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Opioid addiction is an international problem that kills more than 50,000 people each year1. It is defined as the compulsive use of drugs that contain opioids such as morphine, heroin or hydrocodone. The key word here is compulsive. An addict has moved beyond recreational use.

Addiction is a chronic brain disease that requires medical intervention and treatment. Understanding how the medical community diagnoses this disease will help you recognize it in someone you love. Whether it is heroin addiction or opiate addiction, these are the facts you need to know.

How Does Someone Become an Opioid Addict?

young man at balcony in depression suffering from opioid addiction

Opioids are medications prescribed to manage pain. The problem is they also stimulate the brain in a way that creates a feeling of euphoria. This feature makes drugs like heroin and hydrocodone so attractive on the street. Long term use of opioid drugs creates a complex medical problem that comes with physical, social and psychological consequences.

Most addicts start as recreational users or by taking a drug to manage pain. Over time, the brain requires more and more of the drug to create the feeling of pleasure. In fact, the first use is the best. Every dose after that is an attempt to feel the same euphoria. This change in brain chemistry defines addiction as a chronic disease.

How to Diagnose Opioid Addiction

An addict may not realize the extent of their addiction. This is the brain’s way of keeping them using. Family and friends tend to notice the change in a person’s behavior and physical appearance first. There are distinctive signs to watch for if you suspect someone has an opioid addiction:

  • Slurred speech
  • Pinpoint pupils
  • Dry mouth
  • Confusion
  • Lack of attention
  • Coordination problems
  • Depression

Opioid use is associated with what is known as “the nod.” Immediately after using, this person may nod off or have a hard time staying awake.

Signs of Withdrawal Symptoms

A person addicted to opioids must have them to avoid painful and potentially life-threatening withdrawal symptoms, like:

  • Nausea
  • Vomiting
  • Muscle aches
  • Diarrhea
  • Yawning
  • Fever
  • Insomnia
  • Itching

Diagnosing Opioid Addiction

Medicine Bottle with Hydrocodone - A highly addictive opiate

There are criteria established in the Diagnostic and Statistical Manual of Mental Disorders for diagnosing drug addiction2.

  • Tolerance: you need an increased amount of the drug to get high
  • Withdrawal: the symptoms that occur when you stop using opioids. Opioid withdrawal is painful.
  • Using more often than intended: you need more of the drug than anticipated over time
  • The persistent need to use: feeling like you need to use despite attempts to cut down or stop
  • Spending more time using drugs: this includes time spent recovering or trying to obtain the drug
  • Giving up social, occupation and recreational activities to use drugs: You put drug use above everything else
  • Continuing to use: taking drugs even though you know it's damaging to your body and life

When the need to get a fix becomes so overwhelming that you can’t help it anymore, it's a clear indication that the disease of addiction has taken over. An addict will often not recognize or be able to admit a problem exists.

It's often up to family and friends to intervene and help an addict accept their addiction. That's the first step in getting a proper diagnosis and treatment for someone you love.


  1. Prof Christopher J L Murray,"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013," The Lancet, January 2015,
  2. "Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction," Sustance Abuse and Mental Health Services Administration (US), 2004,

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