Opiate Addiction/ Opioid Addiction

While opiates are prescribed to relieve acute pain, prolonged use can lead to opiate addiction (opioid addiction) and abuse. Common opiates include prescription painkillers such as dilaudidoxycodone, hydrocodone and fentanyl, as well the illicit drug heroin. Opiate addiction (including opioid addiction) is the leading cause of the drug overdose in the United States, with an estimated 20,101 deaths due to prescription painkillers and 12,990 deaths due to heroin use in 2015. Opiate addiction is a disease that has destroyed the lives and families of millions. While there is no cure for opiate addiction, this disease can be treated in drug addiction rehabilitation, or drug rehab.

To fully understand the depths of opiate addiction, including opioid addiction, it’s important to consider the intended use of these substances as well as what makes them so addictive.

Opiates are drugs used to treat pain derived from the opium plant. These substances are highly addictive, so they pose the threat of opiate addiction (including opioid addiction) to any person who takes the drug for a prolonged period of time. 

The Sumerians first cultivated the opium poppy plant, or Papaver somniferum, in 3,400 B.C. They referred to it as the “joy plant,” and the wonder drug was soon passed around the world as merchants learned of its multiple uses. Opium was not only used to relieve pain, for which it is still used today, but it was also used to induce sleep and give relief to the bowels. Opiates are also frequently used to treat coughs.

Doctors have been extracting a variety of active substances out of opium for medical purposes for many years. These ingredients occur naturally in the sap of the opium poppy. Natural derivatives of the opium poppy plant are called opiates. Opiates can be manipulated further synthetically. Such man-made opiates are called opioids. Collectively, these opiate and opioid derivatives of the poppy plant include morphine, codeine, oxycodone and heroin.

While there is no major difference in the effectiveness of the drugs, opioids are synthetic or partly synthetic drugs that are made in similar processes as opiates. In opioids, the active ingredients are synthesized by chemical processes. However, the two terms are often used interchangeably.

Nearly as long as the drug has existed, it’s been used both medicinally and abusively to get high. Opiates exist on the drug market in a few different forms — as prescription pharmaceuticals (morphine, codeine, methadone, etc.), and illicit street drugs (heroin, opium, etc).

All of these drugs can be abused, potentially leading to opiate addiction (opioid addiction), even if they are prescriptions. If you listen to drug dealers and opiate abusers speak, they may refer to all of these drugs using slang terms. These street names help evade police attention. Some of the street names for a variety of opiates include:

  • H
  • Hammer
  • Skag
  • Gear
  • Smack
  • Horse
  • Elephant
  • Rock
  • Nose drops
  • Black tar
  • China white
  • White
  • Chinese H
  • White dynamite
  • Dragon
Opiate pain medications are prescribed mainly to treat moderate to severe pain. In most cases, opiates are prescribed following a surgery or procedure of some kind. Common legal opiate drugs include:

  • Morphine is a highly addictive, naturally occurring substance found in the opium plant
  • Meperidine, similar to morphine, is a synthetic prescription medication that produces similar effects. 
  • Codeine, a less powerful but still addictive substance, is primarily used as a cough suppressant. Codeine is typically prescribed as a combination medication. 
  • Hydrocodone is a semi-synthetic opioid. It’s the most frequently prescribed opiate medication on the market, and its brand names include Lortab and Vicodin
  • Oxycodone is another semi-synthetic opioid. Common brand names are Percocet and Oxycontin.  
  • Fentanyl is a highly addictive opiate that is produced synthetically, so it is known as a synthetic opioid analgesic. Fentanyl is commonly prescribed as a skin, or transdermal patch.
Opiates can range in appearance. Drugs like oxycodone and hydrocodone come in pill form. Because they are prescribed in a formulation with acetaminophen or aspirin, different colors denote different strengths of the drug. These combinations are either in pink, blue, peach or yellow.

Opiates are usually swallowed as pills to treat pain. However, there are faster paths that addicted individuals may choose,  including:

  • Chewing the drug in order to increase absorption
  • Crushing and snorting pills for faster entry into the bloodstream
  • Dissolving crushed pills in water and injecting them intravenously

Individuals with an opiate addiction (opioid addiction) usually store their pills in traditional orange pill bottles or hide them in mint tins or candy jars. If the abuser crushes their pills and snorts them, they may keep the powder in small bags, twisted in a piece of cling wrap or in a foil pouch.

Many abusers begin their prescription opiate addiction (opioid addiction) with a legitimate prescription. Often, they will have had a surgery or illness that requires the medication, later becoming addicted to the drug. In some cases, this can lead to heroin abuse.

Heroin is derived from morphine and is typically sold in powder form. Heroin varies in color from white to brown. Besides powder form, heroin can also be found as granules and brown crystalline pieces known as “rock.”

Opiates are highly addictive drugs, making opiate addiction (opioid addiction) a very real possibility. When an abuser takes an opiate, the drug enters the brain through the bloodstream, creating a flood of artificial endorphins and dopamine — neurotransmitters responsible for feelings of reward, pleasure and satisfaction. This creates a rush of happiness and euphoria. This high is so unlike any naturally-occurring rush of dopamine or endorphins that the only way a person can experience it again is by using the drug again.

After repeated use, however, the brain will stop creating dopamine and endorphins, limiting a person’s ability to experience these feelings again to only when they use opiates. Because of the strong and desirable feelings that flood the brain, and because they cannot feel pleasure naturally any longer, it is easy to crave an opiate high. People choose to abuse opiates in order to lessen their pain and continue experiencing these euphoric feelings on demand. This is one of the main reasons opiates are so highly addictive and why opiate addiction (opioid addiction) is such a concern.

There are several steps toward developing opiate addiction (opioid addiction). The first is tolerance — when a person has to use increasingly larger doses of opiates to experience the same high. Next comes physical dependence, when the body will enter withdrawal if the abuser stops taking the drug. Finally, psychological dependence, or cravings for opiates set in — the hallmark of opiate addiction (opioid addiction).

Many people who are in the grips of opiate addiction (opioid addiction) become addicted unintentionally. For some, they begin using the drugs with a legitimate prescription in response to an accident or surgery that would have caused them pain. By the time they no longer need the drugs for their pain, however, opiates have taken hold in the brain and cause a physical dependence starting an opiate addiction (opioid addiction).

Some abusers will fake continued pain symptoms in order to get refills on their prescription, or “doctor shop” and visit different doctors to obtain multiple prescriptions at once. Prescription painkillers are also available on the black market or dark web, but can be very expensive.

For this reason, many who start their opiate addiction using prescription opiates will end up abusing heroin, as it is cheaper to use and easier to get a hold of. In fact, a survey in 2014 found that nearly all of the respondents in treatment for opioid addiction resorted to using heroin because prescription pills were more expensive and harder to obtain.

Long-term opioid use changes the way nerve cells work in the brain. This happens even to people who take opioids for a long time to treat pain, as prescribed by their doctor. The nerve cells grow used to having opioids around, so when they are taken away suddenly, the brain has a volatile reaction. This results in unpleasant feelings and reactions, known as withdrawal symptoms.

One of the hallmarks of opiate addiction (opioid addiction) is a person who abuses opiates even though it has admitted negative effects on their life. They have strong urges to take opiates — called cravings — and they no longer feel satisfied by natural rewards (like chocolate, sex, TV or a walk on the beach).

With stigma still being attached to the word “addiction,” many people avoid going to treatment and end up endangering themselves. We believe that there is no shame in opiate addiction, opioid addiction or any addiction — it is a disease. And, as with any disease, it requires medical care and attention. With the right course of action, detoxification, treatment plans and supervision from the best staff, you can put opiate addiction (opioid addiction) in the past and go about living a happy and successful life. There is no better time to seek treatment than now.


Ceida. “Opioids/Heroin.” Ceida, Ceida.net.au, www.ceida.net.au/depressants/heroin.asp. Accessed 19 Mar. 2017.
Foundation for a Drug-Free World. “What Does Heroin Look Like?” Foundation for a Drug-Free World, www.drugfreeworld.org/drugfacts/heroin/what-does-heroin-look-like.html. Accessed 19 Mar. 2017.
Rudd RA, Seth P, David F, Scholl L. Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015. MMWR Morb Mortal Wkly Rep 2016;65:1445–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm655051e1
The National Alliance of Advocates for Buprenorphine Treatment. “How Do Opioids Work in the Brain?” NAABT, 8 Dec. 2016, www.naabt.org/faq_answers.cfm?ID=6. Accessed 21 Feb. 2017.
Overdose Prevention & Education Network. “What is an Opioid?” OPEN – Overdose Prevention & Education Network, odprevention.org/what-is-an-opioid/. Accessed 21 Feb. 2017.
U.S. Department of Health and Human Services. “The Opioid Epidemic: By the Numbers.” HHS.gov, U.S. Department of Health and Human Services, June 2016, www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf. Accessed 21 Feb. 2017.
Volkow, Nora D. “America’s Addiction to Opioids: Heroin and Prescription Drug Abuse.” National Institute on Drug Abuse (NIDA), National Institutes of Health, 14 May 2014, www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse. Accessed 21 Feb. 2017.
Opiate Addiction
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