If you’ve been paying attention, then you’re aware of the opioid epidemic that our country is facing. The World Health Organization estimates that 2 million Americans are addicted to prescription opiates at some level, meaning that there is a lot of information swirling around about opioid addiction and recovery. By the end of this blog, you should be able to separate the truth from the rumors and have a deeper understanding of opioid use disorder (OUD).
First, opioids include both prescription pain medicines and illegal drugs such as heroin. Though opioids can be prescribed by a doctor to treat pain, their misuse may lead to a dependency or addiction (also known as an opioid use disorder). When people suffer from OUD, they cannot abstain from using opioid substances and may engage in behaviors that interfere with daily life in pursuit of them. Uncontrollable cravings account for one of the obvious indications of OUD. Additional symptoms include:
- Changes in sleep habits
- Weight loss
- Frequent flu-like symptoms
- Decreased libido
- Lack of personal hygiene
- Changes in exercise habits
- Isolation from family and friends
- Stealing from family, friends, or businesses
- New financial difficulties 
What makes opioids so addictive?
When the body has a steady flow of opioids, it cuts down on its own opioid receptors and creates less endorphins. We’re born with natural endorphins and opioid receptors that are tied to our primitive survival paths, such as hunger and thirst. When someone stops taking opioids, the brain isn’t used to making its own receptors and thinks it’s not getting what it needs to survive. That’s when withdrawal kicks in, causing symptoms such as pain and vomiting.
Modern science does a great job with explaining addiction, but if you haven’t experienced it first-hand, it’s very difficult to imagine. Here’s an exercise that may help you understand opioid use disorder a little better.
Imagine you quit drinking water cold turkey.
Water is a must to survive and to feel healthy and normal, but what if you had to go without it for one day? Or two? Or three? Or more? Most of us haven’t experienced severe life-threatening dehydration. What do you think that would that be like?
Surviving one day is probably no big deal. Sure, you’re a little thirsty, but you’re not too distracted by it. Going into day two, though, your thirst is growing and your mouth is dry. While you’re still able to go about all the tasks of life, you find yourself thinking about water – a LOT – and with each hour that passes, you’re becoming more uncomfortable.
By day three and four, life is interrupted. Things are changing in your body and you’re really feeling it. You have a headache and you’re experiencing decreased urine output. Your desire for water is consuming your thoughts.
As the hours continue to morph into days, you get unbearably tired, sleepy, or even dizzy. Your mouth is sticky, and you’re becoming irritable and increasingly obsessed.
It’ll be horrible soon. You’ll get constipated, lightheaded, and you’ll feel your skin drying up. You’ll get muscle cramps, your blood pressure will drop, and you’ll have a rapid heartbeat.
As water deprivation continues, you’ll break into a fever, and then you’ll begin the process of dying. The word ‘desperate’ describes you and every fiber of your being.
On your mind is nothing but water. Not work. Not family. Not money. Water. It doesn’t even have to be clean. You’d drink from the toilet if you could.
How far do you think you would go to feed your biological need for water? Would you lie? Would you steal? Would you deceive the ones you love for just one sip?
Opioid addiction works in a similar way.
Once the body has become physically dependent, the brain will kick into survival mode when it’s not getting the one thing it believes it needs to survive. It will send out signals resulting in the symptoms that parallel the water example. Desperation will take over the mind and every physical sensation from head to toe.
Without the drug, you will believe you’re dying.
There are a small number of people who can overcome and survive these symptoms without assistance. Some might say, “I did it on my own, so you can do it.” But the fact is, what works for one person may not work for the next.
What does the road to recovery look like?
It’s usually a good idea to seek help when attempting to quit opioids. It’s estimated that most people who attempt to solve opioid addiction on their own will relapse in less than 30 days. Those who seek help usually fare better than those who go it alone because they receive unyielding support throughout the recovery process. However, many recovery programs rely only on abstinence and counseling to heal their patients. This is adequate for some, but other individuals may need additional help to control the withdrawal symptoms brought on by detox. These withdrawal symptoms can be eased and controlled with medication, also known as medication-assisted treatment (MAT).
There are a lot of opinions about which method is the better way to go, but let’s consider medication-assisted treatment. This type of treatment combines medications with counseling and behavioral therapies to treat the “whole patient.” Methadone, buprenorphine, and naltrexone are approved by the Food and Drug Administration (FDA) to ease withdrawal symptoms and stop overdoses. According to the Substance Use and Mental Health Services Administration (SAMHSA), these prescribed medications normalize brain chemistry, block the euphoric effects of opioids, relieve psychological cravings, and normalize body functions during withdrawal.
Medication-Assisted Treatment could help many people recover from opioid use disorder, but it remains highly underutilized. In fact, fewer than half of private-sector treatment programs offer medication for opioid use disorders, and of patients in those programs who might benefit, only a third receive it.
So, how did we get here?
The U.S. is currently experiencing its most significant substance use and overdose epidemic it has ever faced, and its beginnings can be traced to three distinct waves.
- The first wave began when there was an increase of opioid prescriptions in the 1990s. That’s when overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) began happening more frequently.
- The second wave started in 2010, with rapid increases in overdose deaths involving heroin.
- The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids – particularly those involving illicitly manufactured fentanyl (IMF).The market for IMF continues to grow, and today it can be found in combination with heroin, counterfeit pills, and cocaine.
Legitimate fentanyl is widely used as a viable pain relief medication, but when manufacturing isn’t well regulated, it can become very dangerous. Producing IMF is not an exact science, and it has been traced to foreign countries, such as China and Mexico, where the highest quality production standards aren’t necessarily practiced. In fact, it’s been determined that overdose and death can be caused by just taking 0.07 ounces (2 mgs) of IMF, depending on a person’s body size, tolerance, and past usage.
Now that we’re in the 2020s, IMF is continuing to haunt our opioid overdose statistics because of its potency and low cost. Drug dealers have been mixing fentanyl with other drugs including heroin, methamphetamine, and cocaine, increasing the likelihood of fatal interaction. It’s increasingly pressed into pills made to look like legitimate prescription opioids – leading to our rising stats for overdoses.
The US Drug Enforcement Administration (DEA) recommends that, unless a drug is prescribed by a licensed medical professional and dispensed by a legitimate pharmacy, you can’t know if it’s fake or genuine. And without laboratory testing, there’s no way to determine the amount of fentanyl in an individual pill. This is especially dangerous because of fentanyl’s potency.
Hopefully, you now have a better understanding of opioid use disorder and how it’s become so dangerous. Some develop the disorder because of bad decisions, but a growing number of those affected by the condition find themselves addicted by something as innocent as a painful injury or surgery.
When you encounter someone fighting opioid use disorder, it’s important to understand that addiction isn’t always something that can be easily turned off. By offering your support to those in recovery, you’re helping to ease the stigma attached to seeking help. Stigma can manifest itself in a variety of ways, including the loss of a job or family members, disrespect from friends and medical personnel, and low self-esteem. It’s this stigma that keeps so many individuals fighting opioid use disorder away from recovery programs. Programs such as Crossroads offer medication-assisted treatment and concentrate on treating the “whole person.” With more than 120 locations across 10 states, there’s probably a Crossroads clinic near you. If you or someone you know is battling opioid use disorder, help is just a call away. Most appointments can be made within 24 hours, and our services are covered by Medicaid, Medicare, and most major insurance companies.
Contact Crossroads anytime at 800-805-6989.
-  “24 Shocking Opiate Addiction Recovery Statistics.” HRF, 23 Oct. 2014, https://healthresearchfunding.org/24-opiate-addiction-recovery-statistics/.
-  Signs of Opioid Abuse (hopkinsmedicine.org)
-  “Medication-Assisted Treatment (MAT).” SAMHSA, https://www.samhsa.gov/medication-assisted-treatment.
-  NIDA. “Overview.” National Institute on Drug Abuse, 2 Dec. 2021, https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/overview Accessed 20 Jul. 2022.
-  “Opioid Data Analysis and Resources.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 June 2022, https://www.cdc.gov/opioids/data/analysis-resources.html.
-  Facts about Fentanyl (dea.gov)