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 that when they are taken away suddenly, the person can have lots of unpleasant feelings and reactions. These are withdrawal symptoms.
Have you ever had the flu? You probably had aching, fever, sweating, shaking, or chills. These are similar to withdrawal symptoms, but withdrawal symptoms are much worse.
That is why use of opioids should be carefully watched by a doctor—so that a person knows how much to take and when, as well as how to stop taking them to lessen the chances of withdrawal symptoms. Eventually, the cells will work normally again, but that takes time.
Someone who is addicted to opioids has other problems as well. For example, they keep taking the drug even though it may be having harmful effects on their life and their health. They have strong urges to take the drug—called cravings. They no longer feel satisfied by natural rewards (like chocolate, TV, or a walk on the beach).
What is the difference between drug tolerance, dependence, and addiction?
Drug tolerance and dependence are a normal part of taking any opioid drug for a long time. You can be tolerant to, or dependent on, a drug and not yet be experiencing addiction to it.
Addiction, however, is not normal. It is a disease. You are experiencing addiction when it seems that neither your body nor your mind can function without the drug. Addiction causes you to obsessively seek out the drug, even when the drug use causes behavior, health, or relationship problems.
How do I know if I’m addicted?
You might be experiencing addiction if you crave the drug or if you feel like you can’t control the urge to take the drug. You may also be addicted if you keep using the drug without your doctor’s consent, even if the drug is causing trouble for you. The trouble may be with your health, with money, with work or school, with the law, or with your relationships with family or friends. Your friends and family may be aware of your addiction problem before you are, because they notice the changes in your behavior.