Opioid drugs are a group of medications that are used to provide pain relief. When used as directed by a doctor, these medications can be safely used for both short-term pain relief, such as after an injury or surgery, and long-term management of severe chronic pain. However, misusing these pain pills to treat moderate to severe pain can lead to health complications, including drug abuse, drug dependence, and withdrawals. 

Please continue reading to learn more about prescription painkillers. We will talk about what you can do to use opioid pain medication safely. We will also list the steps you can take to avoid developing an opioid use disorder or experiencing an opioid overdose. 

What are opioid drugs?

Opioids are a group of drugs that are used for pain management. Some opioids, such as morphine (MS Contin, Kadian), are derived from the opium (poppy) plant. Other opioids are man-made in laboratories (for example, Duragesic, Actiq). Synthetic and semi-synthetic opioids like oxycodone (OxyContin, Percocet) and hydrocodone (Vicodin, Lortab) have a chemical structure similar to the opioids that are naturally derived from the opium plant. 

An opioid drug provides pain control by interacting with opioid receptors in the body. When the medication binds to an opioid receptor, it blocks pain signals. Opioids also trigger the release of endorphins, which are feel-good chemicals in the brain. This creates temporary but powerful feelings of pleasure and wellbeing. While this allows an opioid drug to relieve pain, it also makes the medication highly addictive. 

Why are prescription pain medications dangerous?

If you take opioid pain medication for an extended period to treat long-term pain, the body slows the natural production of endorphins. As a result, the same dose of opioid medications stops producing those strong feelings of wellbeing over time. A person then needs a higher dose to get the same effects. This is known as tolerance and is the first step in drug abuse. People who develop tolerance can feel driven to increase to high doses to keep feeling good.

What are withdrawal symptoms?

People who take prescription pain medications every day for a long time can develop drug dependence. This can be a psychological and physical dependence. Opioid dependence means when a person stops using an opioid drug after heavy or prolonged use, their body goes through withdrawal. The symptoms can range from mild to severe and even be life-threatening. 

Withdrawal symptoms are the body’s reaction to the discontinuation of opioid drugs. They do not occur due to mental weakness or lack of willpower. Withdrawal symptoms in people with an opioid use disorder can include agitation, anxiety, muscle aches, insomnia, abdominal cramping, nausea, vomiting, and runny nose. 

Opioid withdrawal symptoms can be dangerous. No one should attempt to quit using opioid drugs cold turkey. Doctors can help people with substance abuse disorders come off a drug gradually to avoid discomfort during drug withdrawal. 

How does opioid addiction develop?

Addiction or substance abuse is a mental health condition in which a person has a compulsive need for drug use. People with a drug dependence do not necessarily have a drug addiction. In other words, they cannot stop using an opioid drug or other drugs despite negative consequences on their health and other aspects of their life. 

Anyone who takes prescribed opioid medications is at risk of developing opioid abuse and opioid addiction. Indeed, addiction can develop even if you take the opioid medication exactly as prescribed by a pain physician. Whether or not a person will develop an addiction after opioid use is impossible to predict. It depends on various factors such as the dose (a higher dose is associated with a greater risk of opioid abuse and addiction), the duration for which opioids are taken, a person’s personal and family history of substance use disorders, and other factors.

Doctors are aware of the risks of drug addiction associated with opioid pain medication. Therefore, healthcare professionals only increase the dose or prescribe this type of pain medication for more than a few days only if it is medically necessary. To ensure you use opioids safely, your doctor will prescribe the lowest effective dose of the pain medication for the shortest period to treat acute pain. In general, healthcare providers will thoroughly assess the risks versus the benefits of opioid therapy before prescribing it to patients.

What are the short- and long-term effects of opioid abuse?

In the short term, opioids can cause drowsiness, confusion, nausea, constipation, and euphoria. They can also cause dangerous side effects like respiratory depression (slowed breathing) and decreased heart rate. An opioid overdose can lead to death. Researchers are also looking at possible long-term effects of opioids on the brain, including permanent damage.

Who is at risk of opioid addiction?

As noted, anyone can become addicted to opioids. But these drugs are most addictive when they are used by methods other than prescribed. For example, crushing, snorting, or injecting opioids can be life-threatening practices because they can rapidly deliver a very large dose of the medicine, resulting in an accidental overdose and death. Taking more opioids than the prescribed dose or taking it more frequently than prescribed also increases the risk of addiction.

Another factor that plays a role is the length of time for which a person takes the prescribed opioids. Research has shown that if a patient takes opioids for more than a short course of five days, the risk that they will still be on opioids a year later increases significantly. Notably, an addiction can develop quickly after just a few weeks or after many years of opioid use. 

Other factors — both genetic and environmental — also play a role in opioid addiction. For example, a young age, mental health problems like depression or anxiety, poverty, unemployment, a personal or family history of substance abuse disorders, and a risk-taking personality can increase the risk of developing an opioid addiction problem. 

Gender also plays a role. Women are at higher risk of opioid addiction for several reasons. One, women are more likely than men to have chronic pain and be prescribed opioid medications. Two, women may be biologically more prone to pain pill addiction than men.

I have chronic pain. How can I take painkillers without becoming addicted?
You can reduce your risk of becoming psychologically and physically dependent on opioid pain pills by following certain healthy habits such as:

• Give your doctor a list of all your other medications, including supplements.
• Take opioids exactly as prescribed by your doctor (do not take higher doses or take the medicine more frequently than prescribed).
• Never use someone else’s opioid pain relievers. 
• Never use prescription painkillers to get high.

Opioids are generally safe when used for 1-3 days to relieve pain, such as acute pain after an injury or surgery. You should work with your doctor to take the lowest dose possible for the shortest time.

If you or someone you love live with chronic pain and opioid medications are the only modalities of treatment that are effective, you should work closely with your care team, including a pain specialist. By doing so, in addition to opioids, your treatment plan will also include other non-pharmacological interventions such as physical therapy, chiropractic, aqua therapy, massage, and acupuncture. Your healthcare professionals can also prescribe non-opioid pain medications such as NSAIDs (non-steroidal anti-inflammatory drugs) or nerve pain medication such as gabapentin.

You can also help protect your family members and your community by keeping opioid medications safe while you use them and disposing of expired or unused opioids through a drug take-back program. 

Remember that no one is safe from opioid abuse and addiction. If all opioid users recognize this, it can help to reduce the impact of opioid dependence in our communities and reduce the number of preventable opioid overdose deaths.

References

1. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
2. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270
3. https://medlineplus.gov/ency/article/000949.htm
4. https://archives.drugabuse.gov/blog/post/tolerance-dependence-addiction-whats-difference
5. https://www.drugabuse.gov/publications/drugfacts/prescription-opioids