Opiate dependence is the medical diagnosis that is given when an individual develops an inability to stop using opiates such as heroin, morphine, codeine or Oxycontin despite his or her obvious desire to do so.  The World Health Organization defines opiate dependence as:

“a cluster of physiological, behavioral and cognitive phenomena of variable intensity, in which the use of a psychoactive drug takes on a high priority.  The necessary descriptive characteristics are preoccupation with a desire to obtain and take the drug and persistent drug-seeking behavior.  Determinants and problematic consequences of drug dependence may be biological, psychological or social, and usually interact.”

In order for a patient to be diagnosed by a doctor as opiate dependent, he or she must show at least 3 of the following 6 signs or characteristics:

• Intense desire or craving for opiates
• Inability to control opiate use or level of use
• Withdrawal symptoms when drug of choice is not used or using other opiates to prevent withdrawal symptoms
• Tolerance that results in the need for increased doses of the drug to produce the same effects
• Neglecting personal activities that were once interesting and fun in order to use drugs
• Using opiates despite consequences such as health problems, relationship problems or financial problems

Walid-Robinson Opioid Dependence Questionnaire

Opiate dependence is typically determined by a doctor who will use the Walid-Robinson Opioid Dependence Questionnaire to determine the presence of a dependency problem.  The questionnaire was developed based on the World Health Organization clinical guidelines for the diagnosis of dependence which requires that 3 of the above 6 characteristics be exhibited in order to confirm a diagnosis of drug dependence.

If you answer yes to three or more of the following questions, opiate dependence is likely a factor in your life:

• Do you desire to continue taking your opiate medication?
• Do you now experience lengthy periods of use or binge patters of use?
• Do you have tremors and use substances to relieve withdrawal symptoms?
• Are you able to take more drugs without easing the pain?
• Do you neglect food, hygiene or health care?
• Do you want to continue to use the drugs despite knowledge of problems caused or exacerbated by it?

These are just some of the questions that may be used to predict opiate dependence and the need for professional treatment.  If you or someone you know is dependent on opiates, call our helpline at  800-442-6158 Who Answers?  to talk with a treatment professional about the benefits of getting help before it’s too late.

Cause of Opiate Dependence

Most of the time, people who become dependent on opiates find themselves opiate dependent as a result of suffering from pain or a psychiatric problem.  Opiates are often prescribed for the treatment of pain and many of those who take the drugs as prescribed become dependent on them.  Opiates do not seem to cause psychiatric problems such as depression or anxiety so for those who do have underlying psychiatric conditions it is not usually as a result of having become dependent on opiates.

Opiate dependence results from the use of opiates such as heroin, morphine or Oxycontin.  Even taking these drugs under the direction and control of a doctor can lead to tolerance and physical dependence that makes it difficult to quit.  Chronic or repeated exposure to opiates results in opiate dependence.

Signs of Opiate Dependence

Developing an opiate dependence makes it nearly impossible to stop using without help.

The signs of opiate dependence revolve around withdrawal symptoms and the negative effects that not using opiates seems to have on those who are already opiate dependent.  An opiate-naïve individual (someone who is not dependent on the drug) will not feel adverse symptoms of withdrawal when they stop taking the opiates.  An opiate-dependent individual will show signs of withdrawal if he or she doesn’t take opiates and may show an increase in drug-seeking behavior.

Opiate dependence signs include:

• Tremors
• Cramps
• Muscle pain
• Joint pain
• Chills and cold sweats
• Increased heart beat
• Itching
• Restless leg syndrome
• Flu-like symptoms
• Yawning
• Sneezing
• Nausea
• Vomiting
• Diarrhea

There are also a number of psychological symptoms that may become noticeable when opiate dependence is a factor.

Some of the most common psychological symptoms of opiate dependence include:

• Anxiety
• Panic attacks
• Depression
• Paranoia
• Insomnia
• Intense cravings

Severity of Opiate Dependence

The severity of an opiate dependence will depend on a variety of factors including the level of opiate use, the type of drug being used, the frequency of use and the duration of the drug use.  The physical withdrawal symptoms can last for anywhere from a couple of days to a few weeks or more depending on these factors and depending on the method of opiate detox that takes place.  Long acting opioids can take longer to get out of the system.  These include methadone and buprenorphine.

Because opiate dependence is such a dangerous and potentially deadly condition, it’s important to seek professional treatment if you believe that you or someone you know is physically dependent on a drug such as heroin, morphine, methadone or another opiate. Call  800-442-6158 Who Answers? for help finding the best treatment program for your needs. 

Treatment Options

Opiate dependence is considered a very complex health condition that requires extensive treatment in order to help the user avoid opiate abusive behaviors, change their patterns of poor behavior and drug use, overcome psychological elements of the addiction and heal physically.  There are a number of treatment options available for those who do become physically dependent on opiates including medication replacement or maintenance programs such as Methadone Maintenance, inpatient treatment, and outpatient programs.

The primary objective of treating an individual who is opiate dependent is to provide him or her with the support and care necessary to help them overcome physical dependence and create a solid foundation for psychological recovery.  Opiate treatment programs focus on treating opiate dependence by reducing physical cravings, reducing the cases of mortality associated with opiate use, preventing infectious disease, and improving physical health.  The many by which they accomplish these goals differs from one facility to the next and from one patient to the next but typically includes:

• Education
• Support
• Detox
• Medications and medical intervention
• Counseling
• Behavioral therapy
• Other forms of therapy
• Aftercare

Unfortunately, many people who are dependent on opiates do not achieve complete sobriety early on.  It often takes medications such as methadone, buprenorphine, naltrexone or Suboxone to help these people remain abstinent from heroin or other opiate abuse and continue to follow through with their recovery goals.  Ultimately, these drugs can also be eliminated from the treatment protocol to provide the user with complete sobriety but this can take time and requires commitment.