About Addictions


Opioid dependence

Opioid dependence is a real medical condition. It is very common and can happen to anyone. You are not alone. But what is it exactly? Let’s start with opioids to help give you a better understanding.

What are opioids?

Opioids are drugs with opium-like qualities that are either derived from opiates or are chemically related to opiates or opium. They block the body’s ability to feel pain.

Resetting the brain:

For people with severe pain, opioids are very effective medicines, and many patients treated for pain with opioids do not become addicted. For some people, however, opioid dependence is an unexpected consequence of proper pain treatment. The problem comes when someone is unable to stop using the drug after the pain passes. Why does this happen? Over time, opioid prescription painkillers can alter the brain’s chemistry by “resetting” the brains so you begin to feel you need more and more of the drug just to get through your day. That’s why doctors consider opioid dependence a long-term medical condition – one that can be treated effectively.

Signs and Symptoms of Opioid Dependence

Opioid dependence can affect everyone differently. That’s why knowing the signs and symptoms of opioid dependence and how they may relate to you is an important first step in recognizing your own individual risk.

There are general warning signs and symptoms that could indicate you may be at risk of opioid dependence. This is not a complete list so please talk to your doctor if you feel you are experiencing any of these symptoms and to decide on your next step:

  • Digestive disturbances like chronic constipation
  • Sleep problems
  • Sexual dysfunction
  • Anger/irritability
  • Using more of the opioid to get the same effect
  • Frequent absences from work or school
  • Loss of interest in regular activities
  • Loss of friendships or marital problems
  • Inability to stop or cut down on the use of opioids

Opioid dependence can happen to anyone:

The increased usage of prescription painkillers is an issue we all need to be aware of. It is estimated that between 26.3 and 36.1 million people are dependent on opioids worldwide. In South Africa, 44.8% of people are seeking treatment for prescription medicine dependence reported the use of opioids.

How does dependence begin?

No one sets out to become dependent, but why do some people become dependent on opioids while others don’t? While everyone is unique, some known factors can increase the chances that a person will become dependent. These may include:

  • Your genetic make-up – some people may be genetically predisposed to opioid dependence. This means that having a family member who has been dependent on alcohol or another substance may make a person more likely to become dependent on drugs themselves, including opioids.
  • How your body processes drugs – people absorb medications or other drugs differently because of their individual body chemistry.
  • Underlying emotional issues – a person’s emotional state while using a particular medication or drug can lead to differing effects from one person to another.
  • Environmental influences and/or previous substance use – many people may be negatively influenced by those around them to abuse other substances, which may also increase the risk of dependence.


Understanding the path to dependence

May people who become dependent move along a path toward dependence that may look like this:

  1. Prescription: your doctor prescribed you an opioid medication for pain (or you took one for a non-medical use).
  2. Relief or pleasure:your pain is relieved, and / or you discover the medication gives you a heightened feeling of pleasure, which leads to repeated use.
  3. Drug tolerance:your brain’s chemistry can become altered over time as the medication “resets” the brain to make you feel you need the medication to continue daily activities
  4. Physical dependence: when you are not taking the drug, you experience symptoms of withdrawal, such as muscle aches, cramps, vomiting and diarrhoea
  5. Psychological dependence: intense cravings for the drug, you find yourself using the drug more and more or in larger doses
  6. Behavioural dependence: opioid misuse can reset the brain’s chemistry and change your behaviour


Understanding how dependence can begin is an important step to helping you manage opioid dependence. Knowing how it may have started can help you choose a future plan with your doctor, beginning with the right treatment options to help you.