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Opioids are prescription and illicit substances that mimic the body’s natural opioids, which are involved in reducing pain and producing feelings of pleasure. This drug class includes natural opiates, which are derived from the opium poppy, as well as semi-synthetic and totally synthetic opioids that act similarly on the body. Although opioids are used in medicine to treat pain, they are also among the most addictive drugs of abuse. In the US, about one in 10 people will abuse opiates at some point in life. In addition, more than half a million people have used heroin within the last year. For many addicts, opioid dependence can be overcome with inpatient treatment. Below is more about the different types of opioids, their effects on users and society and the treatment available for addiction to these drugs.

Types of Opioids

Opioids are generally divided into the categories of natural opioids, usually referred to as opiates, semi-synthetic opioids and fully synthetic opioids. All of these substances work on the opioid receptors in the body, reducing physical and emotional pain, causing euphoria and reducing anxiety. However, individual drugs in these categories have specific effects that make them more or less common in medical treatment and among addicts:

  • Natural Opioids: Natural opioids are those found in the latex of the opium poppy. Morphine is the most powerful alkaloid in opium and is used in medicine throughout the world for reducing pain, such as during and after surgery. This drug was first used in the 1800s to replace crude opium extracts due to the ease of dosing and consistent effects of morphine.
  • Codeine: Another opioid present in opium poppy latex, is used in over-the-counter painkillers in many parts of the world, but it is available only by prescription in the United States. Although morphine is generally preferred by addicts for its strength, codeine is also commonly abused in pill form or in crude extractions created by addicts.
  • Thebaine: also found in the opium poppy, has poisonous effects in its natural form. As a result, it is not abused by addicts but is used to manufacture common semi-synthetic opioid painkillers that are addictive. These drugs include oxycodone, hydrocodone and buprenorphine.
  • Esters of Morphine: Although several esters of morphine exist, heroin is the best known and most widely abused. Originally designed to treat morphine addiction, heroin was soon found to be far more addictive than morphine, which heroin becomes once inside the body. The addictiveness of heroin is due to its ability to easily cross the blood-brain barrier, a property which allows it to produce much greater levels of euphoria much more quickly when injected, snorted or smoked. Heroin is no longer used in the United States to treat pain, but it is used in the United Kingdom for certain types of pain. Throughout the world, black-market heroin is notorious for causing severe addiction among drug abusers.
  • Semi-Synthetic Opioids: These drugs are produced in the laboratory from natural opioids, such as morphine, codeine and thebaine. Oxycodone, hydromorphone, oxymorphone and hydrocodone are examples of semi-synthetic opioids. Compared to heroin, semi-synthetic opioids are not as easily detected through conventional drug testing. Widely prescribed in medical settings, semi-synthetic opioids are also commonly abused by illicit drug users.
  • Fully Synthetic Opioids: These substances work similarly to natural opioids in the body, but they are completely different in terms of chemical structure. Examples of synthetic opioids are tramadol, methadone and fentanyl. Fentanyl is used for severe pain and has sometimes been used as an adulterant in heroin, which has resulted in epidemics of overdose due to its extreme potency in tiny amounts. Addicts sometimes use fentanyl patches in other ways as well. Tramadol is prescribed for pain and is considered moderately addictive. Methadone is sometimes used to treat chronic pain.

Medical Use and Addiction


In the past, many people viewed opioid addiction as largely occurring on the streets, away from the medical usage of opioids. Now, opioid addiction most commonly results after patients are prescribed opioids for pain. In fact, prescription opioid abusers are now outnumbering the number of addicts taking illicit opioids, such as heroin. Many states are seeing soaring numbers of deaths and emergency room admissions due to prescription opioid abuse. Between 2003 and 2009, Florida had an 84-percent rise in deaths due to these substances. Some doctors say that the epidemic of prescription opioid abuse is related to the widely held belief that patients should not experience pain, which has resulted in opioids being heavily prescribed in medical settings. Now, more prescription drug abusers are seeking inpatient treatment to combat their addiction.

How Opioid Addiction Develops

Many users first begin taking opioids casually with friends but progress to dependence and addiction over time. Because these drugs overload the opioid receptors in the brain, users experience extreme pleasure, comfort and feelings of well-being that many find irresistible from the beginning. Over time, however, the urge to take more becomes practically uncontrollable as users become unable to feel pleasure without opioid drugs. Side effects, such as nausea and irritability, often disappear as usage becomes regular. In addition, addicts experience potentially severe withdrawal symptoms when they attempt to stop using opioids.

Oral opioids, such as painkillers, are often the first forms encountered by addicts. This may be through medical treatment or casual recreation, but once addiction begins to grow, the waning effects of the drugs drive many users to pursue smoked, snorted or injected forms of stronger opioids. Some addicts crush prescription pain drugs, such as oxycodone, and snort them for faster and more intense effects. Eventually, some users progress to heroin for its stronger effects and lower price. Finally, injection becomes the favored method of usage for many long-term opioid addicts due to the fast onset of effects and greater cost effectiveness as less is necessary to get the high that addicts crave. Unfortunately, the greater intensity and faster onset of injected opioids also more easily condition the addict’s brain to use more of the drug and stay addicted over time.

Problems Caused by Opioid Addiction

Psychological and physical dependence begin soon after starting to use opioid drugs in many cases. The presence of tolerance is the first sign of addiction, requiring that users take more of the drug to get the same effects and avoid withdrawal symptoms. Soon, addicts find themselves taking higher dosages than they plan on using. It is not uncommon for a long-term opioid addict to use dosages that would be fatal for someone without a tolerance. More time is devoted to acquiring and using opioids, destroying the person’s ability to work and socialize effectively if at all. With opioid addiction, the long-term user completely loses the ability to enjoy any activity other than opioid usage. As a result, the user effectively becomes a slave to the opioids to which he or she is addicted.

If addicts stop taking opioids, they suffer a wide range of withdrawal symptoms affecting the mind and body:

  • Depression
  • Loss of pleasure
  • Anxiety
  • Anger
  • Irritability
  • Hallucinations
  • Diarrhea
  • Vomiting
  • Acid reflux
  • Fatigue

Because of the intensity of opioid withdrawal, many patients go back to using opioids soon after stopping. Even years after quitting opioids, many recovering addicts find themselves unable to stop thinking of opioids and may go back to taking the drugs again, resulting in a lifelong struggle to stay clean.

Besides withdrawal symptoms, opioid addicts may experience a number of health problems related to their addiction. Long-term opioid abuse suppresses the immune system, exposing the addict to infection and disease that can be fatal. HIV, hepatitis and blood infections are common among injection drug users, who may use and share dirty needles in their hurry to get a fix.

Friends, family and society also suffer from opioid addiction. Addicts may lie and manipulate to satisfy their intense cravings for opioids. In some cases, users engage in criminal behavior to get money for more opioids. Although some users are able to stay employed and maintain a facade of normality during opioid addiction, especially in cases of prescription opioid addiction, long-term heavy usage often takes its toll on addicts and their loved ones by causing antisocial behavior, destruction of relationships, and loss of productivity.

Inpatient Treatment for Opioid Addiction

The devastatingInpatient Treatment effects of long-term opioid addiction make inpatient treatment the only option for many addicts and their families. The intensive combination of detoxification, therapy and life skills training in a safe atmosphere allows many patients to successfully quit using opioids. Rehab centers vary in their techniques, but most programs consist of a few basic elements.

At the beginning of inpatient treatment, medical professionals screen patients for mental health issues that may contribute to their addiction. If depression, anxiety or psychotic disorders are found, medications may be prescribed to help patients stay off of opioids. Doctors and nurses are often on hand to monitor patients as the opioids leave their system.

Therapy in rehab centers usually combines individual and group counseling, an approach that offers more to addicts than either type on its own. One-one-one sessions with trained therapists are tailored to recovering opioid users’ individual struggles with addiction as well as any mental health issues. In group sessions, recovering opioid users develop a deeper understanding of their addiction and help each other through the struggle to quit abusing opioids. In addition, social support that develops in these sessions contributes to long-term success at treatment.

Life-skills training at rehab assists recovering opioid addicts in the process of re-learning skills that are lost during hardcore addiction to opioids. Time management, cooking, cleaning, and finding employment are common topics that are covered. As a result, recovering addicts are better able to adapt to sober life successfully after leaving rehab.

At the end of inpatient treatment, patients often receive extended outpatient counseling to help them stay off of opioids in the long term. This therapy supports recovering addicts as they are faced with opioids, users, and dealers that may stimulate feelings of temptation at home. Although some patients may only need outpatient counseling on a temporary basis, others may choose to continue these sessions indefinitely in order to stay off opioids and help deal with any mental health problems that complicate their struggle to stay clean.

The intensely addictive effects of opioid drugs, both illicit and pharmaceutical, makes them a major problem for individuals prone to drug addiction. In many cases, patients struggle with addiction to these substances throughout life after experiencing opioid dependence for any period of time. Fortunately, inpatient treatment offers a dependable solution to opioid addiction that can pay off with sobriety and better quality of life in the long term.

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