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This health awareness website was created by Accord-UK Ltd and is intended for members of the general public.

Understanding

OPIOID

ADDICTION

From the basics of opioids to the complexities of addiction, this section
will help you to understand opioids and how they can lead to dependency.
We explore the signs and symptoms of opioid addiction and offer important
advice on how to avoid misuse when taking opioid-based medicines.

What is an

opioid?

Opioids are a type of drug naturally found in the opium poppy plant. Some opioids are made from the plant directly, while others are made by scientists in labs using the same chemical structure.1

Opioids are often used as medicines because they can relax the body and relieve pain, for example after surgery or an injury. They can also be used to treat coughing and diarrhoea.1

Opioids work by interacting with the body’s opioid receptors, which are mainly found in the brain and spinal cord. These receptors play an important role in regulating pain, pleasure, and other sensations.1

THE DIFFERENT

TYPES OF OPIOIDS

ILLEGAL

OPIOIDS

Illegal opioids, such as heroin, are not prescribed by healthcare professionals and are often associated with significant health risks2

SYNTHETIC

OPIOIDS

Man-made opioids, like fentanyl and nitazenes, are created in laboratories. They can be many times more potent than natural opioids, posing a higher risk of overdose3,4

PRESCRIPTION

OPIOIDS

Healthcare professionals prescribe these medications to manage pain. Common prescription opioids include oxycodone and morphine5

OVER-THE-
COUNTER (OTC)

OPIOIDS

The opioid codeine is available over-the-counter in the UK, often in combination with other medications, for mild pain relief. However, even OTC formulations require responsible use due to potential risks6

The dangers of

synthetic opioids

Synthetic opioids have gained attention due to their potency and involvement in overdoses and deaths

They are sometimes mixed with other substances, contributing to the opioid crisis.

Fentanyl, in particular, is a powerful synthetic opioid, and even a small amount can lead to a life-threatening overdose.3

Recently, synthetic opioids called nitazenes have been found to be responsible for an increase in heroin-related overdoses and deaths in the UK.4

It can be more difficult to judge how much heroin to take if it has been mixed with nitazenes. If you are in contact with a heroin user it is therefore more important than ever to be able to recognise the possible symptoms of an overdose and how to respond.4

WHAT IS

OPIOID ADDICTION?

An addiction is when something that began as feeling pleasurable now feels like something you can’t live without.

With a drug addiction, there is an out-of-control feeling that you must continue taking a medicine or drug even though it is causing harm. Opioids in particular are highly addictive because they activate the reward centers in our brains.7

It is important to remember that an opioid addiction can affect anyone, regardless of their background or circumstances.

An opioid addiction does not make someone ‘weak’ or ‘bad’, because they are actually struggling with a complex biological and psychological condition.

HOW OPIOIDS CAN

LEAD TO ADDICTION

Opioid addiction is a complex condition involving changes in the brain that first lead to a tolerance and then a dependence to opioids.7

Watch the short film below to learn more about the changes that happen in the body as an opioid addiction develops.

Recognising the signs

of opioid addiction

Opioid addiction can sometimes bring about noticeable changes in behavior that can affect not only the person struggling with addiction but also their friends and family.

The signs of heroin use in particular can be very different from person to person and can depend on things like the length of abuse or presence of mental illness.

Although some changes in behaviour could be a sign of heroin use, remember that they do not necessarily mean that someone has an addiction to heroin or other opioids.

Some common signs

of heroin addiction8

Ignoring housework

Neglecting personal hygiene

Underperforming at school or work

Skipping classes or missing work

Sudden, unexplained need for money

Being secretive

Sudden change in friendships and interests

Wearing long sleeves in warm weather to hide injection sites

For someone who is addicted to legally available opioids, such as prescription or over-the-counter opioids, the signs may sometimes be harder to recognise.

People addicted to opioid medications may seem to handle their jobs and daily responsibilities well, giving the impression of stability at work and home.

However, as time goes on, this addiction can cause serious problems in different areas of their lives.9

The typical signs of

addiction to
opioid medicines9

Taking the medicine differently

Taking opioids unnecessarily

Mood Changes

Sleep pattern changes

Borrowing or ‘losing’ medication

Seeking multiple prescriptions

Poor decision-making

Taking the medicine differently

Using opioid medicines in ways not prescribed by your doctor, such as taking more than the recommended dose or using them for the way they make you feel.

Taking opioids unnecessarily

Taking opioid medicines ‘just in case’ even when there is no pain, which could be a sign of opioid dependence.

Mood Changes

Experiencing noticeable mood swings, ranging from extreme elation to hostility.

Sleep pattern changes

Observing shifts in sleep patterns, which may be linked to opioid use.

Borrowing or ‘losing’ medication

Borrowing medications from others or frequently ‘losing’ medications, leading to repeated prescriptions.

Seeking multiple prescriptions

Visiting multiple doctors to obtain the same prescription, possibly to ensure a backup supply.

Poor decision-making

Engaging in risky behavior that can jeopardise their safety and the well-being of others.

What to do if you

suspect an opioid addiction

If you think that you or someone you know has an addiction to opioids, or is at risk of becoming addicted, there are many resources available to help. Here are a few options:

The GP:

They will be able to assess the situation
and recommend appropriate treatment or
referral options.

NHS Drug Treatment Service:

Offering a range of free and confidential services,
including one-to-one and group, medication-assisted
treatment, blood testing and vaccinations.

Click here to find your local service

If you are concerned about
someone you know, visit the section:

Supporting a friend or relative

...for more information.

How to avoid

opioid addiction

Unfortunately the risk of addiction cannot be completely avoided, but there are steps people can take to reduce their chances of developing a problem with opioids.

These include making sure that prescription opioids are used safely and only when necessary, and being aware of the potential risks of over-the-counter (OTC) opioid-containing medications.10

  • Learn about the potential risks associated with opioid medicines

Be

informed

  • Before you are prescribed opioids, your doctor must know if you have a history of substance use or addiction
  • Take the medicine exactly as directed by your doctor, pharmacist, or on the leaflet included in the pack

Practise

safe use

  • When purchasing pain relief or discussing with your doctor, consider non-opioid alternatives, which can often have a lower risk of addiction
  • Be mindful of your medication use, and seek help if you show any signs of dependence or misuse

Reduce

the risk

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References

  1. National Institute on Drug Abuse (NIDA) (2021). Prescription Opioids DrugFacts. [online] National Institute on Drug Abuse. Available at: https://nida.nih.gov/publications/drugfacts/prescription-opioids [Accessed July 2024].
  2. European Monitoring Centre for Drugs and Drug Addiction (2023). Heroin and other opioids – the current situation in Europe (European Drug Report 2023) | www.emcdda.europa.eu. [online] Available at: https://www.emcdda.europa.eu/publications/european-drug-report/2023/heroin-and-other-opioids_en [Accessed July 2024].
  3. Oasis Runcorn. (2023). Fentanyl Addiction Treatment & Detox | Start Rehab Today. [online] Available at: https://www.oasisrehab.co.uk/rehab/prescription-drug/opioid/fentanyl-treatment/ [Accessed July 2024].
  4. National Patient Safety Alert, July 2023 – Potent synthetic opioids implicated in heroin overdoses and deaths: https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103236 [Accessed July 2024].
  5. Krieger, C. (2018). What Are Opioids and Why Are They dangerous? [online] Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270 [Accessed July 2024].
  6. Mody, S., Kirkdale, C.L., Thornley, T., Dickinson, A., Avery, A.J., Knaggs, R., Rann, S. and Bastable, R. (2020). Over-the-counter codeine: can community pharmacy staff nudge customers into its safe and appropriate use? Pharmacy, 8(4), p.185. doi:https://doi.org/10.3390/pharmacy8040185.
  7. Kosten, T. and George, T. (2002). The Neurobiology of Opioid Dependence: Implications for Treatment. Science & Practice Perspectives, [online] 1(1), pp.13–20. doi:https://doi.org/10.1151/spp021113.
  8. Village Behavioral Health Treatment Center. (2023). Signs, Symptoms & Effects of Heroin Abuse in Adolescents | Village Behavioral Health. [online] Available at: https://www.villagebh.com/addiction/heroin/symptoms-signs-effects/ [Accessed July 2024].
  9. Mayo Clinic (2018). How to tell if a loved one is abusing opioids. [online] Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-tell-if-a-loved-one-is-abusing-opioids/art-20386038 [Accessed July 2024].
  10. Mayo Clinic (2023). How opioid addiction occurs. [online] Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372 [Accessed July 2024].