Opioid addiction has been hitting the headlines with increasing frequency as a result of more deaths and prominent celebrities admitting to using the drugs and going into rehab in order to recover from their addiction. But it is important to distinguish between opioid abuse and opioids addiction. Studies have shown that addiction can arise from abuse, but opioid abuse is not the same as opioid addiction.
Abuse can be broadly defined as any illegal or unintended use of over the counter, prescription, or illegal drugs. Abuse can take various forms, such as taking much larger doses than usual, or taking the medication for the purpose of altering mood or “getting high.” In the case of opioids, for example, they create a pleasurable effect. Therefore, while they are normally used as painkillers or cough suppressants, they are often taken to get high. Studies have shown that the majority of those who go to rehab for prescription opioid addiction never even had the medicine prescribed to them. Sharing and even stealing drugs are common for the purpose of drug abuse. Nearly 260 million prescriptions for opioids were written in the US in 2016—that’s 1 bottle of pills for every American adult, which leaves the door wide open for abuse. Teens also commonly abuse cough syrups and cold medicines. Codeine is considered a “mild” opioid, but its wide availability has made it easy to abuse. Cough syrups will often contain alcohol as well, leading to alcohol abuse. Abuse can also take the form of misusing the drug. One example would be people who grind up opioid pills, dissolve them in water, and inject them. This gives them a faster and more intense high similar to heroin (which is also derived from the opium poppy, just like opioids), but can lead to heart issues, blood clots, severe infection and death.
Addiction can arise as a result of abuse, but not all addicts abuse the drug. Opioids are highly addictive because they “re-wire” the brain in terms of the pain it feels, and the pleasure. Pain is deadened, while a feeling of happiness and well-being is increased. The pleasure felt leads to a desire for “reward” in the form of taking the drug again. Opioids also change the synapses in the brain, which send signals from one brain cell to the next. Studies have shown that “re-modeling” of the brain and addiction can occur in as little as 3 days for some people depending on the opioid and the dosage. Addiction is characterized by the person becoming more and more dependent upon the drug, to the point where they can’t function without it. This will usually be a physical addiction, but can be a psychological one as well, in which the person feels they “can’t cope” without their medication. The physical and psychological nature of the addiction can make it difficult for addicts to recover, especially if they are dealing with very real pain from arthritis or cancer, for example. In general, an addiction is defined as the opioid having such power that it becomes more important than anything else in the person’s life, including job, family, friends, money, or even eating, and sleeping.