Due to the ongoing opioid crisis in the United States, identifying and diagnosing opioid use disorder (OUD) in affected persons has become more critical than ever. Discovering if, in fact, a loved one is engaging in opioid abuse or is suffering from an active addiction may be challenging initially. Ascertainment can involve many factors that rely on the close monitoring of signs, symptoms, and behavioral changes.
Opioids are a class of painkilling (analgesic) substances that can be via prescription or illicit and include hydrocodone, oxycodone, morphine, heroin, and fentanyl, among many others. Health providers often prescribe them legally for treating acute moderate-severe pain. However, due to their addictive nature, some persons have started to abuse them.
Others begin their opioid abuse with legitimately or illicitly obtained prescription drugs but switch to heroin or other hard street drugs when they can no longer afford or obtain their drug of choice. Tragically, many individuals experiment with heroin, which is more potent than most prescription opioids and can be addictive with remarkably little use.
Opioids act on the brain, the limbic system, and the spinal cord, attaching to receptors. This action produces an excessive amount of neurochemicals, such as dopamine, responsible for feelings of reward and well-being. It doesn’t matter whether we’re talking about medications or street drugs—the effects are similar, albeit varying in number and intensity.
The critical difference between these substances is their potentials for abuse, dependence, and addiction. Moreover, the more potent the drug, the higher the potential for addiction. The route of administration makes a difference, as well. Swallowing a pill is less likely to result in tolerance and dependence versus snorting or injecting a powder, which rapidly and more intensely reaches the brain.
Signs and Symptoms of OUD
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an opioid use disorder is defined as problematic opioid use that results in significant impairment or distress.
To qualify for a diagnosis of an opioid use disorder, an individual must experience two or more of the following symptoms (paraphrased) within 12 months:
1. The substance is used in higher amounts or for a longer time than initially intended.
2. The user has a persistent desire or engages in unsuccessful attempts to reduce or control a substance’s use.
3. A significant amount of time is spent pursuing the obtainment and consumption of drugs or recovery from substance use.
4. The individual is experiencing cravings to use opioids.
5. There is continued opioid use that leads to failure to fulfill important obligations at home, work, or school.
6. There is continual opioid use despite recurring social or interpersonal issues that result from this use.
7. Important social or recreational activities are neglected in favor of opioid use.
8. There is repeated opioid use in risky situations.
9. Opioid use is continued despite physical or psychiatric problems that develop as a result of use.
10. Tolerance occurs, which is a condition hallmarked by the need to take increasing doses of a drug to experience the desired effects or a mitigated effect from the same amount.
11. Uncomfortable withdrawal symptoms occur upon discontinuation of drug use.
An opioid use disorder may be considered mild (at least two symptoms), moderate (at least four symptoms), or severe (6 or more symptoms). A relatively mild disorder may be more indicative of abuse, whereas a severe condition would likely be considered full-blown addiction. However, these disorders exist on a spectrum, and like any chronic condition, the severity of symptoms may fluctuate over time.
The terms “abuse” and “addiction” may be a bit archaic compared to the more modern concept of opioid use disorder. These older terms are merely ways of expressing different degrees of how severe an individual’s issues are, how able or unable they are to control drug use, and how many adverse effects have occurred in one’s life.
Signs and Symptoms of Problematic Opioid Use
On top of the diagnostic criteria, other common signs and symptoms of opioid abuse or addiction exist, including the following:
- Impaired vision
- Gastrointestinal issues
- Dry mouth and nose
- Legal issues
- Financial instability and homelessness
- Track marks or sores near injection sites
- Emotional distress resulting from strained or broken relationships
- Anoxia or hypoxia (oxygen deficiency in tissues)
- Increased risk for suicidal thoughts or attempts
In addition to the effects mentioned above, users also tend to struggle with co-occurring mental health conditions, including anxiety, depression, bipolar disorder, post-traumatic stress disorder, and more.
Dependence and Withdrawal
Substance addiction alters how a person’s brain functions, particularly the reward behavior circuits. For chronic users, drug use impacts the entire body. Over time, chronic use results in dependence, a condition characterized by the body’s inability to function normally without the drug being ingested.
When a drug or alcohol-dependent individual attempts to cut back their dose or abruptly halts use, they will experience unpleasant and sometimes painful withdrawal symptoms, such as the following:
- Drug cravings
- Diarrhea and abdominal pain
- Nausea and vomiting
- Body aches and pain
The duration and magnitude of withdrawal symptoms vary between individuals and largely depends on the length and intensity of use, in addition to other factors. The withdrawal process can be difficult to endure and can persist to some degree for several days.
The Treatment Process
Most addiction treatment facilities, such as Just Believe Recovery, tailor their treatment programs to meet each individual’s unique needs and consider their history of drug abuse as well as overall mental and physical health. If you or a health professional has identified problematic opioid use in a loved one, it is probably time to consider treatment options.
Treatment for OUDs come in different formats, can last for various amounts of time, and can occur in a few different settings. However, according to experts, integrated, long-term evidence-based mental health care is the most effective approach. It has been clinically shown to produce better outcomes for individuals in recovery over an extended period.
With the addition of behavioral therapy, individual and family counseling, group support, and other therapeutic methodologies, the chances of successfully completing and sustaining recovery have vastly improved over the last few decades. Following medical treatment, thousands continue to be helped by traditional approaches to recovery maintenance, such as 12-step programs and mind-body connection strategies like mindfulness or yoga.
Get Professional Help Today
An opioid use disorder is not a mark of moral corruption or weakness—it’s a chronic and severe medical condition hallmarked by brain changes that occur due to prolonged drug use. Breaking free of addiction is a long-term, sometimes daunting process that requires patience, focus, and substantial support from health care providers and loved ones.
Just Believe Recovery center employs highly-skilled addiction specialists who deliver comprehensive, evidence-based services to clients with care and expertise. We strive to provide those we treat with the tools, resources, education, and support they so direly need to achieve abstinence and begin their journey to long-lasting wellness and sobriety.