUD, most people need to take medications for opioid use disorder (MOUD).
The following are some symptoms of opioid withdrawal:
- Sweating
- Chills
- Muscle aches
- Abdominal cramping
- Anxiety
- Agitation
- Nausea
- Vomiting
- Insomnia
Access to different types of opioids can affect people’s behavior. For instance, a large number of people who use heroin started with prescription opioids. Heroin is often cheaper and more easily attainable. That’s not to say that this is a common phenomenon — the percentage of people who start taking illicit drugs after using prescription opioids is small. For those who are at a higher risk of addiction, this is something to be aware of.
Some risk factors for OUD include:
- Access to and availability of opioids
- Current or past substance use disorder
- Exposure to substance use and family history
- Having a mental health condition
- History of trauma
Groups provides opioid use disorder treatment for the whole person
Each person who experiences OUD has a unique and complex relationship with opioids. For the best outcomes and long-lasting recovery, treatment for OUD needs to be personalized. Approaches that feed into the stigma of opioid use and shame people for using aren’t nearly as effective as those that emphasize education and personal agency. At Groups, we help people reimagine their future and start their next chapter of life on their own terms.
After experiencing opioid addiction, a person’s risk of using again increases. Limited access to resources, financial strain, unemployment, and family history of substance use are also important factors. Building up positives early in recovery is just as important, if not more important, than abstinence. Our programs combine MOUD with one-on-one counseling and peer support. This three-pronged approach gives members the comprehensive support they need to change their lives for the better.
Are you considering treatment for OUD or concerned about a loved one? Give our Recovery Support Specialists a call today. If Groups doesn’t offer treatment in your state, you can locate other treatment options here.
