The Facts About Opioid Use Disorder

When used as directed, opioids can be effective for pain management. However, they are also highly addictive and can become lethal when taken in high doses.

The Centers for Disease Control and Prevention (CDC) defines opioid use disorder (OUD) as a "problematic pattern of opioid use that causes significant impairment or distress." Also sometimes referred to as opioid dependence or opioid addiction, OUD can lead to serious symptoms that include sexual dysfunction, depression and even death.

Anyone who takes opioids to manage pain should be under the close supervision of a doctor and should already be working on a plan to taper off the medication to prevent the development of OUD.

In 2017, the U.S. Department of Health and Human Services (HHS) declared the wide misuse of opioids—now known as the opioid epidemic—a public health emergency. Following the declaration, HHS announced a five-point strategy to combat the national crisis.

Data published by the HHS for 2019 indicates that more than 10 million people misused prescribed opioids during that year, while 1.6 million people had opioid use disorder. The data also found that 1.6 million people misused pain relievers for the first time, while 70,630 deaths were linked to opioid drug overdoses.

While the opioid crisis was announced relatively recently, the CDC stated that it began in the 1990s when pharmaceutical companies convinced lawmakers that narcotics weren't addictive. These drugs were heavily promoted to patients and doctors for prescription use.

But even then America was no stranger to opioids. The use and misuse of opium date back hundreds of years.

Opioids are used to treat moderate to severe pain and are often prescribed to manage pain after a serious injury or an invasive surgery with a potentially extensive recovery time. They are also used to mitigate pain in individuals with cancer.

So how do opioids treat pain, exactly? They work by relaying a signal to the brain that causes it to block pain sensations. They simultaneously cause some people who take them to feel calm, happy and even euphoric.

Opioids not only dull your perception of pain, but they can also increase your feelings of pleasure.

There are several different types of opioids, all of which must be prescribed by a doctor. Some examples of opioids include:

• Buprenorphine
• Codeine
• Fentanyl
• Heroin
• Hydrocodone
• Hydromorphone
• Methadone
• Morphine
• Oxycodone
• Oxymorphone
• Tramadol

Some opioids are made from compounds that naturally occur in a plant called the opium poppy. Others are made synthetically in a lab. Some opioids may contain a combination of synthetic and naturally derived ingredients.

Because of their highly addictive nature, anyone who takes opioids is at risk for OUD. In fact, the CDC reports that as many as 1 in 4 patients who take opioids long term may become addicted.

It's a common misconception that taking opioids means you will absolutely become addicted. Still, it is important to talk with your doctor about the safest and most sustainable way to manage your pain. The conversation should take into account that opioids may provide short-term relief but leave you vulnerable to long-term risks.

Opioids also have a high risk of OUD because your body's tolerance to opioids increases as you take higher doses. As a result, opioids can seem to make your chronic pain worse as they become less effective at treating it—all while remaining just as addictive.

As with any other type of addiction, a personal or family history of substance use, certain mental health issues, and other environmental and biological factors can put you at greater risk for developing OUD.

Taking opioids as prescribed can cause side effects that include:

• Confusion
• Constipation
• Dizziness
• Drowsiness
• Headache
• Nausea
• Respiratory depression
• Sexual dysfunction

When taken improperly, these drugs can result in coma and even death due to respiratory depression. Taking opioids for the long term, particularly misusing them, can lead to complications such as:

• Addiction
• Chronic constipation
• Female infertility
• Liver damage
• Worsened pain

Pregnant women experiencing opioid dependence can pass that dependence to babies, which carries with it the risk of severe withdrawal symptoms upon birth and even congenital defects.

Using opioids puts you at risk of developing opioid use disorder, but the risks don't stop there.

Opioid use can have a profound impact on romantic and sexual relationships due to the mental and emotional side effects. There are also physical side effects, such as male impotence and general sexual dysfunction.

Whether taken for a short time or for the long term, opioids have been correlated with an increased risk of mental health problems, such as depression, and even heart conditions. Opioids also carry the risk of liver damage, female infertility, coma and death.

In order to receive a diagnosis for OUD, an individual must first be thoroughly evaluated by a doctor, according to the CDC. The evaluation may include testing the patient's urine for drugs and reviewing prescription drug monitoring program reports.

Opioid use disorder can be diagnosed as mild, moderate or severe depending on the number of criteria met for the diagnosis. Treatment for OUD may vary depending on the severity of the diagnosis.

If you're struggling with opioid misuse, talk to your doctor about potential treatment options and lean on your support system, whether they be loved ones or a mental health professional. Hiding the symptoms of opioid use disorder can have deadly results. Build a strong support system outside of your doctor's office, including friends and family.

The safest way to avoid OUD is to take prescribed opioids for no more than three days for acute pain management and to take them at the lowest dose and for the shortest time possible, according to Mayo Clinic.

Opioids are unlikely to be safe or effective at treating chronic pain on a long-term basis. If you're struggling with chronic pain, talk to your doctor about less-addictive painkillers, nonpharmacological therapies and other pain management strategies, if possible.

Another way to prevent OUD is to keep prescribed opioids stored in a secure location to prevent them from getting into the wrong hands. Other medications, treatments and lifestyle changes can help mitigate chronic pain. There are also pain management alternatives that can be used during labor.

Medication-assisted treatment (MAT), which involves the use of medications in conjunction with counseling and behavioral therapies, can be used to treat OUD and other substance use disorders. MAT can be used to treat addiction to prescribed opioids and heroin.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the medication prescribed as part of treatment works by:

• Normalizing the brain's chemistry
• Blocking the euphoric feelings caused by opioids
• Providing relief from physiological cravings
• Helping the body function without the adverse effects of the opioids

Buprenorphine, methadone and naltrexone are the medications approved by the U.S. Food and Drug Administration (FDA) to treat addiction to opioids, including codeine, heroin, hydrocodone, morphine and oxycodone. Naloxone is another MAT drug used to prevent opioid overdose by reversing the toxic effects of an unsafe dosage that has already been taken.

Treatment plans can vary depending on the severity of an individual's OUD diagnosis. If you are struggling with opioid dependency, don't hesitate to talk to your healthcare provider about possible treatments.

Research has found that sexual dysfunction can occur as a result of a decrease in testosterone levels. The prolonged use of opioids at high levels is associated with lowered sperm count. Heavy opioid use has also been connected to DNA fragmentation in sperm.

Not only can opioid use cause erectile dysfunction (ED), it can lead to infertility.

Individuals who use opioids are more likely to experience conditions such as depression and heart problems, both of which may come with sexual health complications of their own. Before using opioids, it's important to know they can affect your mood and cause other side effects that may get in the way of maintaining meaningful relationships.

Living with OUD is neither a safe nor easy road. If you have OUD, you must seek treatment from a medical professional and support from friends and family. Recovery may not happen quickly or be easy, but it can be lifesaving.

Starting your OUD recovery journey can seem daunting, but identifying where you can get help can be a significant step forward. Recovery and treatment resources can be found through the National Institutes of Health, the CDC and SAMHSA, in addition to resources available to you locally.

What are 5 opioid drugs?

There are several different types of opioids, all of which must be prescribed by a doctor. Five of the most common examples of opioids include oxycodone, oxymorphone, hydrocodone, hydromorphone and fentanyl.

Are codeine and morphine opioids?

Codeine and morphine are opioids. According to the CDC, opioids are a class of drugs that include all-natural, semisynthetic and synthetic opioids. Other opioids include oxycodone, oxymorphone, hydrocodone, hydromorphone, fentanyl, morphine, codeine, methadone, tramadol, buprenorphine and heroin.

What plant is a natural painkiller?

Substances naturally occurring in the opium poppy plant can serve as natural painkillers. Opioids are drugs that either come from or mimic these substances to help the brain block pain signals from the body and boost feelings of pleasure.