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Why Are Opioids So Addictive?

By WebMD Connect to Care Staff
Millions of Americans misuse opioids every year. But what makes these drugs so addictive?

Opioids work by blocking out pain and making you feel calm and happy, which can lead to a huge potential for abuse and addiction (opioid use disorder or OUD). The 2018 National Survey on Drug Use and Health reports that approximately 10 million Americans misuse opioid painkillers each year.

“Human nature is to maximize pleasure and minimize pain,” addiction counselor Lin Sternlicht, LMHC, MA, EdM, tells WebMD Connect to Care. “ Opioids are highly effective at doing so on a psychological and physiological basis.” The power of these addictive drugs lies in their ability to disrupt essential neurochemical systems in our bodies.

Effects of Opioids

According to the National Institute on Drug Abuse (NIDA) as well as decades of research outlined by the US Library of Medicine, opioids are known to cause the following: 

  • Stimulate endogenous opioid receptors in the nervous system
  • Reduce pain
  • Provide a feeling of relaxation
  • Bring about euphoria
  • Boost reward pathway chemicals like dopamine
  • Reinforce drug use behaviors
  • Lead users to crave more

“Over time, the individual’s body struggles to produce natural neurotransmitters as it becomes dependent on the substance to produce them,” Sternlicht says. “This is often why some individuals dependent on opioids report having a low mood when they are not under the influence of the substance or report needing the substance just to ‘feel normal.’”

A 2018 study in Borderline Personality Disorder Emotional Dysregulation found that using opioids leads to emotional irregularities, including negative thoughts and feelings, as well as a lesser capacity for experiencing pleasure without drugs. When people with chronic pain start to depend on opioids, they may begin to feel hopeless about their pain, seeing no way out except for drug use.

“Opioids become so addictive because they give the user a break from their own mind. Aside from the physical relaxation of the body, and numbness, the mind slows down, and thoughts and feelings lessen,” psychotherapist Jason Shiers, Dip.Psyh MBACP tells WebMD Connect to Care. “The user becomes calm and experiences peace of mind, drowsiness, and escape from their everyday reality. Once people start to get a feel for the chemically enhanced lifestyle, it is much easier for them to cope.”

Accessibility and legal status both contribute to the widespread popularity of opioid drugs. In some cases, addiction begins when you get a long-term prescription for chronic pain medication. In addition, users also often obtain opioids from friends and family members who have pills leftover from old prescriptions.

“Opioids are the drug of choice for so many addicts for various reasons,” addiction specialist and psychoanalyst Colin McDonnell, MA tells WebMD Connect to Care. “Primarily, they are very easy to access without fear of criminal charges. Being a legal, controlled substance, they also do not carry the stigma normally associated with other drugs. Using them can be very easy to explain to others. The effects on the body are also much easier to hide from others than more visibly intense drugs.”

Get Help Now

Dealing with addiction on your own is extremely difficult. Don’t hesitate to reach out for professional help to give you freedom from opioid dependency.

If you or a loved one is struggling with opioid addiction, WebMD Connect to Care Advisors are standing by to help.

Treatment & Resources for Opioid Addiction