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What Are Opiates?

The terms opiate and opioid are usually used interchangeably although they have different meanings and usages. Historically, opioids was a chemical term used to refer to synthetic drugs that mimicked opium. However, today this term is used for a class of drugs that either simulate the effects of opium or are derived from it.

Opiates, on the other hand, are natural drugs that are derived directly from the natural poppy plant. Whether these drugs are found in their synthetic or natural form, they come with a high risk of addiction and might cause serious side effects and adverse consequences on users.

Although opiates are typically prescribed for the relief of chronic and acute pain, using them in the long term might cause addiction. Examples of these drugs include painkillers like fentanyl, hydrocodone, oxycodone, and Dilaudid - as well as heroin.

According to new research, opiate addiction - which also covers opioid addiction - is among the leading causes of substance overdose in the US with more than 20,000 deaths attributed to the prescription painkillers in this class of drugs while over 12,990 deaths being linked to heroin in 2015.

Additionally, opiate addiction has been classified as a medical condition. It continues rampaging the country and destroying the lives of millions of Americans. Although there is currently no cure for such an addiction, the condition can still be treated through detox, rehabilitation, and treatment.

But what are opiates? How they work? What are their potential for addiction? Read on to get answers to these questions and any more you might have about opiates:

What Are Opiates?

Derived for the poppy plant, opiates are medications used in the treatment of pain. However, the drugs come with a high potential for addiction and you might develop chemical dependence to them if you use them for a long time period.

After being derived from the poppy plant, opiates are sometimes synthetically manipulated even further. When this happens, the man-made (or synthetic) opiates are referred to as opioids. Collectively, opioids and opiates are a class of drugs that also include heroin, oxycodone, codeine, and morphine.

Although there are no main differences in the success rates and effectiveness of these substances, opioids are the synthetic (or part synthetic) drugs made through processes that are similar to how opiates are manufactured. However, these terms are broadly used interchangeably.

For almost as long as the drug has been in existence, it has been used both for medical and recreational purposes. On the drug market, opiates come in the form of illicit street drugs like opium and heroin as well as prescription pharmaceuticals such as methadone, codeine, and morphine.

However, all these drugs come with a high risk of addiction - because people abuse them for the intoxicating and mind altering effects they can. When this happens, the abusers often develop chemical dependence on the drugs and eventually become opiate addicts.

On the street, the opiate class of drugs is known by a variety of slang terms, including but not limited to:

  • Black tar
  • China white
  • Chinese H
  • Dragon
  • Elephant
  • Gear
  • H
  • Hammer
  • Horse
  • Nose drops
  • Rock
  • Skag
  • Smack
  • White
  • White dynamite

Opiate Uses

Opiate pain drugs are primarily prescribed for the treatment of moderate to severe cases of pain. Examples of such cases include immediately after an invasive medical procedure, such as surgery. As such, there are some legal opiate drugs on the market today, including:

  • Codeine: Codeine is a highly addictive opiate primarily used to suppress cough in many cough medications. However, it is usually prescribed together with other drugs.
  • Fentanyl: Another highly addictive and potent opiate, fentanyl is produced synthetically (which means that it is a synthetic opioid analgesic). It is prescribed in the form of a transdermal or a skin patch.
  • Hydrocodone: A semi-synthetic opioid, hydrocodone is perhaps the most prescribed of all opiates. It comes in a variety of brand names, including Vicodin and Lortab.
  • Meperidine: Meperidine is similar to morphine in the effects it produces but is actually a synthetic (man-made) prescription drug.
  • Morphine: Morphine is one of the most highly addictive of all opiates. It is derived from the naturally occurring opium found in the poppy plant.
  • Oxycodone: A semi-synthetic opioid, oxycodone is also known by the brand names OxyContin and Percocet.

Since opiates are a class of drugs, the individual substances and medications vary widely in terms of appearance. Hydrocodone and oxycodone, for instance, come in the form of pills. They are usually prescribed in formulations that contain aspirin or acetaminophen. As such, they are available in different colors to show the different strengths and potency of the drug combination. These colors include yellow, peach, blue, and pink.

In most cases, opiates are designed to be taken orally in the treatment of pain. However, those who are addicted to these drugs often abuse them in various ways, such as by:

  • Chewing the pills to increase the rate at which they are absorbed by the body
  • Crushing the pills and snorting the resulting powder to ensure they enter the bloodstream faster
  • Dissolving the powder in water after crushing the pills before injecting the resulting solution directly into the bloodstream

Most people who are addicted to opiates also tend to store the pills in orange pill bottles although some of them hide their stash of drugs in candy jars or mint tins. When abusers crash the pills for snorting, they may keep any powder that remains inside small bags, in foil pouches, or twisted inside pieces of cling wrap.

Many opiates abusers develop an addiction to the medications after receiving a legitimate prescription from their physician. This might be after they had an illness or a surgical procedure that requires them to take the medicine to manage their pain. Over time, however, they start using these prescriptions in the wrong way and against their doctor's express instructions - which leads them down the road to tolerance, chemical dependence (both physical and psychological), and eventually to addiction. Some may eventually start abusing heroin while chasing the high that opiates give.

Heroin, on the other hand, is a morphine derivative commonly sold in the form of a powder. It ranges in color from brown to white. However, it is also available in the form of brown crystalline pieces or granules known on the street as rocks.

Opiate Addiction

As we mentioned earlier, opiates are among the most addictive class of drugs. When you take these drugs, therefore, they will go straight through your bloodstream and into your brain.

While in the brain, opiates will attach themselves to the opioid receptors and cause of a flood of dopamine and endorphins - the neurotransmitters that are responsible for the natural feelings of satisfaction, pleasure, and reward.

This effectively creates an intense rush of euphoria and happiness - otherwise known as a high - which is unlike any other naturally occurring rush of endorphins and dopamine. As a direct result, the only way you can recreate the effect is by abusing the opiate again.

Repeated use, however, will cause your brain to stop naturally creating endorphins and dopamine. At this stage, you will have limited your natural ability to experience these sensations and feelings and will have to resort to opiates to be able to do so.

Due to the strong and desirable effects that opiates cause inside the brain and because you might not be able to experience pleasure naturally without using these drugs, you may develop intense cravings for them and the high they create.

Many users eventually start abusing opiates to lessen any pain they feel while simultaneously ensuring they continue to experience these happy and euphoric effects on demand. This is why opiates are classified as a highly addictive class of drugs.

That said, opiate addiction develops in several steps. For starters, you will become tolerant to the drugs meaning that you will need to take increasingly larger and larger doses to achieve the same desirable effects.

After some time, you will become physically dependent on them. This means that your body will experience severe withdrawal if you stop abusing the drugs. Eventually, you may develop psychological dependence, which is characterized by intense and unavoidable cravings for the substances. At this stage, you will clinically be diagnosed as an opiate addict.

Most people who battle opiate addiction get to this point accidentally. For instance, you might receive a legitimate prescription from your doctor to use these drugs to manage pain resulting from an accident, injury, or surgery.

After using the drugs for a while, you might be cured and not need them anymore. However, they would already have taken your brain hostage and you may be physically dependent on them. Therefore, you will continue abusing them just to ensure you are able to get through your day to day life.

When this happens, you might lie to your doctor that your pain hasn't subsided yet to ensure that they continue writing you prescriptions for the drugs. Alternatively, you could start visiting different doctors with the aim of getting multiple prescriptions at the same time. Some people also purchase these prescription painkillers on the dark web or the black market, despite the fact that this is such an expensive undertaking.

For this reason, some people who receive a prescription for opiates might end up abusing the drugs and eventually transition to heroin - which is easier to obtain and cheaper in the long run. A 2014 survey showed that close to every respondent in a study of people receiving treatment and rehabilitation for opiate addiction eventually transitioned to heroin after they found prescription pills harder and more expensive to get hold of.

In the long term, abusing opiates will change how the nerve cells inside the brain work - a common occurrence even among patients who have been taking these drugs in the exact way their doctors instructed when they issued them with a prescription.

When this happens, your brain's nerve cells might become so used to the presence of the drugs that your brain might react in a volatile way if you take the substances out of the equation. This may lead to intense withdrawal symptoms, which are variously described as unpleasant reactions and feelings.

Among the hallmarks of an opiate addiction is the act of continuing to abuse the drugs even after you can see the negative effects it is causing in your life. When you get to this stage, you may have such strong urges and cravings to take the drugs that you will no longer be satisfied when you engage in normal activities like taking an evening walk, sex, eating chocolate, or watching your favorite shows on television.

Additionally, since stigma is still attached to addiction, you might avoid seeking treatment through a valid rehabilitation program because you don't want people to think you are weak or that you have a medical condition. However, this will only increase the risks that you face with continued opiate abuse.

Signs And Symptoms Of Opiate Abuse

Today, opiate addiction is classified as a serious health condition. This means that if you do not manage and control it, it may lead to a variety of adverse effects - including but not limited to an overdose and sudden death.

To this end, it is vital that you watch out for the classic signs and symptoms of opiate abuse and addiction. These signs are not difficult to observe because the class of drugs tends to leave tangible signs - physical, psychological, behavioral, and social - that are difficult to ignore.

When you abuse these drugs or you develop an active chemical dependence and addiction to them, you may start making your substance abuse a higher priority over and above everything else in your life. Some of the common signs and symptoms of such a condition cover the financial, professional, legal, social, and interpersonal sides of your life. Consider the following:

a) Financial Symptoms

When you develop an opiate addiction, you might do just about anything possible to ensure you get the drugs. This means that you will have to spend more and more money to obtain them. With time, such pursuit of the effects of opiates might cause financial strain in your life.

Other financial signs of such an addiction may include:

  • Bankruptcy
  • Borrowing money from friends, family, and other loved ones
  • Cashing out your life savings, retirement accounts, and any other little nests of money you might have put aside to get opiates
  • Forfeiting your home after you are unable to pay your mortgage or rent
  • Losing your business because you have been using funds from the business to pay for your drug habit
  • Stealing company funds and losing your job as a result
  • Stealing to be able to pay for the drugs

These financial troubles are sometimes tied closely to any legal problems you might encounter as a result of your opiate addiction. Whether you get arrested after being apprehended possessing or trying to buy the drugs illegally or as a result of driving while intoxicating on these substances, you are highly to have more of these problems when you are addicted to opiates. Eventually, paying for bail and other legal expenses can add up over time and dig you even further with your finances.

Additionally, your financial problems might be exacerbated by any troubles you encounter at work. Due to your addiction, you may start reporting to your duty station later than usual, leaving work earlier than other people, or missing altogether while looking for the inevitable high that comes with abusing opiates.

Such drug abuse also causes problems with cognition, which may lead to a reduction in the quality of your work as well as in your job performance. If you are in school, you may encounter similar problems. In fact, statistics show that students with opiate use disorders often skip classes, perform poorly in school, and lose their opportunity to graduate.

b) Social and Behavioral Symptoms

Once you develop chemical dependence on opiates, the drugs might take center stage in your life. As a direct result, you might lose interest in any activity you used to enjoy in the past.

Once you stop caring about the clubs and groups you were an active member of, you may start avoiding them in lieu of spending more time obtaining, using, and recovering from abusing your preferred opiates.

You could also end up losing your membership in these groups/clubs as a result of displaying unacceptable behavior on multiple occasions - especially if you show up to the meetings while intoxicated.

Such behavior may eventually destroy your personal and professional relationships, another one of the classical signs of an addiction. Other signs and symptoms of opiate abuse that could affect your behavior and social life include:

  • Starting fights with your loved ones
  • Lying to your loved ones so that they do not catch you abusing opiates
  • Forgetting your familial responsibilities, such as paying bills on time or picking up your children from school
  • Become increasingly violent towards your partner/spouse and children
  • Avoiding and ignoring family members, friends, and other loved ones

c) Other Signs and Symptoms

The other miscellaneous symptoms of opiate abuse and addiction include but are not always limited to:

  • Experiencing unexpected changes in mood
  • Faking injuries and pain so that you can get doctors to write you new prescriptions for the drugs
  • For intravenous drug users, wearing shirts with long sleeves even in warm weather to conceal track marks
  • Having more than enough prescription pads and pill bottles
  • Hurting yourself intentionally to receive a prescription for opiate medications
  • Losing weight
  • Not eating

Although you might find it difficult to talk to a loved one when you suspect that they have been abusing opiates as a result of any combination of the signs and symptoms above, you need to remember that it is easier to deal with the conversation than have to pay expensively for them to get better after suffering an overdose - which could even cause them to lose their lives.

Irrespective of their reaction and response - which could range from accusations that you are trying to sabotage them to feelings of anger and being insulted - it is imperative that you encourage them to get help before it is too late.

Effects Of Opiate Abuse

Abusing opiates might rewire the brain and elicit certain physiological, psychological, and behavioral changes. As a direct result, such abuse comes with a variety of effects. Initially, abusing these drugs causes:

  • Constipation
  • Constricted pupils
  • Dry mouth
  • Feeling euphoric
  • Feeling lightheaded
  • Feeling overly elated for no apparent reason
  • Flushed face
  • Insomnia or hypersomnia (Sleeping too little or too much)
  • Lack of coordination
  • Sweating

If you do not seek help immediately before the condition gets worse, you might experience more serious and severe symptoms, including but not always limited to the following:

  • Chest pain
  • Difficulty breathing or complete inability to breathe
  • Difficulty swallowing or complete inability to swallow
  • Dizziness or drowsiness
  • Fast heartbeat
  • Headaches
  • Hives
  • Low blood pressure
  • Nausea
  • Rash
  • Seizures
  • Shallow or slowed breathing
  • Slowed heartbeat
  • Swollen throat, feet, hands, tongue, and/or face
  • Vomiting

Since opiates act on the brain, abusing these drugs might lead to the following adverse psychological effects:

  • Confusion
  • Depression
  • Irritability
  • Loss of appetite
  • Mood swings
  • Panic attacks

In the same way, abusing opiates might increase your risk of contracting certain diseases. In particular, using them intravenously could potentially cause you to get infected with HIV and Hepatitis B and C.

That said, every form of opiates use and abuse may lead to an overdose - which occurs when you take too much of the drug and to such toxic amounts that body reacts negatively to it. You should keep in mind that some of these episodes of opiate overdose tend to turn lethal unless they are treated immediately as an emergency.

In the same way, the longer you continue abusing this class of drugs, the higher your risk of suffering even more serious - and sometimes permanent - damage to your health and wellness. In particular, you might damage certain core parts of your body, including your heart, brain, and CNS (central nervous system).

Opiate abuse and addiction might also affect your unborn baby if you continue it while pregnant. Other long term effects include but are not limited to:

  • Addiction
  • Blood borne illnesses, like HIV, Hepatitis B, and Hepatitis C
  • Blood infections
  • Brain damage
  • Coma
  • Dental problems
  • Gastrointestinal problems, including bowel obstruction and constipation
  • General loss of your natural cognitive abilities
  • Impotence
  • Partial paralysis
  • Respiratory depression
  • Sexual dysfunction
  • Skin abscesses
  • Vein collapse
  • Weaker immunity

On the other hand, pregnant women who continue abusing opiates may place their babies are risk. Some of these prenatal risks of opiate exposure may include:

  • Abnormal infant interactions with auditory and/or visual stimuli
  • Hepatitis-positive infants
  • HIV-positive infants
  • Infant opiate addiction
  • Infant resistance to cuddling and soothing
  • Neonatal abstinence syndrome, which includes respiratory distress, convulsions, and tremors
  • Newborn withdrawal
  • Preterm delivery

When children who were exposed to opiates prenatally continue growing, they may display a variety of other effects and symptoms, including but not limited to sleep disturbances, shorter than normal attention span, and hyperactivity.

Studies have also shown that older children might display perceptual difficulties and mild memory deficits as well as depression when they reach young adulthood. Although the data is not yet clear about the exact effects of prenatal opiate exposure, the best course of action is for pregnant women to avoid abusing these drugs and ensure they are getting help in the form of addiction treatment and rehabilitation even while pregnant.

That said, opiate addiction is not discriminatory and will spare no one irrespective of sexuality, upbringing, socio-economic status, gender, and age. However, even though there is no universal cure for such an addiction, it can be managed and treated.

In most cases, treatment consists of evaluation, detox, and a highly customized and personalized program designed to rehabilitate you until you no longer need opiates to function normally.

Opiate Withdrawal And Detoxification

As we mentioned earlier, detox - also known as detoxification - is an essential part of the opiate recovery process. Although the process is uncomfortable and difficult for many, it gives the body enough time to cleanse itself of every substance and toxin that was left over when you quit using opiates. During this time, you might have to contend with the withdrawal symptoms you experience.

Still, detox is the first step you have to take when you begin the journey to sobriety and full recovery. It also elicits physiological and psychological restoration to your body. However, the process is quite difficult because it might lead to a variety of undesirable effects and withdrawal symptoms, including:

  • Abdominal cramping
  • Aggression
  • Anxiety
  • Depression
  • Diarrhea
  • Dilated pupils
  • Excessive sweating
  • Fatigue
  • High blood pressure
  • Hyperactivity
  • Inability to concentrate
  • Insomnia
  • Irritability
  • Lacrimation or excessive tearing
  • Mood swings
  • Muscle aches
  • Muscle spasms
  • Nausea
  • Paranoia
  • Rapid heartbeat
  • Restlessness
  • Runny nose
  • Uncontrollable yawning
  • Vomiting

Opiate Overdose

You might overdose while abusing opiates and especially if you relapse during/following detox. Since this class of drugs triggers receptors that are found in the segment of the brain that regulates your breathing, taking them in high doses could interrupt your breathing and cause sudden death.

Other symptoms of an opiate overdose include:

  • Pinpoint pupils
  • Respiratory depression
  • Unconsciousness

The best way to deal with any case of an overdose is by calling 911 immediately and getting emergency medical assistance immediately. You can also administer an opioid antagonist like Naloxone to reverse any adverse effects of the overdose.

Opiate Addiction Treatment

To avoid any adverse effects of opiate abuse and addiction, it is imperative that you seek treatment at an accredited rehabilitation facility. Following detox, you might have a variety of rehab options and programs specifically specialized to deal with opiate addiction.

Most of these treatment facilities will use different strategies - including therapeutic and medical interventions - to get you to overcome your addiction and adjust to a life free of opiates.

In most cases, the rehab process will be split into the following distinctive phases/stages:

1. Assessment

Rigorous assessment and testing is usually the first step while undergoing rehabilitation for drug abuse and addiction. The evaluation team will typically conduct psychiatric and medical tests to find out the extent of the addiction as well as uncover any existing co-occurring mental health problems. After the assessment, the treatment team will have a better understanding of your needs and requirements and - as such - be able to craft a more personalized and customized treatment and rehabilitation plan for you.

2. Detoxification

During this stage, the rehabilitation team will help your body get rid of the opiates and any remaining toxins left over in your body and system. However, since opiate detox might prove to be dangerous, it is imperative that you ensure it is conducted under medical supervision and care.

3. Rehabilitation

You will get an unique rehabilitation and treatment plan geared specifically to meet your particular needs and preferences. However, in the case of opiate abuse and addiction, rehab will include a wide variety of therapies - both mainstream and traditional/alternative - as well as group therapy and individual counseling. You may also be taught about triggers, how to avoid them, and leading a lifestyle free of substance abuse and addiction.

4. Aftercare

Before you check out of the treatment facility, the rehabilitation team will create an effective aftercare and relapse prevention plan for you. This might include sessions with counselors and therapists, attending 12 step and non-12 step support group meetings (such as NA - Narcotics Anonymous), doctor appointments, mandatory drug testing, and staying at a sober living home. Through aftercare, you can ensure that you continue with the progress you made while in rehab through a network of support and guidance.

Overall, the best way to deal with opiate abuse and addiction is by undergoing intensive rehabilitation - preferably at an inpatient or residential rehabilitation facility. After that you can transition to an outpatient program to further boost your progress and ensure you do not relapse. The earlier you get started on this process, the easier it might be for you to overcome your opiate dependence and restart life on a fresh slate.