Anyone who takes opioids can develop opioid use disorder (OUD), which includes addiction, whether they take prescription opioids or illegal opioids such as heroin. However, treatment and support are available for people living with OUD.

Opioids are a class of drug that people typically take to reduce pain. Doctors may prescribe certain opioids for pain relief, but other opioids, such as heroin, are illegal in the United States.

If people take opioids at all, even within medical guidelines, it may increase their risk of developing OUD. However, taking opioids under the guidance of a physician rarely results in OUD.

The Centers for Disease Control and Prevention (CDC) define OUD as a type of substance use disorder (SUD) in which a person develops a problematic pattern of opioid use that causes significant impairment and distress. OUD is a chronic condition that can affect anyone. Addiction is the most severe form of OUD.

According to the CDC, about 2.7 million people in the U.S. report living with OUD. Additionally, according to the 2021 National Survey on Drug Use and Health, about 1.1 million people aged 12 years or older used heroin in the past 12 months.

This article discusses why people take opioids, whether heroin differs from other opioids, what opioid use disorder is in more detail, and when to seek support.

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People mostly take opioids to help relieve pain. They contain chemicals that relax a person’s body and reduce their feelings of pain.

Doctors may treat people with moderate to severe pain using opioids, often if they have:

  • undergone surgery
  • experienced an injury
  • had certain health conditions

People also take opioids recreationally. Opioids may make people feel:

  • relaxed
  • euphoric
  • happy

However, people should only take opioids with professional medical advice and guidelines. Opioid misuse can cause serious side effects and addiction and possibly be fatal.

Both heroin and prescription opioids have similar effects. However, doctors do not use heroin as a medication in the U.S., as it is listed as a Schedule I substance under the Controlled Substances Act. This means it has a high potential for misuse and no accepted medical use in the U.S.

According to research by the National Institute on Drug Use, if people misuse certain prescription drugs, they may then be more likely to use heroin.

When a person takes heroin, it rapidly enters their brain and binds to areas that control their:

Heroin has a short half-life of around 3 minutes in the blood after injection, but one of its active metabolites — 6-monoacetylmorphine (6-MAM) — has a half-life of 30 minutes, which lengthens the amount of time a person experiences the drug’s effects. Active metabolites form when the body metabolizes, or breaks down, a drug. They then produce effects in the body.

Therefore, people who use heroin may do so several times a day to maintain the effect. In contrast, prescription opioids such as methadone may have a half-life of many hours.

A person’s tolerance to heroin typically also increases over time. This means they may only get the same effect by taking increasingly stronger doses. Since heroin is illegal in the U.S., people can only obtain it in unregulated and unknown doses.

As they do not know how much heroin they are taking per dose, they may overdose. A heroin overdose can cause slow and shallow breathing, or a person to go into a coma. It can also be fatal.

A person should call 911 immediately if they recognize any signs of overdose in themselves or another person.

OUD refers to a problematic pattern of opioid use that causes people significant impairment or distress.

People with OUD may experience:

  • an overpowering desire to take opioids
  • increased opioid tolerance
  • withdrawal symptoms if they stop using opioids

People who take prescription opioid medication have an increased risk of developing OUD. They are particularly at risk if a doctor prescribes them opioids for more than 90 days.

A person may also be more likely to develop OUD if they have risk factors such as:

Doctors can treat OUD. They may diagnose a person with OUD if they experience two or more of the following criteria over a year:

  • having a strong desire to take opioids
  • taking opioids despite disruption to their life
  • taking opioids in a way that interferes with obligations
  • taking opioids in physically dangerous situations
  • increasing doses or experiencing increased tolerance to opioids
  • having a desire to reduce opioid use
  • spending a lot of time getting or using opioid medication
  • reducing or not doing important activities due to opioid use
  • having withdrawal symptoms if their dose reduces
  • needing a higher dose of opioids
  • continuing to take opioids despite physical or psychological problems

If a person thinks they or someone they know is experiencing any of the signs above, they should speak with a doctor about the possibility of having OUD. Each bullet point above counts as one criterion.

Doctors may treat OUD with a combination of medications and behavioral therapy.

Additional support is available for people with OUD. The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is a free and confidential treatment referral service for people with SUD.

The helpline is available 24-7, 365 days a year, in English and Spanish. The number to call is 800-662-4537.

Doctors may prescribe opioids for medical purposes. Heroin is an illegal opioid in the U.S.

People may develop OUD as a result of using prescription opioids or illegal opioids. However, developing OUD when taking prescription opioids under the guidance of a doctor and as prescribed is rare. Addiction is the most severe form of OUD.

However, people can recover from OUD, including heroin addiction, with professional help, support, and treatment. A person should speak with a doctor if they think they may be living with OUD. Additionally, SAMHSA offers free and confidential advice to help people with OUD begin their recovery.