How Addictive Are Opioids?

For over a decade, the opioid epidemic has impacted people from all walks of life. Most anyone who has access to prescription pain medications or heroin can be pulled into the vicious cycle of opioid abuse and addiction. But just how addictive are opioids?

Opioids attack your physical health, and soon thereafter, your mental health. What may start as a treatment for an injury can soon turn into a compulsion that takes over your life. Likewise, when used on a recreational basis, addiction is all but certain.

Opioids and Their Interactions With the Brain & Body

The human body houses a natural opioid-driven system. Opioid receptors can be found in the brain and throughout the central nervous system (CNS). These receptors release endorphin chemicals, also known as the body’s “feel-good” chemicals, which include dopamine, serotonin, and norepinephrine. The body only releases endorphins when needed, such as when an area has been injured. Endorphin secretions also play a role in regulating many other processes, such as your emotions, how you perceive pain, pleasure sensations, and your thinking.

Opioids, such as heroin and prescription painkillers, produce nearly the same effects as the natural endorphins found in the body. So why are opioids so addictive? Their ability to interact with the body’s natural opioid system accounts for the high addiction potential that opioids have. Whether you’re taking an illegal, unregulated opioid like heroin or a doctor-prescribed painkiller, the risk of addiction remains the same.

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Are Opioids Addictive When You Follow Prescription Guidelines?

According to the American Medical Association, an estimated 45 percent of heroin users were first addicted to prescription opioids. Despite the clear-cut directions on the prescription bottle, more than a few people end up taking more than what’s prescribed. Unfortunately, taking painkillers for any length of time opens you up to physical dependence, especially if you’re taking them to relieve pain. The physical dependence on opioids can develop in as soon as four to eight weeks.

The body’s opioid system automatically adjusts to the effects of prescription opioids by cutting back on its endorphin secretions. When this happens, you have to take a larger dose to experience the drug’s pain-relieving effects. This auto-adjust mechanism means your tolerance level for opioids has increased. Not only will you have to keep increasing the dosage level but you’ll likely experience pain spikes in-between doses. Are opioids addictive because of this vicious dependency cycle? Yes, but there’s more to it than that.

How Addictive Are Opioids?

Short-Term Effects of Opioids

Once the brain and body come to depend on opioids, you’re more than likely to experience withdrawal effects when the body needs its next dose. Opioid withdrawal is a powerful, short-term addictive effect that drives you to keep taking the drug whether you want to or not. Like increasing tolerance levels, withdrawal stems from physical dependence on opioids and lays the groundwork for addiction to take hold.

Here are some withdrawal symptoms you might experience:

  • Agitation
  • Fatigue
  • Restlessness
  • Sweating
  • Muddled thinking
  • Depression
  • Irritability

Long-Term Effects of Opioid Abuse

Addiction is one of the most damaging, long-term effects of opioid abuse. And while opioids work by triggering the release of high levels of endorphins, their ability to trigger dopamine secretions account for why opioids are so addictive. Dopamine, one of the brain’s primary neurotransmitters, plays a part in regulating movement, emotions, and mental well-being. The levels of dopamine in the brain also impact the brain’s reward system, which is where addiction develops.

Are opioids addictive because of the brain’s reward system? Yes. This system records anything and everything that promotes your survival, such as food, water, and sex. It determines what aspects of your life support survival by the levels of dopamine in your body at any given moment. From there, the reward system uses this information to direct your thinking, values, and priorities. Since opioids easily increase dopamine levels in the brain, the reward system views opioid abuse as essential to your survival.

Behavioral Effects

Drug Cravings

The answer to how addictive are opioids can be seen in the nonstop cravings users and those in recovery struggle with on a daily basis. As physical as cravings may feel, they’re actually a product of opioid effects on the brain’s reward system. People in recovery who’ve abstained from opioid abuse for months can still experience drug cravings when the physical basis for “needing” the drug is gone. This is the psychological aspect of addiction at work.

Once the brain’s reward system “learns” the importance of opioids, getting and using the drug becomes a compulsion. Not only that, but the importance the reward system has placed on using the drug can also make a person do almost anything to obtain it. In effect, drug cravings help drive the addiction cycle and can continue to do so long after drug use stops.


Like drug cravings, triggers are driven by the effects opioids have on your brain reward system. Cravings stem from the brain’s “need” for the drug. Triggers are the little details your reward system recorded when drug use occurred. While each person’s triggers are different, they all tend to fall into broad categories, including:

  • Emotional triggers, which are feelings, such as sadness, happiness, or anxiety that the brain associated with drug use
  • Pattern triggers, which are routines, such as certain seasons, events, or certain times of day that stimulate your desire to use drugs
  • Social triggers, which include certain people or groups of people that prompt drug cravings

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Why Opioid Addiction Treatment Is So Important

By the time you become addicted to opioids, the drug has rewired your brain’s circuitry. The effects of moderate, long-term, and chronic opioid abuse leave the brain in a perpetual state of chemical imbalance, a condition that promotes continued drug abuse. How addictive are opioids can be seen in how these drugs hijack the brain and hold it hostage, even after drug use stops.

Opioid addiction rehab programs provide the level of support the brain needs to function without opioids. This includes medication-assisted therapies that help restore a normal chemical balance in the brain. This line of treatment alone can work wonders when it comes to helping you resist drug cravings and also providing much-needed relief from uncomfortable withdrawal symptoms. Opioid rehab programs also help you replace addiction-based thinking and behaviors with coping strategies that support a drug-free lifestyle. In the absence of these types of supports, it’s very difficult to overcome opioid addiction.



Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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