Painkillers and Addiction: Narcotic Abuse

What Is Narcotic Abuse?

One of the most frequent reasons people go to the doctor is for pain relief. There are a number of different drugs that can ease pain. 

Opioids -- also called opiates or narcotics -- are pain relievers made from opium, which comes from the poppy plant. Morphine and codeine are the two natural products of opium. Synthetic modifications or imitations of morphine produce the other opioids:

• Heroin
• Dilaudid (hydromorphone)
• Percocet, Percodan, OxyContin (oxycodone)
• Vicodin, Lorcet, Lortab (hydrocodone)
• Demerol (pethidine)
• Methadone
• Duragesic (fentanyl)

When people use narcotics only to control pain, they are unlikely to become addicted to the drugs. However, opioids provide an intoxicating high when injected or taken orally in high doses. Opioids are also powerful anxiety relievers. For these reasons, narcotic abuse is one of the most common forms of drug abuse in the U.S.

Terms like opioid abuse, drug abuse, drug dependence, and drug addiction are often used interchangeably, but experts define them as follows:

• Drug abuse, including opioid abuse, is the deliberate use of a medicine beyond a doctor's prescription. In the case of opiates, the intention is generally to get high or to relieve anxiety.
• Dependence occurs when the body develops tolerance to the drug, meaning higher doses are needed for the same effect. In addition, stopping the drug produces drug withdrawal symptoms.
• Drug addiction occurs when the person has drug dependence, but also displays psychological effects. These include compulsive behavior to get the drug; craving for the drug; and continued use despite negative consequences, like legal problems or losing a job.

Narcotic Abuse Symptoms

Signs and symptoms of opioid abuse include:

• Analgesia (feeling no pain)
• Sedation
• Euphoria (feeling high)
• Respiratory depression (shallow or slow breathing)
• Small pupils
• Nausea, vomiting
• Itching or flushed skin
• Constipation
• Slurred speech
• Confusion or poor judgment  

Symptoms of Opioid Drug Withdrawal

If a person uses opioids for a long time, they develop physical dependence and tolerance. Usually, opioid abusers will then take more of the drug, to continue to get high. If a person stops using opioids after they become physically dependent on the drug, they will experience drug withdrawal symptoms.

Symptoms of drug withdrawal from opioids include:

• Anxiety
• Irritability
• Craving for the drug
• Increased respiratory rate (rapid breathing)
• Yawning
• Runny nose
• Salivation
• Gooseflesh
• Nasal stuffiness
• Muscle aches
• Vomiting
• Abdominal cramping
• Diarrhea
• Sweating
• Confusion
• Enlarged pupils
• Tremors
• Loss of appetite

The symptoms of opioid drug withdrawal aren't medically dangerous. But they can be agonizing and intolerable, contributing to continued drug abuse. In general, how severe opioid drug withdrawal symptoms are, and how long they last, depends on how long the person has been abusing opioids and how much they have been taking.  

Medicines like methadone or Suboxone can be used to prevent withdrawal symptoms after a person stops using, a process called detoxification ("detox"). After drug withdrawal is complete, the person is no longer physically dependent on the drug. But psychological dependence can continue. Most people with drug addiction eventually relapse in response to stress or other powerful triggers.