Misuse, Addiction & Overdose
Misuse & Addiction
Opioids are highly addictive, in large part because they activate powerful reward centers in your brain called endorphins, your brain’s feel-good neurotransmitters. Endorphins muffle your perception of pain and boost feelings of pleasure, creating a temporary but powerful sense of well-being. When an opioid dose wears off, you may find yourself wanting those good feelings back even if you no longer “need” the medication for its prescribed use. This is how potential drug misuse, abuse, or addiction starts.
Anyone who takes opioids is at risk of misusing them, abusing them, or developing addiction. Many legally and appropriately prescribed prescription opioids are misused or diverted to others who then abuse them. Misusing and abusing opioids can lead to addiction. Doctors define drug addiction as an irresistible craving for a drug, out-of-control and compulsive use of the drug, and continued use of the drug despite repeated, harmful consequences. Opioids have a high potential and well-known history for causing addiction in some people, even when the medications are prescribed appropriately and taken as directed. Individuals who become addicted may prioritize getting and using these drugs over other activities in their lives, often negatively impacting their professional and personal relationships. It is unknown why some people are more likely to become addicted than others.Your personal history and the length of time you use opioids play a role, but we can’t predict who’s vulnerable to eventual dependence on and abuse of these drugs.
Opioids change the chemistry of the brain and lead to drug tolerance, which means that over time the dose needs to be increased to achieve the same effect. Taking opioids over a long period of time produces dependence, such that when people stop taking the drug, they have physical and psychological symptoms of withdrawal (such as muscle cramping, diarrhea, and anxiety). Dependence is not the same thing as addiction; although everyone who takes opioids for an extended period will become dependent, only a small percentage also experience the compulsive, continuing need for the drug that characterizes addiction.
Opioid addiction can cause life-threatening health problems, including the risk of overdose. Overdose occurs when high doses of opioids cause breathing to slow or stop, leading to unconsciousness and death if the overdose is not treated immediately.Opioids in particular pose a higher risk of overdose as they can depress the central nervous system causing breathing to slow, sometimes to the point of stopping altogether.
Both legal and illegal opioids carry a risk of overdose if a person takes too much of the drug, or if opioids are combined with other drugs (particularly tranquilizers called benzodiazepines). But it’s important to understand, overdose can happen to anyone-even first time opioid users.
Recognizing an opioid overdose can be difficult. If you aren’t sure, it is best to treat the situation like an overdose—you could save a life. Do not leave the person alone. Signs of an overdose may include:
- Small, constricted “pinpoint pupils”
- Falling asleep or loss of consciousness
- Slow, shallow breathing
- Choking or gurgling sounds
- Limp body
- Pale, blue, or cold skin
If you think someone is experiencing an overdose CALL 911 IMMEDIATELY and seek medical care for the individual.
Reversing Overdose with Naloxone
Naloxone is a non-addictive, life-saving drug that can reverse the effects of an opioid overdose when administered in time.
While naloxone has saved countless lives through programs that equip medical first responders and law enforcement groups, it is also important for community members to be aware and equipped with life-saving naloxone administration kits. This is particularly important in rural areas where EMS may take some time to arrive.
Good Samaritan Laws exist in many states. In the event of an overdose, these policies protect the victim and the person seeking medical help for the victim from drug possession charges. Learn more about access and use laws for Naloxone in your community at Prescription Drug Abuse Prevention System website.
- NIDA: Opioid Overdose Reversal with Naloxone (Narcan, Evzio)
- SAMHSA: Opioid Overdose Prevention Toolkit
- Time for Honest Discussions About Naloxone
- Naloxone Prescribing: 5 Things to Know
- PDAPS: Naloxone Overdose Prevention Laws By State
- Prevent & Protect: Resources for Providers, Families, and Communities