Opioid use disorder signs, treatment options and other frequently asked questions

Opioid use disorder is a medical term used to describe the chronic misuse of opioids, a class of drug commonly prescribed to treat prolonged or severe pain by blocking pain signals between the brain and the body. Patients with this disorder experience opioid addiction, severe withdrawal symptoms and increased tolerance over time. OUD affects people of all social, economic and educational backgrounds. According to the U.S. Department of Health and Human Services, 1.6 million Americans had an OUD in 2019.

Many patients who were prescribed opioids start with oxycodone. As a person’s tolerance increases over time, they may begin using stronger opioids, such as heroin, a highly addictive drug made from morphine. An even more potent opioid is fentanyl — according to the federal Centers for Disease Control and Prevention, fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine.

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Physical symptoms can include drowsiness, nausea, shallow breathing and slurred speech. Patients with long-term OUD are at risk for health issues like chronic constipation, breathing problems and heart rhythm abnormalities. OUD can also interfere with a patient’s work life and personal relationships, and a patient may give up on normal activities due to opioid use.

Many patients with OUD experience cravings and a consistent, strong desire to use opioids, often ingesting larger amounts than what is recommended or taking opioids over an extensive period of time.

Dependence refers to a physical need to ingest opioids to regulate the body’s pain and withdrawal symptoms. Addiction is a more severe form of opioid dependence in which a person’s opioid use becomes overwhelming, resulting in compulsive behaviors to satisfy the brain’s reward center. People with dependence retain a level of control over opioid use, while those with an addiction find opioid use difficult to restrict. A person diagnosed with OUD typically struggles with addiction rather than dependence.

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Treatments for OUD can include medication, behavioral therapies or a combination of both. Medications are often used to reverse the negative effects of opioids on the brain — they can help relieve withdrawal symptoms and dissipate cravings. Patients may also receive counseling and therapy, which can depend on the severity of the addiction. Behavioral therapies can include inpatient treatment, outpatient counseling or even long-term therapeutic communities.

Although there are several treatments for OUD, the disorder usually requires continuous, extensive care over time — a person may struggle with opioid use throughout their entire life. There is currently no cure for OUD, but with treatment it can become manageable, and recovery is possible.

Health care providers of all types can encounter patients with OUD, which is why it’s important for physicians in every specialty to understand how to recognize and treat this disorder. If you or someone you know is struggling with opioid addiction and you’re seeking help, reaching out to your primary care provider is a great place to start.