Opioid Addiction: 7 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Darcy Lewis on May 11, 2021
  • Young adults having a discussion during special group therapy
    Opioid Addiction: Successful Treatment Is Possible
    Opioid use disorder—the medical term for opioid addiction—is a major public health crisis in the United States. The Centers for Disease Control and Prevention (CDC) reports that more than 70,600 people died of drug overdoses in 2019. Of these, nearly 50,000 fatal overdoses were related to opioids, meaning more than 130 people in the U.S. die after overdosing on opioids every day. Many more—an estimated 1.7 million people in 2017—are living with substance use disorders related to prescription opioid pain relievers. If you or someone you care about is one of them, here’s what you should know about getting help for opioid use disorder.
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    1. “Know the signs of opioid use disorder.”
    Opioid use disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, as a problematic pattern of opioid use leading to problems or distress. People with opioid use disorder experience intense cravings for opioids. Other symptoms include taking larger amounts of drugs than prescribed or taking them for a longer time than planned. People with opioid use disorder are unable to cut down their opioid use and often develop problems honoring commitments at school, work or home. “There are patients who can take opioids long-term safely and reliably, but many can’t,” says Michael Fingerhood, MD, chief of the Division of Chemical Dependence at Johns Hopkins Bayview Medical Center in Baltimore. “Anyone who takes opioids for longer than a few days should expect their doctor to ask lots of questions about their lifestyle, level of functioning, and how opioids are affecting them.”
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    2. “You can have physical dependence on opioids without being addicted.”
    One reason opioids are so dangerous is that the pain-killing effects of opioids steadily diminish over time. That means you will need larger doses over time to get the same effect. It also means you will get withdrawal symptoms like nausea, vomiting, diarrhea and anxiety if you stop taking them suddenly. “If you take opioids for longer than about 10 days, your body becomes dependent on them and you must slowly taper the dose before stopping,” says Dr. Fingerhood. “This is not the same as opioid use disorder, which includes intense cravings for opioids as well as physical dependence.”
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    3. “Seek professional help to end your opioid addiction.”
    If you believe opioids have become a problem in your life, start by talking to your doctor. He or she can help you determine whether you are experiencing dependence or full-blown opioid use disorder, develop a drug-tapering strategy, and refer you to outside resources as needed. “As a family physician, sometimes I share my concerns about a patient’s opioid use and sometimes the patient brings it up first,” says Allen Schwartzstein, MD, of SSM Health Dean Medical Group in Madison, Wis. “Then we’ll have a calm, non-confrontational discussion about treatment options. A trusting doctor-patient relationship goes a long way.”
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    4. “Opioid treatment programs don’t just trade one addiction for another.”
    The U.S. Food and Drug Administration (FDA) has approved several medications that treat opioid use disorder effectively. Methadone, buprenorphine and lofexidine reduce withdrawal symptoms and drug cravings. Naltrexone blocks opioid drugs from producing any feel-good effects. Each drug offers various pros and cons. “The most important message here is that you are absolutely not trading one addiction for another by using medication to treat opioid addiction,” says Dr. Schwartzstein. “People should not be afraid to try medication.”
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    5. “A multifaceted approach is best for treating opioid addiction.”
    For the best results in treating opioid use disorder, the National Institute on Drug Abuse recommends medication assisted treatment (MAT), in which appropriate medications are combined with behavioral counseling tailored to meet your individual needs. Vinay Shah, MD, an internist at Henry Ford Hospital in Detroit, agrees a team approach is best. “When I identify a patient with opioid use disorder, I can refer them to experts in my clinic including addiction specialists, psychologists, pharmacists, and case workers,” he says. “And I will still be there to handle their overall medical care.”
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    6. “Opioid addiction can be treated on an outpatient basis.”
    Years ago, the only way to get treated for opioid use disorder was to leave daily life behind and check into an inpatient facility for days or weeks. Today, there are more options. “More family doctors are willing and able to treat addiction in the office, thanks to medications like buprenorphine,” says Dr. Schwartzstein. “I’m happy to refer patients for inpatient treatment, but I’ve found that most of my patients prefer to receive in-office, community-based care for opioid use disorder.”
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    7. “Carry naloxone with you if you take opioids.”
    Naloxone (Narcan) is a drug that can reverse an opioid overdose within seconds. It is available as an injection and a nasal spray. First responders like police officers and emergency medical technicians typically carry it with them. It is available everywhere by prescription. Both CVS and Walgreens now allow consumers to purchase naloxone without a prescription in nearly every state.

    If you take opioids for chronic pain, your doctor may write you a prescription for naloxone to keep with you at all times. If not, ask about it. “My computer system issues an automatic reminder for me to prescribe naloxone whenever I prescribe an opioid,” says Dr. Fingerhood. “We talk about making sure patients and family members know how to use naloxone.” He adds, “It’s important to realize that not everyone who dies of an opioid overdose has opioid addiction,” which is why anyone taking opioids should be prepared to respond to an overdose.
Opioid Addiction: 7 Things Doctors Want You to Know
  • Michael Fingerhood, MD - Healthgrades - Opioid Addiction: 7 Things Doctors Want You to Know
    Chief of the Division of Chemical Dependence, Johns Hopkins Bayview Medical Center, Baltimore, Md.
  • Allen Schwartzstein, MD
    Family physician at SSM Health Dean Medical Group, Madison, Wis., and board member, American Academy of Family Physicians.
  • Vinay Shah, MD

    Internist, Henry Ford Hospital, Detroit, Mich.

About The Author

  1. Drug Overdose Deaths. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/data/statedeaths.html
  2. Effective Treatments for Opioid Addiction. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction/effective-treatments-opioid-addiction
  3. Medications to Treat Opioid Use Disorder. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work
  4. Opioid Overdose Crisis. National Institute on Drug Abuse. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
  5. Opioid Use Disorder. American Psychiatric Association. https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder/opioid-use-disorder
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Last Review Date: 2021 May 11
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