Opioids deaths are frighteningly common among people using any form of this drug. Opioids can cause death, and they do so much more easily that many people expect. It doesn’t matter what type of opioid someone is taking; all opioids can kill.

When people think of deadly opioid drugs, oftentimes they think of heroin. Heroin is a good drug to think about when trying to determine which drugs easily cause death. It’s incomplete, however. Prescription opioids—painkillers—are as easily lethal as their illegal counterparts. This is because all opioids work the same way in the brain and body. What they do in the body is why they are so deadly.

Opioids Deaths: How Opioids Can Kill You

Unfortunately, opioids deaths are common because many don’t understand how opioids work in the brain and body.

When someone takes a prescription painkiller or an illicit opioid drug, the opioids bond to specific opiate receptors in the brain and body. Not long after the person began using the opioid, his body stopped producing its own opioids, like endorphins. The body, then, was quickly dependent upon opioids. The body needed them to function, and if the person stops taking the opioid, he begins to experience opioids withdrawal symptoms.

The nature of opioids guarantees that dependence will happen, and many people who become dependent remain on opioids to avoid withdrawal. Further, especially in the case of prescription painkillers, they need legitimate pain management. These drugs are tricky things, though, and it’s very easy to develop a tolerance of opioids. This means that someone has to take more and more in order to get the same effect.

Opioids dependence often leads to opioid tolerance, which means that someone is taking increasingly high doses of the opioid. Opioids naturally slow down breathing, but when the dose is too high, the person experiences overdose (opioids toxicity). Breathing slows, becomes shallow, and stops. It is this opioids respiratory depression that is nearly always the cause of opioids death.

Opioids Respiratory Depression

Suppression of breathing is the deadliest aspect of opioids. It can happen to a first time user or someone who has been using opioids for years (and again, this applies to legally prescribed painkillers and illicit street drugs). Addiction is not required to die from opioids use. Opioids don’t discriminate. They’ll kill anyone.

One other cause of opioids death, albeit on a much smaller scale than the opioid-induced respiratory depression that can happen to anyone using any opioid, is contaminants that are often found in heroin. Obviously, there are no regulations monitoring heroin production, and it’s often tainted with things like talc, quinine, and other poisons. However, the vast majority of opioids deaths come from an overdose that shuts down the respiratory system.

Opioids Deaths: How Often Do They Happen?

The statistics are staggering. A lot of people are dying from taking their prescribed painkillers, using someone else’s prescription painkillers, or from heroin and other illegal drugs. Here’s a look at some facts and figures that highlight the scope of the opioids epidemic:

• In less than 10 years (2006-2014), opioids overdose death rate rose 200% (Full House Committee on Oversight and Government Reform, 2016).
• In 2014, opioids deaths numbered 29,467 (10,574 of those were from heroin), while cocaine deaths numbered 5,415 (Nolan & Amilo, 2016).
• 16,651 opioids deaths happened in 2010 from prescription painkillers alone (Foreman, 2014).
• Approximately 78 Americans die every day from opioids overdose (Full House Committee on Oversight and Government Reform, 2016).

How opioids work in the body is a big reason for the opioids death rate. Another reason for the high number of deaths is that opioids are widely available and relatively easy to obtain. Yet another is that people are often unaware of the dangers of taking opioids. The more people know, the better they’ll be able to keep themselves safe. So yes, opioids can kill you. But they don’t have to.

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Prior to the 1950s, opioids were the prescription drug of choice to treat depression. While they were reasonably effective, people easily developed tolerance to opioids so that they required higher doses just to have the same effect on their mood. Further, opioids are highly addictive, and when it would come time to taper off medication, not only did people go through opioid withdrawal, they found that their depression worsened. A change was needed, new antidepressants began to be developed, and opioids fell out of fashion as a depression treatment.

Now, researchers are beginning to take another look at the potential opioids offer for depression and anxiety treatment. To understand why and to come to your own conclusion about whether opioids are effective for these mental health conditions, it’s helpful to know how the body’s own opioid system works.

Your Brain’s Own Opioid System and What it Has To Do with Depression and Anxiety

Opioids have a very specific way that they work, which is known as the opioids mechanism of action. The opioid system includes four different types of opioid receptors as well as four opioids produced in the brain and body.

Opioids attach to receptors and go to work, doing things like relieving pain and producing a euphoric high. Where do these opioids come from?

Opioids can originate outside of the body (known as exogenous opioids) and include morphine, Vicodin, oxycodone, heroin, and many others (Types of Opioids and Opioids Examples). They can also originate in our own brain and body (known as endogenous) and include hormones and neurotransmitters that we know as endorphins, dymorphins, enkephalins, dynorphins, and endomorphins.

The opioids naturally produced in our brain are required for our wellbeing. Our opioid system is important in controlling feelings of pain, stress, anxiety, hopelessness, and pleasure. Researchers are looking into the theory that if someone has a deficiency somewhere in the opioid system in which not enough endorphins, etc. are produced, opioid medication can fill the gap. The possibility is strong that prescription opioids could help depression and anxiety.

That said, the opioid system and all types of opiates, as well as depression and anxiety, aren’t that simple. It’s not a matter of topping off the opioid tank and calling it good. First, there are the dangers of taking opioids even for legitimate medical reasons (the chances of dependence, addiction, overdose, and opioid deaths are significant). Also, we have different types of opioid receptors which cause different reactions. Some have been shown to improve depression and anxiety while others have shown to worsen depression and anxiety.

Opioids for Depression and Anxiety

It’s becoming increasingly clear to researchers that there is a relationship between opioids and depression. Opioid dysfunction in the brain and body can contribute to

• Inability to feel pleasure, which is a major effect and symptom of depression
• Mood-related difficulties

Different opioids can interact with different receptors, increasing feelings of pleasure, improving energy and mood, and blocking activity in opioid receptors that cause these depression-related problems. Prescription opioid medication would activate some receptors and block others to treat depression. Among the opioids for depression, buprenorphine has shown great potential for use as an antidepressant.

Researchers are still very hesitant as to whether prescription opioids such as buprenorphine should be used in mental health treatment. In addition to developing tolerance and possibly opioid addiction, opioids might disrupt the reward system of the brain as well as decrease motivation—things that are already problematic in depression.

Experts are weighing the pros and cons of using opioids for depression. They’re doing the same for anxiety, and the picture so far is equally unclear. Some things are known about the connection between opioids and anxiety:

• Deficiencies in the opioid system can contribute to anxiety.
• Our opioid receptors and opioids themselves play a role in stress and anxiety.
• Our system boosts the effects of anti-anxiety medications such as the benzodiazepines
• Some components of this opioid system actually increase anxiety
• Anxiety is one of the symptoms of opioid withdrawal, so taking an opioid for anxiety, then stopping, defeats the purpose of taking an opioid medication in the first place

Two things are becoming clear: taking prescription opioids for depression and anxiety can be effective, and taking opioids for these conditions can be dangerous due to the nature of opioids. Research is still ongoing on the endogenous opioid system and how this part of our brain and body contributes to anxiety and depression, and studies continue on how exogenous opioids work on that system to improve mental health. Will the benefits outweigh the risks of opioids for depression and, separately, opioids for anxiety? We’ll have to wait and see.

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Opioids prescription painkillers, while highly addictive with a dangerous potential for overdose, do have a legitimate purpose. Opioid drugs are used for pain management. Opioids prescription medication is widely and effectively used for a variety of medical situations: opioids for chronic pain are used to treat and manage conditions that cause long-term suffering, while opioids for pain from surgery, acute injury, or other temporary conditions are prescribed for short-term pain relief.

Opioid painkillers (also referred to as opiate painkillers or opioids narcotics) are widely prescribed (Opioids vs. Opiates: What’s the Difference?). Two hundred million prescriptions were written for opioids pills in 2009, and that number has been steadily rising since then (Foreman, 2014).

List of Opioid Painkillers

Many types of opioid painkillers are available for treating pain. Some are stronger than others, but all reduce pain and produce a euphoric high. This list contains the names of opioid painkillers. Generic names are listed first, followed by brand names in parentheses.

• Buprenorphine (Buprenex, Butrans transdermal patch)
• Butorphanol (Stadol)
• Codeine [Available in generic form only]
• Hydrocodone (Hysingla ER, Zohydro ER)
• Hydrocodone and acetaminophen (Lorcet, Lortab, Norco, Vicodin, Allay, Anexsia, Dolacet, Dolagesic, Duocet, Hydrocet, Hydrocet, HY-PHEN, Panacet, Panlor, Stagesic, T-Gesic, Ugesic, Zydone)
• Hydromorphone (Dilaudid, Exalgo, Hydrostat)
• Levorphanol (Levo-Dromoran)
• Meperidine (Demerol)
• Methadone (Dolophine, Methadose)
• Morphine (Astramorph, Avinza, Duramorph, Kadian, MS Contin, Ora-Morph SR, Rescudose, Roxanol)
• Morphine and Naltrexone (Embeda)
• Nalbuphine (Nubain)
• Oxycodone (OxyContin, Roxicodone, Oxecta)
• Oxycodone and acetaminophen (Percocet, Endocet, Roxicet, Roxilox, Tylox, Xartemis XR)
• Oxycodone and Naltrexone (Troxyca ER)
• Oxycodone and naloxone (Targiniq ER)
• Oxymorphone (Numorphan)
• Pentazocine (Talwin)
• Propoxyphene (Cotanal-65, Darvon)
• Tapentadol (Nucynta)
• Tramadol (Ultram)
• Tramadol and Acetaminophen (Ultracet)

Additionally, opioids can be blended with aspirin or ibuprofen in a single pill. Whether opioids are on their own, combined with another opioid, or combined with over-the-counter medicine, they provide much-needed pain relief to millions of people. Some people use these opioid prescription narcotics without a problem. Others progress from use to abuse.

Opioids Use and Abuse

Opioids use, which is taking medications as prescribed for the purpose of pain relief, isn’t a problem. Problems begin as use intensifies, is done more than directed, and turns into opioids abuse.

In opioids abuse, someone takes his own opioids prescription painkillers more often than prescribed or in higher doses than prescribed. When she can no longer get a prescription from a doctor, she turns to other sources. To obtain prescription opioids for the purpose of abuse, people turn to diverted sources, or any source other than a legitimate prescription. Diverted opioid sources include

• Getting them for free from a friend or relative
• Buying them from a friend or relative
• Stealing them from a friend or relative
• Obtaining multiple new prescriptions through “doctor shopping”
• Buying them from a dealer or stranger
• Purchasing them on the internet
• Writing a fake prescription
• Stealing from a doctor, pharmacy, or hospital

When taken correctly—for pain and under a doctor’s supervision—opioids prescription painkillers can be beneficial. There are many different types of opioids prescriptions in varying potencies to treat your unique pain. Because the potential for abuse, opioid dependence and addiction is high, being vigilant about what you’re taking and how it’s affecting you will help you reduce pain while maintaining a life free from opioid abuse and addiction.

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Treatment for opiates addiction is possible, and there are effective, research-based methods of approaching it. However, there isn’t a one-size-fits-all technique for the treatment of opiate addiction. There are too many individual differences to have a single treatment plan that applies to everyone.

Multiple factors affect opiate treatment choices and outcomes. Among them:

• The specific opioid to which the person is addicted and whether other substances are used/abused simultaneously
• The person’s overall mental and physical health
• Amount of social support the person has
• Access to treatment centers, clinics, support groups, etc.

The most effective treatment for opiates addiction takes into account these individual differences and creates a fitting plan. This doesn’t mean, however, that there isn’t a structured, researched-based treatment approach for people addicted to opioids. There are reliable methods that help people safely overcome opioid abuse and once again live healthy lives (Opioids vs. Opiates: What’s the Difference?).

Opioid Addiction Treatment Options

There are three accepted treatment approaches that are used to treat opioid addiction:

• Medication alone
• Behavioral treatments/counseling
• Medication-assisted treatment (MAT)

When medication treatment for opioid addiction is used alone, it’s frequently done in a standard hospital setting followed by visits (sometimes daily) to a doctor at a primary care clinic. This approach is not highly recommended because, usually, medication alone isn’t enough to end addiction.

Behavioral treatments are also used in effectively helping people overcome opioid addiction. Cognitive-behavioral therapy (CBT) is a researched-based counseling approach that is helpful in treating drug abuse. Behavior approaches help people change unhealthy thought patterns and behaviors as well as learn and use strategies to manage cravings and avoid situations that trigger a relapse. Counseling also helps people improve personal relationships, the ability to function at work, home, and in the general community. Counseling, which can take the form of individual, group, or family therapy, is a very effective treatment for opiates addiction, but it doesn’t work well on its own in the treatment of opioid addiction.

The best of both worlds—medication and counseling—is medication-assisted therapy for opioid addiction. MAT involves using both medication and counseling/behavior therapy to help people with their addiction to opioids. People seeking this more comprehensive approach will typically find it in an addiction treatment center. Medical doctors provide the medication aspects of opioid addiction treatment. Whether the goal is short-term detoxification (detox), long-term maintenance treatment, or both, specific medications are used in opioid addiction treatment. These medications, like the drugs they’re treating, are opioids.

Opioid Addiction Medication: Agonists and Antagonists

A common misunderstanding is that by treating opioid addiction with another opioid is doing nothing more than replacing one addiction with another. This couldn’t be further from the truth.

Opioids medication is a crucial part of treatment because the opioids people become addicted to, whether opioids prescription painkillers or street drugs like heroin, change the brain. They create imbalances that affect impulse control, decision-making, learning, reward-seeking, and more. Opioids work in the brain and body by attaching to and overtaking its opioid receptors. To fix these imbalances in the brain, opioids medication is needed.

In the treatment of opioid addiction, doctors don’t just use any opioid. They use one of three opioid medications approved by the FDA to treat addiction to opiates:

• Methadone
• Buprenorphine
• Naltrexone

Methadone is a synthetic opioid agonist, which means it is made in a lab and it attaches to opiate receptors to replace the opioids of the addiction. It dulls cravings and decreases opioid withdrawal symptoms. Unlike other opioids, methadone doesn’t produce a euphoric high, but it does relieve pain. Methadone can be dangerous to the heart, causing arrhythmias that can be fatal; therefore, it is given in controlled doses and gradually tapered down.

Buprenorphine is a partial agonist, so it doesn’t fully attach to opioid receptors. It does, however, prevent other opioids from reaching the receptors. Buprenorphine helps with withdrawal symptoms, which is a valuable part of treatment. It also makes it so people can no longer get high from heroin or opioids, which is important for maintaining sobriety.

Naltrexone is an opioid antagonist. This type of opioids medication completely blocks opioid receptors so that opioids entering the system can’t attach. Naloxone (Narcan) can actually reverse the effects of opiates, something that is very beneficial in the treatment of opiate addiction. This antagonist is also available in a long-acting, injectable form called Vivitrol, and it’s useful for people who have difficulties in taking medication or who don’t have easy access to health care.

Opioid use creates changes in the brain that can be difficult to treat. Opioids are easy to become addicted to and hard to overcome. That said, treatment is absolutely possible. According to the National Institute on Drug Abuse, “Years of research have shown that substance use disorders are brain disorders that can be treated effectively.”

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If you feel that sex tends to follow a pattern that fulfills your partner's desires rather than your own, it's time to pluck up the courage and tell them what you'd like. Sex counselor Suzie Hayman has some tips to take the embarrassment out of voicing your desires.

Preparation

• Have a pen and paper to hand.
• When it comes to sharing your desires, make sure you're not going to be disturbed and find somewhere comfortable to sit together.

Know your desires

We all have desires we'd like to have fulfilled, but we may be careful of suggesting them for fear of embarrassment.

This exercise puts both of you in the same position of asking - and offering - and gives you the chance to say what you'd really like to do and have done.

What you want and what you'd like to offer needn't be extreme or exotic. They can be as simple as having your feet rubbed or giving your partner a hug or kiss. The key is that they make both the giver and receiver feel sexy and wanted.

Because it's a fair swap, it gives both of you the chance to express your real desire. But remember, you have the right to say no to any suggestions you don't like.

Write a list

Sit down on your own and write down ten things you'd like your partner to do for you, sexually and romantically.

This can range from "Tell me you love me" to "Stroke my nipples with a feather" and "Tie me up". Then write down ten things you'd like to do for them.

Share your lists

Pick a time when you're both feeling happy and comfortable with each other. Settle down with a cup of coffee or glass of wine and share your wish lists, point by point.

Find a treat you'd really like your partner to give you and match it with something they want. Agree to swap treats, either at a specific time and place or some time within a set period - over the next week, for example.

Once you've both had your desires fulfilled, go through the list again and choose something else. You each have the right to say no to specific requests, but it does cut both ways.

Keep adding to your lists and take it in turns to ask for your treat or offer them a treat.

Related Information:

• Pleasing Yourself
• Orgasms

Opioid addiction does not have to be a permanent part of your life. Opioid addiction help is available and can be highly effective in assisting you with safely stopping drug use and addiction. It can be anxiety-provoking and quite overwhelming to figure out what help is available for opioid addiction. These guidelines are designed to help you determine where to find the help you want and need.

Treatment Help for Opioid Addiction

A wide range of treatment options exists to provide help for opioid addictions. These include

• Inpatient treatment in a standard hospital or treatment center (necessary for medical detox, which uses medication)
• Outpatient treatment of opioids withdrawal symptoms with your primary care provider
• 12-step programs that rely on social support and spirituality
• Therapy/counseling, which typically includes behavior or cognitive-behavior therapy to learn skills and techniques to avoid using opioids going forward
• Motivational/incentive treatment programs that provide positive reinforcement and rewards for remaining drug-free
• Alternative methods such as acupuncture, meditation, yoga, equine therapy, art therapy, and wilderness programs. These approaches can’t treat opioid addiction on their own. These supplemental therapies and are often found in treatment facilities.

As researchers study which treatment for opioid addiction approaches are the most effective, two things are becoming clear. Each individual is unique with his or her own personal interactions with and reactions to opioids; therefore, there isn’t a one-size-fits-all approach to opioid addiction treatments.

That said, the other thing that researchers have uncovered is that addiction treatment centers are more effective and far safer than standard hospitals or primary care outpatient clinics; rather disturbingly, hospitals and clinics have an opioid patient death rate that is 10 times higher than that of inpatient opioid treatment facilities (Preidt, 2017). Opioid treatment facilities are both effective and safe for opioid addiction help.

In general, treatment centers are inpatient, also called residential. The addicted person seeking help with withdrawal and cessation stays at the facility for a specified period of time. The length varies according to individual needs and the nature of the center. While there, treatment can include any of the above options (with the exception of seeing a doctor in an outpatient clinic) plus other therapies offered by the specific clinic. Treatment approaches are tailored to each individual for maximum safety and effectiveness.

Hotlines, Helplines for Finding Opioid Addiction Treatment

Drug addiction hotlines are valuable resources and point you to the right opioid addiction help for you. Addicted individuals, as well as concerned friends and family members, can call these helplines free of charge to get information about opioid addiction and treatment, general information about addiction, types of treatment options available, and general things to expect during treatment. Helplines can even tell you what is available in your area, which insurance companies and policies the treatment facilities accept, and they can help connect you with treatment facilities.

Addiction helplines and the people on the other end of the line are non-judgmental and accepting. They’re there to help, not to belittle. Using hotlines is a safe way to begin your treatment process. These three helplines are reputable and impartial—they aren’t affiliated with any particular treatment center.

Substance Abuse and Mental Health Services Administration (SAMHSA)

• Provides addiction information and helps callers locate treatment centers
• 1-800-662-HELP (4357)
• Online Treatment Locator

Recovery.Org

• Helps individuals and loved ones find the right treatment center for their needs
• 1-888-500-2086

DrugAbuse.Com

• Offers multiple hotlines, including drug-specific helplines
• Call the opioid-specific helpline: 1-877-331-3952

Deciding to seek help for opioid addiction can be stressful and anxiety-provoking. It can be hard to know where to start, who to trust, or where to go. Feeling that way is normal and is the reason these helplines exist. They’ll help you figure out what treatment centers exist in your area and even get you connected with them. The process is overwhelming before you begin, but as soon as you do, hope will replace that overwhelmed feeling.

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Symptoms of opioid addiction can be the keys to getting help for yourself or your loved one. Opioid addiction can be fatal when left unchecked. Unfortunately, opioid addiction can be tricky to spot, so knowing what to watch for is important. While technically there’s a difference between symptoms and signs—simply put, symptoms are felt while signs are seen—here they’re combined as opiate addiction symptoms and signs.

First and foremost, symptoms of opioid addiction begin with misuse or abuse. Both misuse and abuse involve the same behavior: using a drug for pain relief and the high that comes from taking it. Once someone develops opioid dependence and tolerance, he needs more and more of the drug, and he needs to keep it in his system consistently to avoid unpleasant opioids withdrawal symptoms. This is when the misuse or abuse begins, and the person uses too much, taking more prescription pain pills than prescribed or buying an increasing amount of an illicit street drug like heroin.

The difference between misuse and abuse is the intent. In misuse, the person is using prescription painkillers incorrectly, taking higher doses than prescribed and doing it more frequently than she was instructed by her doctor. She does this because she is craving the pain relief she needs as well as the high that comes with it. In abuse, someone purposely seeks either pain pills that aren’t prescribed to her (from people she knows or from a dealer on the streets) or heroin specifically to get high.

Misuse or abuse is where addiction begins and is the first sign to watch for when determining whether you or someone you care about is addicted to opioids. Other drug-related behaviors provide signs of abuse, too.

Symptoms of Opioid Addiction: Drug-Focused Behavior

When someone is addicted to opioids, they become the focal point of his life. He needs these drugs, and his efforts are focused on obtaining them, at all costs. Some examples of this addictive behavior include:

• Obsessive thoughts about getting the next fix
• Compulsive drug-seeking
• Spending a lot of money to get opioids
• Stealing money, things to sell, or breaking into homes to steal prescriptions
• Selling belongings
• Engaging in risky behavior, in addition to theft, to obtain opioids
• Crushing prescription pills to make the effects stronger
• Continued use despite negative consequences
• Obtaining and using opioids becomes the main priority and focus
• Lack of control over use

Signs and Symptoms of Addiction to Opioids: Other Behaviors

In addition to the drug-seeking behaviors that are a hallmark of addiction, someone addicted to opioids exhibits other telling behaviors as well, such as:

• Secrecy about use of opioids
• Increased isolation to hide drug use
• Social isolation
• Wearing clothing that hides track marks
• Poor work performance
• Poor school performance
• Neglecting responsibilities
• Letting relationships (family, friends) slide
• Changing friends, sudden association with a different crowd
• Neglect of personal hygiene
• No longer caring about appearance

Physical Signs and Symptoms of Opiate Addiction:

Opioids affect the body. The more opioids someone takes, the more she feels it, and the easier others can spot it. Some of the physical signs and symptoms of opiate addiction are

• Uncontrollable opioid cravings
• Nausea/vomiting
• Loss of appetite
• Weight loss
• Headache
• Runny nose
• Red eyes
• Eyes glazed over
• Cough
• Excessive energy
• Insomnia
• Poor health due in part to a suppressed immune system
• Track marks on arms from needle use
• Inflamed veins if using needles
• Arms and legs feel heavy
• Lethargy (no energy, not caring about anything other than opioids)

Psychological Signs and Symptoms of Addiction to Opioids

Opioids work in the brain to actually change the brain, which is why addiction is considered a disease of the brain. It makes sense, then, that people have psychological, mental health, symptoms of opioids addiction. Among these psychological signs:

• Obsessive thoughts about opioids
• Paranoia
• Hallucinations
• Confusion
• Memory problems
• Increased sensitivity to sounds
• Strong emotions
• Anxiety
• Irritability
• Mood Swings
• Depression
• Rapid speech
• Personality changes

While there are many signs and symptoms of opioid addiction, they’re not all obvious. Many of these are difficult to spot or can be explained away as something else. If you recognize any of these in yourself or in a loved one, use the lists above to check for more. And if you suspect opioid addiction, seek help. Treatment and help for opioid addiction are available.

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Opioid addiction is something that can happen very easily among people using these drugs. It can follow opioid dependence, which is an automatic physical response to the presence of opioids and the onset of withdrawal when opioid levels in the body drop. Opioid dependence is inevitable, but opioid addiction, while it happens easily, is not a given. So what is opioid addiction, exactly? What causes opioid addiction to happen so easily? Knowing these answers can help you avoid opioid addiction yourself, treat addiction, or help someone you know to get help for opioid addiction.

Like other addictions, opioid addiction is considered to be a brain disease. Opioids change the brain in ways that in turn lead to specific negative, self-destructive behaviors. Someone addicted to opioids compulsively seeks and uses these drugs with increasing intensity despite the problems it causes in her life. While often aware of the health, relationship, and legal problems the addiction is creating, a person addicted to opioids will use anyway. He has no other choice. The opioids have “rewired” the brain to need them.

Opioids are highly addictive. Whether they are legally prescribed painkillers such as morphine, Vicodin, codeine, oxycodone, or myriad others or they’re street drugs like heroin, people can easily become addicted to opioids. It’s not because people are weak, flawed, or “bad.” Opioid addiction happens because of the nature of the drugs, not the nature of the person’s character. Let’s take a look at what it is about the nature of opioids that causes addiction.

What Causes Opioid Addiction: The Physiology of Opioid Use

Opioids serve a positive purpose. They relieve pain. They also have a very pleasant euphoric effect. Both are reasons people take opioids in the first place. These don’t guarantee addiction, though. There is a specific process that underlies the reason for opioid addiction.

• The body and brain produce their own natural opioids (endorphins are among them).
• Because we make our own opioids, we have opioid receptors throughout our brain and body.
• When we take any type of opioid for any reason, the brain and body decide that they don’t need to make any of their own, so they stop producing these much-needed neurotransmitters and hormones.
• The opioids we take or use, not the naturally occurring ones that were made in our body, now bond to our opioid receptors.
• If we stop taking painkillers, heroin, etc., there are no natural opioids to take their place, and the brain and body begin to experience opioids withdrawal. This is dependence.
• We resume taking the opioids because the withdrawal symptoms are unpleasant.
• We also continue to take opioids because they activate the reward center of our brain, providing good feelings (both emotionally and physically) and numbing pain. We like this. Our reward centers crave more, but they’re greedy. They get used to the amount we’re taking, and they demand more. But they’re also stingy, and we give them more, they still give us the same amount of pleasure and pain relief. We are now tolerant of opioids.
• We use more opioids now because we need more to activate our reward centers, relieving pain and producing a high, and to avoid the unpleasant withdrawal symptoms that begin the very moment the drug levels in our system drop.
• With the reward system activated and taking over, cravings begin along with the compulsive opioid-seeking and intensified use. Addiction has begun, and without support and treatment, it is likely to intensify and continue because of the strong physiological need for and response to opioids.

Once addicted to opioids, someone must have them. She might misuse her prescription, taking more than she is supposed to. He might take prescriptions that aren’t his, another form of misuse. She might do what 80 percent of heroin users do: turn to heroin after misusing prescription painkillers (National Institute on Drug Abuse, 2017). The physiological need created by the opioids themselves perpetuates the addiction.

While opioid addiction can happen easily, taking an opioid painkiller isn’t a guarantee that you’ll become addicted. Take the medication as prescribed by your doctor, be diligent about checking in with him or her as well as self-monitoring your symptoms, and you can avoid opioid addiction.

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People who have become dependent on opioid drugs, whether prescription painkillers or illicit street drugs such as heroin, experience opioids withdrawal as soon as the substance begins to leave their system. Opioids withdrawal, sometimes referred to as abstinence syndrome, can begin quickly, even between doses of prescribed drugs when one is leaving the system and has not yet been replaced by more.

There are several factors involved in withdrawal from these euphoria-inducing, pain-killing drugs. Read on for information about opioids withdrawal symptoms, timeline, and treatment of opiate addiction.

Opioids Withdrawal Symptoms

Opioids withdrawal is uncomfortable, frequently described as a horrible experience. It involves both physical and mental health symptoms. Physical symptoms typically appear first, followed by psychological symptoms as the withdrawal process progresses.

The earliest opioids withdrawal signs resemble the common flu. These include

• Runny nose
• Watery eyes
• Sweating
• Excessive yawning
• Nausea and/or vomiting

Next can come

• Cravings
• Goosebumps and shivering
• Muscle aches and/or cramps
• Joint pain
• Loss of appetite
• Stomach cramping
• Diarrhea
• Tremors
• Increased heart rate
• Increased sensitivity to pain

Rarely, and only in extreme cases, opioid withdrawal symptoms include

• Fever
• Seizures
• Coma

Mental health symptoms of opioids withdrawal include

• Anxiety
• Depression/dysphoria
• Restlessness
• Irritability
• Insomnia

These symptoms are what’s possible for someone to experience when withdrawing from opioids. Not everyone experiences every symptom, nor does everyone experience everything with the same intensity. Further, the length of time that these symptoms last also varies.

Opioids Withdrawal Timeline

Because there are so many individual differences as well as factors that affect withdrawal, there isn’t a fixed schedule for the opioids withdrawal process. There is, however, a general pattern that helps establish a rough timeline for opioids withdrawal.

The onset of withdrawal depends on the opioid taken, how much is taken, and how it is put into the body. The withdrawal process can begin very quickly, as soon as a dose begins to wear off. In other cases, opioids withdrawal symptoms appear within the first 24 hours after the last opioids were used. Additional symptoms emerge over the next 72 hours. In less severe cases of opioids dependence, withdrawal symptoms can begin to wane in about a week. In more severe cases, the total recovery period lasts at least six months.

Several factors influence the length or timeline of the opioids withdrawal period:

• How frequently someone uses an opioid
• Severity of the opioid addiction (determined in part by an assessment called the Clinical Opiate Withdrawal Scale, or COWS)
• The individual’s overall physical and mental health
• The method of use (injection, snorting, and smoking are faster than pills to act and to exit the body)

The withdrawal timeline is also influenced by the opioids withdrawal help someone receives.

Opioids Withdrawal Treatment

A single opioids withdrawal protocol doesn’t exist because there are too many individual differences and influencing factors to create one set system of procedures. Despite the lack of a single treatment plan that applies to everyone, there are general treatment approaches to help people with opioids withdrawal.

Treating mild opioids withdrawal can be done with over-the-counter (OTC) pain relievers and anti-inflammatory drugs. Sometimes, doctors prescribe medications to help with nausea and diarrhea. Fluids and rest complete the treatment of mild withdrawal symptoms.

More intense withdrawal can require hospitalization or residential treatment for medical detox. This treatment is done to stabilize someone both physically and emotionally, and it involves

• Medications like clonidine to reduce opioids withdrawal symptoms
• Medications known as opioid antagonists or partial antagonists to block opioids receptors and prevent other opioids from attaching; these include the medications methadone, suboxone, buprenorphine, and naloxone
• Counseling
• Education
• Family therapy
• Support groups

No matter the treatment method and location, necessary for opioid withdrawal is time itself, and the exact amount is difficult to determine up front. Treating symptoms isn’t the only part of the process. The body and brain need time to repair themselves. They need time to begin producing natural opioids again. Opioids are necessary for many body systems to function. Therefore, it’s not a simple matter of just waiting for withdrawal symptoms to disappear. The brain and body must relearn how to produce and use endogenous opioids once again.

For safe and successful opioids withdrawal, it’s important to avoid stopping suddenly. Medical supervision, counseling, and emotional and social support are crucial for a positive treatment experience and outcome. The best treatment of opioids withdrawal incorporates the whole person, both their physical and mental health.

article references

How to say what you'd like to try and letting them know when they've hit the spot. How to find the erogenous zones. Be honest, positive and demonstrative

Communicating about sex

Talking with your partner about what you like and what you want can take your sex life in new and fulfilling directions and deepen your relationship as a whole, says sex and relationships counselor Suzie Hayman.

No one is a mind reader

In many couples, one or both partners feel that the other doesn't understand how to satisfy them sexually. And I know from my work at a sex and relationships counselor that this can knock the confidence of both people.

The problem is that when it comes to sex we expect to be instant experts, with instinctive knowledge of what pleases us and a partner. But actually, sex is just like any other skill. If we want to learn how to drive a car or ride a bike, we have to start as beginners and take lessons. And with sex, to understand your own responses and your lover's, you have to learn and practice.

This is because everyone responds differently to sex and sexual arousal. Some like gentle touches, others prefer heavier, rougher contact. One person will be turned on by something another finds unpleasant or uninteresting. Unless you're psychic, the only way to get to know your partner's tastes, and for them to get to know yours, is by communicating.

Say what you'd like to try

Talking about what you like and dislike has several benefits. Not only can simply talking about sex add to your excitement, but the more you talk, the more relaxed and confident you'll be with your partner. I know from my work that most people would like more variety in their love lives, but they're held back from suggesting whatever they'd like to try, whether it's oral sex, bondage or new positions, by embarrassment or fear of rejection.

But you don't have to come out with a bald request. One good technique is to find the option you fancy on the web or in a magazine or a book, and point it out, saying, "That looks fun. Want to try it?" The chances are that, far from being put off, your partner will jump at the chance to experiment. (For more ideas see I'd like you to...).

Non-verbal cues

Communication is vital but there's no need to subject each other to a commentary or a barrage of instructions. You can make your needs known with a range of non-verbal cues. (For more ideas see Bedroom talk).

Let them know when they've hit the spot

Next time you have sex, make sure your partner knows when they've found the right place. If they need a bit of guidance, gently move their hands to demonstrate what turns you on. Make the communication two-way; listen and notice the movements and sounds your partner makes, so you can pick up their likes and dislikes, too.

Be honest, positive and demonstrative

If you're going to say what you'd like and ask what your partner wants, there are three important points to keep in mind.

• Be positive. Don't tell your partner they're terrible in bed. Remember something they did that you really liked and say, "When you did that, I really..." They'll get the message.
• Be honest. There's no point in faking it or saying you like something you don't, because that gives your partner no incentive and no guidance to do better.
• Be demonstrative.

Erogenous zones

The most sensitive sexual areas are

• Breasts, nipples, genitals and lips
• Ear lobes, fingers, toes
• The soft skin inside the elbows and knees, the small of the back and the nape of the neck

Related Information:

• Get to Know Your Body
• Orgasms
• Have You Gone Off Sex?
• Aphrodisiac
• Too Busy for Sex?

Read: Exercises to Improve Your Sex Life