When people think of opioid use problems or addictions, they may think of street-obtained, or "street" opioids, such as heroin or fentanyl. However, problematic opioid use can also include improperly taking prescribed opioid medications such as oxycodone, morphine or codeine, or taking an opioid medication that was not prescribed for you.
Opioids are a class of powerful drugs that are usually prescribed to treat severe pain. If opioids are abused, they can create feelings of intense pleasure or euphoria, but they can also lead to fatal overdose. Opioids are an effective medication when used as prescribed, but they carry a risk of addiction because of their powerful effects.
Both street-obtained and prescription opioids can be misused. Heroin is a common street opioid that can be snorted or smoked, though it carries the greatest risks when injected. These risks include spreading HIV or hepatitis B or C by sharing needles, skin infections, collapsed veins, bacterial infections and overdoses. People can also misuse prescription medication by crushing the pill and then chewing, snorting or injecting it.
Fentanyl is an opioid that is prescribed as a skin patch. It is 100 times more powerful than morphine and used to treat severe pain. Most street fentanyl in Canada is produced illegally as a powder and is being increasingly found in street drugs such as heroin and cocaine, and used to make tablets that look like prescription medications. Many overdoses have occurred because people did not know that what they were taking was contaminated with fentanyl.
If you or someone you know uses opioids, it is a good idea to have a free naloxone kit. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose and allow time for medical help to arrive.
If someone is overdosing, call 911 right away! You can then use your naloxone kit while you wait for medical help.
Opioid addiction is defined by a group of signs, symptoms and behaviours that indicate a person is both physically and psychologically dependent on the substance. These include:
Opioid addiction involves more than just physical dependence. For example, a person with cancer who is prescribed opioids for severe pain may experience withdrawal symptoms when they stop taking the medication, but is not addicted. Opioid addiction also involves psychological dependence. This means that the drug is so central to the person’s life that the need to keep using becomes a craving or compulsion, even if the person knows that using is harmful.
Cravings and increasing tolerance may lead the person to buy drugs on the street or go to more than one doctor to get the same drug. They may smoke, snort, crush or inject the drug in order to feel high faster and more intensely. This could affect their relationships with family members or friends, or cause a person to neglect their responsibilities.
Opioid addiction is caused by a combination of physical and psychological factors. They include:
Risk factors for developing opioid addiction include:
Two main treatment options are available for opioid addiction:
Methadone and buprenorphine are opioid medications that do not cause intoxication at the correct doses. When they are prescribed, they eliminate a person's withdrawal symptoms, which may help them stabilize their life. Opioid addiction treatments usually involve a combination of opioid agonist therapies and addiction treatment counselling.
Fundamentals of Addiction: A Practical Guide for Counsellors © 2014 Centre for Addiction and Mental Health
Straight Talk: Fentanyl © 2017 Centre for Addiction and Mental Health
About opioids © 2017 Government of Canada
Opioid crisis in Canada © 2018 Government of Canada
What is fentanyl? © 2017 Royal Canadian Mounted Police
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