Narcotic Use Disorder

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KEY POINTS

• Narcotic use disorder is a pattern of using narcotics that leads to serious personal, family, and health problems. Narcotics are often prescribed to relieve pain.
• Narcotic use disorder can be treated. For any treatment to be successful, you must want to stop using narcotics. Your healthcare provider may prescribe a medicine that will help you get through withdrawal symptoms. Self-help groups such as Narcotics Anonymous, support groups, and therapy may be helpful.
• The best way to help yourself is to see your healthcare provider and make plans to stop using narcotics.

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What is narcotic use disorder?

Narcotics, also called opioids, are drugs that dull the sense of pain and cause drowsiness or sleep. They are often prescribed to relieve pain. Narcotics are also sold illegally. Examples of narcotics are:

• Codeine
• Heroin
• Hydrocodone (Vicodin)
• Morphine
• Oxycodone (Percocet, OxyContin)
• Methadone

Narcotic use disorder is a pattern of using drugs that leads to serious personal, family, and health problems. The more of these statements that apply to you, the more severe your substance use disorder is.

1. You use more or use narcotics for longer than you planned.
2. You want to cut down or quit, but are not able to do so.
3. You spend a lot of time and energy getting drugs, using drugs, and getting over the effects.
4. You crave narcotics so much that you have trouble thinking about anything else.
5. You have problems at work or school, or stop taking care of people who depend on you.
6. You have relationship problems because you don’t keep your promises, or you argue or get violent with other people.
7. You stop doing things that used to matter to you, such as sports, hobbies, or spending time with friends or family, because of your narcotics use.
8. You use narcotics even when it is dangerous, such as while driving or operating machinery.
9. You keep using narcotics even though you know that it is hurting your physical or mental health.
10. You need to use more and more narcotics, or use more often to get the same effects. This is called tolerance.
11. You have withdrawal symptoms when you stop using.

Narcotic use disorder may also be called drug abuse, substance abuse, dependence, or addiction.

You may be abusing prescription narcotics if you:

• Take them for reasons other than why they were prescribed
• Take more than the prescribed dose
• Continue to use them when you no longer have pain

Not everyone who uses prescription narcotic pain medicine will become addicted.

What is the cause?

The cause of narcotic use disorder is not known. The brain makes chemicals that affect thoughts, emotions, and actions. Narcotics change the balance of these chemicals in your brain. When you use narcotics regularly, your brain starts to get used to them. As a result you don't feel right unless you use narcotics. When you stop using narcotics suddenly, the balance of chemicals in your brain changes, which causes the symptoms of withdrawal.

You have a higher risk of becoming dependent on drugs if you:

• Have a family history of drug or alcohol abuse
• Have abused alcohol or drugs in the past
• Are easily frustrated, have trouble dealing with stress, or feel like you aren’t good enough
• Are regularly around people who use alcohol or drugs
• Have a mental health problem
• Have constant pain

What are the symptoms?

The symptoms of narcotic use disorder depend on how much and how often you use the drug. The symptoms can be mild to severe, such as:

• Sleepiness
• Constipation, nausea, and vomiting
• Pinpoint pupils
• Slurred speech
• Trouble with memory and paying attention
• Slowed breathing, which can lead to death

The symptoms of narcotic withdrawal can be mild to severe. You may have some of these symptoms when you stop using narcotic:

• Nervousness and restlessness
• Muscle and bone pain
• Nausea, vomiting, and diarrhea
• Runny nose and watery eyes
• Large, dilated pupils
• Cravings for narcotics
• Sleep problems
• Jerky leg movement that you can't control

How is it diagnosed?

Your healthcare provider will ask how much and how often you use narcotics. Be honest about your drug use. Your provider needs this information to give you the right treatment. He will also ask about your symptoms and medical history and examine you. You may have blood or urine tests.

How is it treated?

Narcotic use disorder can be treated. For any treatment to be successful, you must want to stop using narcotics. Do not try to use alcohol and other drugs to reduce withdrawal symptoms.

Stopping narcotics should be done slowly. It may take days or months. Your healthcare provider will watch you closely and slowly reduce the amount you take during this time. Your healthcare provider may prescribe medicine to help you get through withdrawal. These medicines often work best when used while you are in therapy and in a support group. Your healthcare provider may prescribe a medicine that blocks the feelings of pleasure that narcotics give you. Other medicines may be prescribed to block cravings for narcotics. These medicines may be used for a short time, or sometimes for many years.

You may need to stay in a hospital or rehab center while you withdraw from narcotics. Treatment for withdrawal symptoms may include medicines, vitamins, and IV fluids. You will also be treated for any health problems such as a heart attack, stroke, or other life-threatening problems.

If you are abusing or dependent on narcotics and want to quit, get help.

Self-help groups such as Narcotics Anonymous, support groups, and therapy may be helpful. Kinds of therapy may include:

• Cognitive-Behavioral Therapy (CBT). CBT helps you look at your thoughts, beliefs, and actions, and understand which ones cause problems for you. Then you learn to change unhealthy ways of thinking and acting.
• Family therapy. Often people with substance use disorders don’t realize they have a problem or aren’t ready to accept treatment. This leaves loved ones frustrated and confused. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family understand each other better and make changes.
• Substance use disorder treatment programs. Your healthcare providers and counselors will work with you to develop a treatment program. You may be able to go to therapy a few times a week (outpatient therapy). Or you may need treatment in a hospital or rehab center. You may need to stay there for several weeks, or you may be able to go to a clinic or hospital each day.

Recovery is a long-term process. Many people with substance use disorders try to quit more than once before they finally succeed. Don't give up. You can quit and quit for good. Get help and try again. Follow-up treatment is very important so that you don’t go back to using drugs.

If you have overdosed, call 911 or get emergency care right away.

How can I take care of myself?

The best way to help yourself is to see your healthcare provider and make plans to stop taking narcotics. If you are already seeing a healthcare provider, it is important to take the full course of treatment he or she prescribes.

Get support. Talk with family and friends. Consider joining a support group in your area.

Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.

Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Don’t use alcohol or drugs. Exercise according to your healthcare provider's instructions.

Avoid situations where people are likely to use alcohol or drugs.

Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.

Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

People and resources in your community that can help you include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance abuse treatment programs. You may want to contact:

• Narcotics Anonymous
  818-773-9999
  http://www.na.org
• The Addiction Recovery Guide
  http://www.addictionrecoveryguide.org/resources/recovery/