Opioid use disorder (OUD) is when a person keeps using opioids despite the cognitive, behavioral, and physical problems they cause.
Opioids are a class of drugs made from opium. Ones like oxycodone are legal when prescribed by a doctor. Others like heroin are illegal. They are often mixed with other substances, snorted, or used for the wrong reasons, such as to get high or to fall asleep.
The cause is not known. Things like genetics, the environment, and peer pressure may play a role.
How it Affects the Brain
Opioids help release chemicals in the brain that cause joy. Over time, you need more drugs to cause the same release. This leads to misuse.
Family history of drug use or acting without thinking
OUD can lead to:
Being unable to stop or limit use
Craving the opioid
Making a habit of using the opioid even though it causes problems
Moving from one doctor to another to get more
Rapid increase in the amount of opioids needed
Use that gets in the way of doing normal things
Using a lot of effort to get more of the opioid
With regular use, the body begins to need the drug to get through the day. A person may get sick when they stop or take less of the opioid. It may result in nausea, vomiting, shaking, and sweating. This can make it harder to stop using.
The doctor will ask about your symptoms and health history. You will also be asked about your use of opioids. A physical exam will be done. This is often enough to make the diagnosis.
Blood, urine, saliva, sweat, and hair may also be tested to look for signs of opioid use.
The first step is to stop using opioids. This is also known as detox. The second step is to change behaviors to stop from using the drug again.
It can take some time to recover. Treatment may be given in a rehabilitation program. Many people may need to be treated several times. It may include 1 or more of the following:
Medicines may be given to ease withdrawal symptoms and lower the risk of using again. Common ones are:
Buprenorphine/Naloxone—a combined drug
can help a person learn about the issues and lifestyle choices that lead to opioid use. This can help a person learn coping and problem-solving skills. A person can also learn how to replace opioid-use behaviors with healthier choices. Therapy sessions may be 1-on-1 or with a person's family.
Narcotics Anonymous is a 12-step program. It helps to support people who are recovering from OUD.
The best way to prevent OUD is not to use opioids.
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Hall W, Doran C, et al. Illicit opiate abuse. National Center for Biotechnology Information website. Available at: http://www.ncbi.nlm.nih.gov/books/NBK11797. Accessed September 2, 2020.
Kosten TR, Baxter LE. Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. Am J Addict. 2019 Jan 31.
Treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction. Accessed September 2, 2020.
Types of treatment programs. Principle of drug addiction treatment: A researched-based guide. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states/types-treatment-programs. Accessed September 2, 2020.
Last reviewed March 2020 by
EBSCO Medical Review Board
Adrian Preda, MD
Last Updated: 2/19/2021
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