Explanation:
Opioids produce high levels of positive reinforcement, increasing the odds that people will continue using them despite negative resulting consequences. Opioid use disorder is a chronic lifelong disorder, with serious potential consequences including disability, relapses, and death. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition describes opioid use disorder as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:
Taking larger amounts or taking drugs over a longer period than intended.
Persistent desire or unsuccessful efforts to cut down or control opioid use.
Spending a great deal of time obtaining or using the opioid or recovering from its effects.
Craving, or a strong desire or urge to use opioids
Problems fulfilling obligations at work, school or home.
Continued opioid use despite having recurring social or interpersonal problems.
Giving up or reducing activities because of opioid use.
Using opioids in physically hazardous situations.
Continued opioid use despite ongoing physical or psychological problem likely to have been caused or worsened by opioids.
Tolerance (i.e., need for increased amounts or diminished effect with continued use of the same amount)
Experiencing withdrawal (opioid withdrawal syndrome) or taking opioids (or a closely related substance) to relieve or avoid withdrawal symptoms.
While opioid use disorder is similar to other substance use disorders in many respects, it has several unique features. Opioids can lead to physical dependence within a short time, as little as 4-8 weeks.2 In chronic users, the abruptly stopping use of opioids leads to severe symptoms, including generalized pain, chills, cramps, diarrhea, dilated pupils, restlessness, anxiety, nausea, vomiting, insomnia, and very intense cravings. Because these symptoms are severe it creates significant motivation to continue using opioids to prevent withdrawal.
As with other addictions, both genetic factors and environmental factors, such as ease of access, contribute to the risk of opioid use disorder. Access to prescription opioids and to heroin have contributed to the current opioid epidemic.2
According to the American Medical Association (AMA), an estimated 3 to 19 percent of people who take prescription pain medications develop an addiction to them.3 People misusing opioids may try to switch from prescription pain killers to heroin when it is more easily available. About 45 percent of people who use heroin started with an addiction to prescription opioids, according to the AMA.
More than half of people misusing opioid medications report 3
Obtaining them for free or stealing them from a friend or family member
Going to multiple doctors to get additional prescriptions
Filing prescriptions at different pharmacies so that no one will notice how many pills they get each month
