What you need to know
- Anyone can develop OUD, even if you’re prescribed opioids by a doctor.
- Taking opioids in any way other than prescribed, experiencing ongoing stress, or having a family history of substance use disorder can increase your risk of developing OUD.
- Harm reduction programs offer tools that prevent overdose deaths and support people in staying safer.
Opioids are a class of drugs that includes some prescription pain medications (like oxycodone and hydrocodone) and illegal substances (like heroin). Opioid use disorder is a chronic medical condition that affects the brain’s reward and stress systems, which may cause physical and mental distress. It can develop for many reasons and can happen to anyone, even if the opioids are prescribed by a doctor.
Read on to learn what causes OUD, who may be at higher risk, and how to find support.
What causes OUD?
When someone takes opioids repeatedly, the body doesn’t make as many endorphins, which are the hormones that reduce pain and stress. Over time, the same amount of opioids may not provide the same relief—a process known as tolerance. People may find themselves needing a higher dose to feel comfortable, and stopping opioids suddenly can lead to difficult withdrawal symptoms like pain, anxiety, or nausea.
Taking more opioids than prescribed increases the risk of overdose since opioids can slow down or stop your breathing.
If you think you’ve developed a tolerance to opioids, or you are having trouble reducing or stopping opioid use, talk to a health care provider right away. Stopping opioids suddenly can be dangerous, and a clinician can help you make a safe plan.
Who is most at risk for OUD?
Taking opioids for more than a few days, taking a higher dose than prescribed, or taking opioids in a way other than prescribed—like snorting or injecting them—increases the risk of OUD.
Experiencing stress, like losing a job or having problems at home, is a major risk factor for OUD and other substance use disorders.
“Often, the problems in our life can’t be resolved or fixed, and that lack of control can leave us feeling confused, disoriented and stuck,” said Amy Goodwin, a licensed professional counselor and behavioral health counselor at UCHealth Behavioral Health Clinic, in a UCHealth Today article. “Substances can give us the illusion that we are relieving our stress or distress without altering or evolving our behavior.”
Even exciting life changes can impact your relationship with substances like opioids, especially if you’re genetically predisposed to risk-taking behaviors.
“Starting a new job, or having a child may activate a genetic vulnerability,” said Wendy Richardson, a California-based certified addiction specialist, in an ADDitude article.
Other factors that increase your risk of OUD include:
- A family history of substance use disorder
- Mental health conditions or brain differences like ADHD
- A history of physical or emotional abuse
- Tobacco use
- Poor school performance
Teens and young adults are also more likely to develop OUD. Plus, women are at increased risk because they’re more likely to experience chronic pain, which can lead to prolonged prescription opioid use.
Tools that help prevent opioid overdose
Naloxone is a lifesaving, easy-to-use medication that can reverse an opioid overdose. Anyone can carry it. Having naloxone is especially important if you or someone in your household uses opioids—whether prescribed or not—or takes other drugs that may be unknowingly mixed with opioids.
Naloxone “is unequivocally a life-saving medication that works very well at reversing opioid overdoses. The more it is available in the community, the more likely it can help someone during those first critical couple of minutes when they need it,” said Dr. Kathryn Hawk, a Yale Medicine emergency and addiction medicine physician-researcher, in a 2023 YaleMedicine article. “It’s also very safe and won’t harm anybody who uses it.”
You may be able to get naloxone for free from local harm reduction programs and some community centers and public libraries. It’s also available without a prescription at many pharmacies, at some grocery and convenience stores, and online. A two-dose package typically costs less than $50.
Learn how to use naloxone from the American Medical Association or sign up for a free online training.
Some harm reduction programs may also offer drug test strips, which help people understand what’s in their drugs. Substances may be unknowingly mixed with fentanyl (a potent opioid) or xylazine (a non-opioid tranquilizer), which can increase the risk of overdose. Test strips give people more information to make safer choices. However, test strips are still considered “drug paraphernalia” in some states, which can limit access.
Learn how to use fentanyl test strips and xylazine test strips from NYC Health.
How can I get support for opioid use disorder?
Effective treatment for OUD often includes a combination of medication along with counseling or behavioral therapy. These treatments can help people with OUD stabilize brain chemistry, reduce cravings, and lower the risk of resuming opioid use.
If you’re looking for treatment for OUD, contact SAMHSA’s National Helpline (1-800-662-HELP) to find treatment options near you. Local harm reduction programs can also help connect people to treatment when they’re ready while offering ongoing care and community support.
For more information, talk to your health care provider.