Opioid Use Disorder
Condition
(OUD; Opioid Abuse; Opioid Addiction; Opioid Dependence)
Definition
Opioid use disorder (OUD) is when a person keeps using opioids despite the problems they cause with thinking, behavior, and the body.
Opioids are a class of drugs made from opium. Some like oxycodone are legally prescribed by a doctor. Others like heroin are illegal. They can be injected, sniffed, snorted, or smoked. Opioids are often mixed with other substances, including cocaine (called speedballing).
Causes
The cause of OUD not known. Things like genetics, the environment, and peer pressure may play a role.
Opioids help release chemicals in the brain that cause joy. Over time, you need more drugs to cause the same release. This leads to misuse.
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Risk Factors
Things that may raise the risk of OUD are:
- Anxiety, depression, loneliness, and past or current alcohol use disorder
- Misuse of medicines
- Family history of drug or alcohol use, or acting without thinking
Symptoms
OUD can lead to:
- Being unable to stop or limit use
- Craving the opioid
- Making a habit of using the opioid even though it causes problems
- Moving from one doctor to another to get more
- Fast increase in the amount of opioids needed
- Use that gets in the way of doing normal things
- Trying very hard to get more of the opioid
With regular use, the body begins to need the drug. Stopping or taking less of the opioid may cause nausea, vomiting, shaking, and sweating. This can make it harder to stop using it.
Diagnosis
The doctor will ask about symptoms, past health, and opioid use. A physical exam will be done. This is often enough to make the diagnosis.
Blood, urine (pee), saliva, sweat, and hair may also be tested to look for opioid use.
Treatment
The first step is to stop using opioids. This is also known as detox. The second step is to change behaviors to stop from using the drug again.
It can take some time to recover. Treatment may be given in a rehabilitation program. Many people may need to be treated several times. It may include one or more of the following:
- Medicines, such as:
- Buprenorphine
- Buprenorphine/Naloxone—a combined drug
- Methadone
- Naltrexone
- Therapy (individual or family)—to help a person learn:
- Coping and problem-solving skills
- How to replace opioid-use behaviors with healthier choices
- Support groups, such as Narcotics Anonymous—to support recovery from OUD
Prevention
The best way to prevent OUD is not to use opioids.
Family Doctor—American Academy of Family Physicians
National Institute on Drug Abuse
CANADIAN RESOURCES:
Canadian Centre on Substance Abuse
Centre for Addiction and Mental Health
Family Doctor—American Academy of Family Physicians
National Institute on Drug Abuse
CANADIAN RESOURCES:
Canadian Centre on Substance Abuse
Centre for Addiction and Mental Health
References
- Drugs, brains, and behavior: The science of addiction. National Institute on Drug Abuse website. Available at: https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction.
- Hall W, Doran C, et al. Illicit opiate abuse. National Center for Biotechnology Information website. Available at: http://www.ncbi.nlm.nih.gov/books/NBK11797.
- Kosten TR, Baxter LE. Review article: Effective management of opioid withdrawal symptoms: A gateway to opioid dependence treatment. Am J Addict. 2019 Jan 31.
- Opioid use disorder. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/opioid-use-disorder.
- Opioid addiction. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/opioid-addiction.
- Opioid withdrawal. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/opioid-withdrawal.
- Treatment approaches for drug addiction. National Institute on Drug Abuse website. Available at: https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.
Contributors
- Adrian Preda, MD
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