Opioid Use Disorder: Symptoms, Causes, Effects, and Treatment Services

Opioid Use Disorder (OUD) is a medically recognized chronic brain disease characterized by a compulsive urge to use opioids—whether prescribed pain relievers or illicit narcotics—despite clear evidence of harm to physical health, mental wellbeing, and social functioning. According to the American Psychiatric Association (APA), OUD is diagnosed when opioid consumption causes clinically significant impairment or distress.

Opioids constitute a broad pharmacological class that includes natural opiates derived directly from the opium poppy plant (e.g., morphine, codeine), semi-synthetic opioids (e.g., oxycodone, hydrocodone), and synthetic opioids engineered to replicate opiate effects (e.g., fentanyl, methadone). In contrast, the term opiates is reserved for compounds naturally extracted from the poppy. This distinction is crucial: synthetic opioids like illicit fentanyl analogs are among the deadliest drivers of modern overdose fatalities.

Epidemiological surveillance by the New Jersey Office of the Attorney General’s NJ CARES program reveals a staggering 115.7% increase in opioid-related deaths in Burlington County over a nine-year period from 2013 to 2022. This local surge reflects national trends, as the Centers for Disease Control and Prevention (CDC) confirms opioids now account for over 70% of all drug overdose deaths in the United States.

As Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA), emphasizes: “Synthetic opioids are reshaping the overdose crisis; our response must adapt swiftly to prevent needless loss of life.”

Understanding the pharmacological diversity of opioids enables clinicians and policymakers to balance therapeutic pain management with robust addiction prevention protocols. Risk mitigation strategies include Prescription Drug Monitoring Programs (PDMPs), community-based naloxone distribution, and access to Medication-Assisted Treatment (MAT) combining behavioral therapies with FDA-approved medications such as buprenorphine and methadone.

What Is Opioid Use Disorder (OUD)?

Opioid Use Disorder is a medical condition characterized by a problematic pattern of opioid use leading to serious psychological or physical distress despite negative consequences. 

The symptoms include a strong desire to use opioids, increased tolerance, and withdrawal symptoms with cessation. Opioid addiction is a severe and widespread issue, affecting over 16 million people globally and resulting in between 100,000 and 125,000 deaths annually, according to the CDC. 

Opioids can be categorized into natural, semi-synthetic, and synthetic types, each with unique characteristics and risks.

What are the Most Popular (Addictive) Opioids?

The most popular opioids are fentanyl, heroin, prescription opioids, and methadone. Opioid-involved overdose deaths rose from 49,860 in 2019 to 81,806 in 2022. 

Below is a list of the most popular and dangerous opioids:

1. Fentanyl

Fentanyl is a synthetic opioid used medically for severe pain management but is also widely abused due to its extreme potency, being 50 to 100 times stronger than morphine. Available in various forms, including transdermal patches, lozenges, and injectables, fentanyl is found illicitly in powder form or mixed with other drugs. 

Its powerful effects lead to a high risk of addiction, overdose and death. According to the CDC, fentanyl and other synthetic opioids accounted for 76,226 in 2022 and 74,702 overdose deaths in 2023, making it the most deadly opioid.

2. Heroin (Diacetylmorphine)

Heroin is an illegal opioid widely abused for its intense euphoric effects. Typically found as a white or brown powder or as a black sticky substance known as “black tar heroin,” it can be injected, snorted, or smoked. 

Heroin is highly addictive, with nearly 745,000 people in the United States addicted, according to the National Institute on Drug Abuse (NIDA). Heroin overdose deaths peaked at around in 2015 with 5,871 deaths in 2022, according to the National Center on Health Statistics and CDC Wonder data.

3. Natural & Semi-Synthetic prescription Opioids (morphine, oxycodone, hydrocodone)

Natural & Semi-Synthetic Opioids, such as morphine, oxycodone, and hydrocodone, are commonly prescribed for managing moderate to severe pain. These opioids are frequently abused for their euphoric effects. 

According to the National Survey on Drug Use and Health (NSDUH), approximately 3.6 million people in the United States misuse prescription pain relievers like oxycodone annually.  Drug overdose deaths involving prescription opioids totaled 16,706 reported deaths in 2021

Types of prescription opioids include:

• Morphine: Used medically for severe pain management, morphine is highly addictive and commonly abused.
• Oxycodone: Known by brand names such as OxyContin and Percocet, oxycodone is widely prescribed and frequently misused.
• Hydrocodone: Often combined with acetaminophen in products like Vicodin, hydrocodone is both commonly prescribed and abused.

4. Methadone

Methadone is a synthetic opioid used for pain management and opioid replacement therapy. Although it is used to help treat opioid addiction, methadone itself can be addictive and is associated with overdose deaths. 

What Are The Effects Of Opioid Use Disorder?

The effects of Opioid Use Disorder (OUD) have a wide range of effects that are debilitating on both a physical and psychological level. 

Here are some key effects of opioid use disorder:

• Physical Health Effects: Chronic opioid use leads to tolerance, requiring higher doses to achieve the same effects, which increases the risk of overdose. Common physical symptoms include nausea, constipation, and drowsiness. In severe cases, opioid misuse leads to respiratory depression and death.
• Mental Health Effects: OUD can significantly affect mental health, leading to mood swings, depression, and anxiety. The disorder diminishes an individual’s ability to experience pleasure from normally enjoyable activities.
• Behavioral Changes: Individuals with OUD exhibit behavioral changes such as increased secrecy, withdrawing from social activities, and neglecting responsibilities. There’s often a compulsive need to obtain and use opioids, even in the face of harmful consequences.
• Social and Economic Impact: OUD leads to significant social issues, including job loss, financial difficulties, and strained relationships. Legal problems may also arise from activities related to obtaining opioids.
• Risk of Infection: Injecting opioids increases the risk of contracting infectious diseases such as HIV and hepatitis due to needle sharing and unsafe injection practices.

What Are The Signs and Symptoms of Opioid Addiction?

Symptoms of opioid addiction include uncontrollable cravings and an inability to curtail opioid use despite adverse consequences to their personal relationships or financial stability. These signs encompass a range of physical, emotional, and behavioral indicators.

Here are some common symptoms associated with opioid addiction:

• Whole body symptoms: Cravings for drugs and excessive sweating.
• Mood-related symptoms: Feelings of euphoria or general discontent that fluctuate dramatically.
• Physical symptoms: These include chronic constipation, small pupils, nausea, a reduced sex drive, increased sensitivity to pain, shallow breathing, or slurred speech.

The early Signs & Symptoms of opioid addiction include:

• Increasing tolerance
• Euphoria
• Escalation of dosage
• Frequent mood swings
• Social withdrawal
• Changes in sleep patterns
• Neglect of responsibilities
• Lying or secretive behavior
• Seeking prescriptions from multiple doctors
• Preoccupation with obtaining and using opiates
• Neglecting personal appearance and hygiene.

What are the Causes of Opioid Addiction?

The causes of opioid addiction are a complex condition influenced by biological, psychological, and social elements. Understanding the causes of opioid addiction helps in developing effective prevention and treatment strategies. 

The primary causes of opioid use disorder are listed below.

1. Prescription Painkiller Misuse

One of the leading causes of opioid addiction is the misuse of prescription painkillers. The most common reason cited by individuals for misusing prescription painkillers was to relieve physical pain, accounting for 65.7% of misuse cases among those aged 12 or older in 2019​​. Prescription opioids like oxycodone, hydrocodone, and morphine are prescribed for pain management but can lead to dependency and addiction if not used correctly.

2. Chronic Pain

Individuals suffering from chronic pain conditions are at a higher risk of developing opioid addiction. Chronic pain leads to prolonged use of prescription opioids, increasing the risk of tolerance and dependence. Patients require higher doses over time to achieve the same level of pain relief, which can escalate into addiction.

3. Psychological Factors

Mental health disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD) are significant contributors to opioid addiction. Individuals with these conditions use opioids as a way to self-medicate and alleviate their psychological symptoms, leading to misuse and addiction.

4. Genetic Predisposition

Genetics plays a crucial role in the susceptibility to addiction. Studies have shown that genetic factors can account for 40-60% of an individual’s vulnerability to addiction. A family history of substance abuse increases the likelihood of developing opioid addiction.

5. Environmental Factors

Environmental influences, including exposure to drugs within the family or community, socioeconomic status, and peer pressure, contribute to the development of opioid addiction. Stressful life events, such as trauma or abuse, also increase the risk.

6. Social and Cultural Influences

The social environment and cultural attitudes towards drug use impact the prevalence of opioid addiction. In some communities, the normalization of drug use and lack of access to proper medical care and education about the risks of opioid misuse can lead to higher rates of addiction.

7. Ease of Access

The availability of prescription opioids and illicit opioids like heroin and fentanyl contributes significantly to the opioid crisis. Easy access to these drugs increases the likelihood of misuse and addiction.

What is Opioid Withdrawal?

Opioid withdrawal symptoms occur when one stops taking opioids for a period. It is intense and uncomfortable, causing symptoms like nausea, vomiting, diarrhea, muscle aches, restlessness, anxiety, depression, insomnia, and strong drug cravings. These symptoms typically begin within hours after the last dose and peak within a few days, making the early stages of recovery challenging.

Attempting to go through opiate withdrawal without proper medical supervision can be hazardous. The severity of symptoms leads to dehydration, electrolyte imbalances, and other medical complications. Moreover, the intense discomfort and emotional distress of withdrawal increase the risk of relapse, as individuals might turn to opiates to alleviate their suffering.

What Are The Opioid Use Disorder Statistics in New Jersey?

According to the New Jersey Department of Health’s Overdose Data Dashboard, fentanyl and other synthetic opioids were involved in 83% of total overdose deaths in New Jersey in 2022. 

New Jersey saw a staggering 87,745 treatment admissions, underscoring the pressing need for intervention and support., Opiates, heroin in particular (an illegal opiate), accounted for nearly 38% by NJ.GOV.

What Are The Treatment Options For Opioid Addiction?

Treatment options for opiate addiction include inpatient and outpatient treatment. They target the physical, psychological, and social complexities of this challenging condition, offering individuals pathways to recovery and improved quality of life.

The treatment options for opioid addiction are explained below:

Did you know most health insurance plans cover substance use disorder treatment? Check your coverage online now.

Inpatient Treatment

Inpatient treatment, also known as residential treatment, is a comprehensive approach to addressing opiate addiction that involves individuals residing at a specialized facility during their treatment. 

Inpatient treatment includes the following components:

• Medical Detoxification: Inpatient programs begin with a medically supervised detox phase, where individuals are safely weaned off opiates while managing withdrawal symptoms under the care of medical professionals.
• Therapy and Counseling: Inpatient programs provide a range of therapy and counseling services, including individual therapy, group therapy, and family therapy. These sessions address the psychological aspects of addiction, underlying issues, and coping strategies.
• Structured Schedule: Inpatient programs offer a structured daily schedule that includes therapeutic activities, educational sessions, physical exercise, and holistic therapies aimed at promoting overall well-being.
• Peer Support: Being in a residential setting allows individuals to connect with peers who are also on the path to recovery. Peer support provides a sense of camaraderie and understanding that can be invaluable during treatment.
• Holistic Approaches: Many inpatient programs incorporate holistic therapies such as yoga, meditation, art therapy, and mindfulness practices to address the mind-body connection and promote relaxation.

Inpatient treatment offers a higher level of support and structure, increasing the chances of successful recovery compared to less intensive outpatient options. 

Outpatient Treatment

Outpatient treatment is a flexible approach to addressing opiate addiction that allows individuals to receive treatment while living at home and continuing with their daily responsibilities. It is suitable for those who do not require 24-hour medical supervision or for individuals who have completed inpatient treatment and are transitioning back into their regular lives.

Outpatient treatment involves the following components:

• Counseling and Therapy: Outpatient programs offer individual therapy, group therapy, and counseling sessions to address the psychological aspects of addiction, teach coping strategies, and provide support.
• Medical Monitoring: While not as intensive as inpatient treatment, outpatient programs may include medical check-ins to monitor progress and ensure safety during the recovery process.
• Flexibility: Outpatient treatment provides flexibility, allowing individuals to maintain their daily routines, such as work or school commitments, while attending treatment sessions during designated times.
• Education: Educational sessions provide information about addiction, relapse prevention, and healthy lifestyle choices to support long-term recovery.
• Peer Support: Group therapy sessions in outpatient programs provide opportunities for individuals to connect with peers who are also working toward recovery, fostering a sense of community.

The success rates of outpatient treatment for opiate addiction vary based on several factors, including the individual’s level of motivation, the severity of the addiction, the support system at home, and the quality of the outpatient program.

Is Insurance Coverage Available For Opioid Addiction Rehab Programs In New Jersey?

Yes, insurance coverage is available for opioid addiction rehab programs in New Jersey. Under the Affordable Care Act, both private and public insurance plans, including Medicaid and Medicare, are required to cover substance use disorder treatments as essential health benefits. 

This coverage includes services such as detoxification, inpatient and outpatient rehab, medication-assisted treatment (MAT), and counseling. However, the extent of coverage varies based on your specific insurance plan and the treatment provider. It’s advisable to contact your insurance provider directly to understand the details of your coverage.