Addiction and dependence are two specific conditions resulting from opioid abuse. Opioid addiction causes different signs and symptoms than physical dependence, and each medical condition requires different approaches to treatment. While these two conditions are independent of one another, it is possible – and even common – for people to suffer from both addiction and physical dependence after sustained substance abuse. Because of this close association between the two, people often view the two conditions as being the same.
The human body is dynamic – it responds and adapts to the environment, including the air, food, and sunlight it encounters. The human body also responds to the effects of chemicals, such as pharmaceuticals and painkillers. Humans take medicine because the primary action of the drug changes the body or brain in a beneficial way. Doctors prescribe morphine, OxyContin, and other opioids because these drugs change the way the brain perceives pain. Opioids also act on the brain to create a pleasant sense of euphoria that makes this drug attractive for recreational use and emotional relief.
Aside from making those primary, perceived beneficial changes in the brain, opioids make subsequent changes in the brain and body. These drugs make slight neurological changes that affect decision-making and other brain processes. Opioids also stiffen smooth muscle groups, including the muscles lining the intestines, skin and even in the pupil of the eye.
Physical Dependence on Opioids
Opioids and other substances also have a toxic effect that your body deals with by changing its own chemistry. With continued use, especially at high doses common with substance abuse, your body acclimates to the high toxicity by making significant and more long-lasting adjustments in chemistry.
With continuous opioid use, a person’s body begins to depend on a certain level of opioids to feel “normal.” Typically, when a person stops taking opioids suddenly, their body struggles to regain control over its chemistry and rid itself of the toxins. The opioid-dependent person feels this struggle for chemical balance through very unpleasant, flu-like symptoms that last for days or weeks.
Doctors refer to this process as opioid detoxification, but most people call it “withdrawal.” Symptoms of withdrawal include agitation and anxiety, muscle aches, watery eyes and runny nose, insomnia, profuse perspiration, diarrhea, and yawning.
Treatment for opioid dependence focuses on lowering opioid levels, alleviating symptoms, reducing toxins, and helping the patient maintain optimism and dignity. Unlike traditional drug rehabs, inpatient medical detoxification provides the best hope for successful detoxification. It is because physicians can reduce opioid levels quickly and safely while administering medications to ease withdrawal symptoms.
Long-term use of certain opioids makes body and brain changes more permanent. These secondary changes to the brain, including alteration of the perception of pleasure and inability to make reasonable decisions, ingrain themselves into neurological pathways deep inside the brain. Left untreated, these neurological changes create an addiction. Opioid addiction changes the way a person thinks, feels, and behaves.
The main symptom of opioid addiction is craving. An addict thinks only about getting high and obsesses about finding more of his substance of choice even before his supply runs out.
Secondary symptoms include social isolation and unsociable behaviors. These neural-behavioral changes allow addiction to gain a firmer grasp on the individual by separating her from the people who might intervene from the addictive process.
Treatment for opioid addiction involves rerouting those unhealthy neurological pathways to healthier ones. Psychotherapy focuses on brain and social exercises that give the individual the cognitive and behavioral tools he needs to live without drugs.
Substance abuse can lead to physical dependence, or addiction, or both. Treatment for co-existing conditions usually begins with detoxification for physical dependence then psychotherapy for addiction. The combination of these two treatments addresses the very two different side effects of substance abuse.