Opioid Use Disorder | Risk Factors, Diagnosis, Symptoms, & Treatment

The opioid epidemic has become a public health crisis in the United States over the past three decades. Opioids are highly addictive substances and heavy or frequent use can result in opioid use disorder (OUD). 

Treatment for OUD should be comprehensive and personalized for each individual’s needs. A combination of medication, therapy, and 12-step groups can be highly effective for treating OUD.

What Are Opioids?

Opioids are naturally occurring opiates and synthetic opioids, including illicit drugs and prescription drugs. Prescription painkillers are most often prescribed to treat severe or chronic pain.

Opioid drugs include the following:

• heroin
• oxycodone
• fentanyl
• codeine 
• morphine
• hydrocodone 

Opioids bind to opioid receptors in the central nervous system, which can relieve pain and produce a euphoric “high.” The euphoria and relaxation associated with opioids contribute to their risk for abuse and dependence. 

Risk Factors For Opioid Use Disorder

Despite the stigmas that exist about addiction, substance use disorders (SUD) can happen to anyone. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), both recreational and prescription opioid use increases your risk for developing an addiction. 

Risk factors for OUD may include:

• seeking multiple opioid prescriptions from different clinicians
• self-medicating 
• taking opioids for the euphoric effects
• history of alcohol or drug abuse

Opioid Use Disorder Diagnosis & Symptoms

Also known as opioid addiction, OUD is characterized by the compulsive use of opioids despite negative consequences. The American Psychiatric Association includes OUD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 

According to the American Psychiatric Association (APA), OUD is characterized by repeated use of opioids within a 12-month period along with at least two of the following symptoms:

• taking increasingly higher amounts of opioids 
• inability to stop using opioids, despite a desire to stop
• spending excessive amounts of time getting and recovering from opioids
• intense cravings
• opioid use interferes with work, school, or family 
• problems with relationships
• less interest in other activities
• continued use despite health problems
• increased tolerance
• withdrawal 

Chronic opioid abuse can result in increased tolerance and physical dependence. Once you are dependent, you will likely experience opioid withdrawal symptoms when you stop. 

Although withdrawal is a symptom of OUD, dependence is not the same as addiction. OUD requires at least one other symptom for a mild diagnosis and six or more symptoms for a severe diagnosis.

Opioid Overdose

Opioids lower heart rate, blood pressure, and breathing, and high doses can result in respiratory depression. 

OUD affects millions of people worldwide and contributes to thousands of overdose deaths each year. The risk of drug overdose increases when opioids are taken in combination with alcohol or benzodiazepines. 

If you think a loved one may be experiencing an opioid overdose, contact emergency services immediately. You can also administer Narcan (naloxone) while you wait for help to arrive. Learn more about opioid overdose risks here.

Opioid Use Disorder Treatment

If you think you or a loved one may have an OUD, there is a wide variety of services available for treatment. Addiction treatment should be comprehensive and tailored to each person’s individual needs. 

Treatment programs usually involve a combination of medication, therapy, and support groups. Addiction education can help people learn to identify triggers, which can help decrease the risk of relapse and overdose.

Treatment of opioid use disorder may include:

Detox

Opioid dependence may require professional help in a detoxification center. A detox program provides 24/7 supervision and monitoring of withdrawal symptoms. You may also receive medications to ease severe withdrawal symptoms. 

Medication-Assisted Treatment (MAT)

MAT programs provide medication along with therapy for an effective treatment approach. These FDA-approved medications replace opioids with long-acting but less euphoric opioids. Maintenance therapy requires frequent appointments but can improve quality of life and reduce cravings. 

Methadone Treatment

Methadone is an opioid agonist, meaning it binds to the same opioid receptors as other opioid drugs. Methadone can help block euphoric effects and decrease opioid cravings. In addition, methadone maintenance reduces the spread of infectious diseases, like HIV and Hepatitis C. 

Buprenorphine Treatment

Buprenorphine is a partial opioid agonist and although it activates opioid receptors, it does so to a lesser extent than other opioids. 

According to the Centers for Disease Control and Prevention (CDC), physicians who specialize in addiction psychiatry or are specially certified can prescribe buprenorphine.  

Sometimes, buprenorphine is combined with naloxone. Naloxone is an opioid antagonist and blocks the euphoric effects of other opioids. Buprenorphine and buprenorphine/naloxone (Suboxone) reduces cravings and the risk of an opioid overdose. 

Inpatient/Residential Program

Inpatient rehab provides a highly structured program that removes you from triggers and unhealthy environments. You are surrounded by peers and staff that are focused on recovery. 

During treatment, you may receive behavioral therapy, group therapy, and support groups. You may also be introduced to holistic activities, like yoga and meditation. 

Outpatient Program

Outpatient programs allow you to continue to live at home and travel to weekly treatment sessions. A healthcare provider will create a treatment schedule that may include group therapy, family therapy, and behavioral therapy. 

Support Groups

Support groups, including Narcotics Anonymous and other 12-step programs, provide a supportive community of people focused on recovery. 12-step programs are a beneficial addition to any treatment plan and can benefit long-term recovery. 

If you would like to know more about opioid use disorder treatment, please contact Ark Behavioral Health today.