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Opioid Cravings

In 2020, roughly 2 million people in the United States claimed to have an opioid use disorder (OUD).2 OUD is associated with problematic patterns of opioid use despite an abundance of adverse consequences that may result. Repeated use of an opioid drug can result in the development of significant opioid dependence.4

Once a person develops this physiological opioid dependence, should they suddenly stop using opioids, they may experience uncomfortable withdrawal symptoms and have intense cravings to use opioids.4

This article will discuss what opioid cravings are, how they develop, as well as relapse prevention techniques that can help prevent a return to opioid use in the face of strong cravings.

What Are Opioids?

Opioids are a class of drugs that include both illegal substances and legal prescription medications used for their pain-relieving effects.4

Illegal opioids include heroin.3 Some legally prescribed opioids include:4

  • Oxycodone.
  • Percocet.
  • Morphine.
  • Vicodin.
  • Codeine.
  • Hydrocodone.
  • Fentanyl.

Opioids are most often prescribed to treat pain, but they are sometimes prescribed to manage cough or diarrhea.4 Some people misuse opioids for their relaxation and euphoric effects, or to get “high.”4 However, misusing opioids can be dangerous due to a range of adverse health effects. These can include respiratory depression and overdose, and because of the rewarding properties, may reinforce compulsive patterns of use, which could lead to addiction.4

Types of Opioids

Opioids work by binding to and activating different opioid receptors in the brain.4 These receptors are also found in some other areas like the spinal cords and organs.4 Opioid receptor activation not only modifies pain signaling but leads to the release of dopamine—a neurotransmitter involved with rewarding behaviors. Due to these effects, people often want to use opioids again to repeat the experience.4

Some of the most well-known opioids are:

  • Oxycodone: A semi-synthetic opioid that is available in several immediate-release and extended-release formulations.6
  • Percocet: A brand-name combination medicine that contains oxycodone and acetaminophen (Tylenol).5
  • Morphine: The prototypical opioid painkiller; pharmaceutical formulations are derived from the morphine opiate alkaloid extracted from the opium poppy. Morphine may be administered orally, as an injectable solution, and in other forms.7, 8
  • Hydrocodone: A widely prescribed semi-synthetic opioid included in several combination formulations as an analgesic as well as an antitussive (cough medicine).9
  • Vicodin: A combination medicine that contains hydrocodone and acetaminophen.9
  • Codeine: A medication also manufactured from an opiate alkaloid precursor derived from the opium poppy. It is a relatively less potent opioid than morphine and is sometimes used to manage moderate pain, cough, and diarrhea.7, 10
  • Heroin: A highly addictive opioid drug extracted from morphine, which has no known medical use.

What Are Opioid Cravings?

Drug cravings are an uncontrollable and overwhelming desire to use a drug.11 Cravings are thought to be an important component of some substance use disorders, including opioid addiction.11 Opioid cravings may also be a predictor of future substance use, particularly in the short term.11

Drug cravings are one symptom of opioid withdrawal; however, they can also arise as the result of cues or triggers, which are reminiscent of past substance use.1 Common cues are returning to places where you once used drugs, hanging out with people who you used to use drugs with, or seeing drug paraphernalia.1

Even if a person is in recovery, opioid cravings can return and may put you at risk for relapse.11 Because cravings can play such a big role in relapse, it’s important to have a relapse prevention plan in place following rehab.

How to Overcome Opioid Cravings

Addressing cravings during recovery may be helpful in preventing future opioid use. You and your treatment team can work together to create a relapse prevention plan, which may include continuing care and/or medication to help you better cope with drug cues and cravings.12, 13

Therapeutic interventions for opioid cravings include:13, 15

  • Cognitive-behavioral therapy (CBT): CBT can be done in individual or group settings and can help you learn valuable coping skills to avoid or handle triggering situations.
  • Contingency management: This technique uses positive reinforcement like rewards to help you abstain from opioid use.
  • Family therapy: This form of therapy can help people struggling with opioid use and their families understand the influences to use drugs and begin healing their relationship with one another.

Approved medications to help manage opioid cravings include:13, 14, 15

  • Methadone is an opioid receptor agonist that blocks withdrawal symptoms and cravings. It can be used in both short- and long-term treatment of OUD.
  • Buprenorphine is an opioid receptor partial agonist that helps to ease withdrawal symptoms and cravings. Like methadone, buprenorphine may also be helpful in early recovery and later, for longer-term OUD treatment.
  • Naltrexone is an opioid receptor antagonist that blocks the activity of opioid receptors to help prevent the pleasurable effects of opioids and reduce cravings.

Using several different approaches to address opioid cravings is important because everyone experiences cravings differently.16 Triggers, level of intensity, and frequency of cravings can vary from person to person, so having individualized treatment plans may be helpful.16

Quitting Opioids Safely

Quitting opioids with medical supervision can help create a safe environment that may produce positive health outcomes. Supervised detox can provide a person more access to resources they may not otherwise have on their own.11

Find Treatment for Opioid Use Disorder

If you are struggling with opioid use disorder (OUD), opioid cravings, or relapse, there are people to support you. American Addiction Centers (AAC) has caring admissions navigators ready to listen and take your call 24/7 at . They can help you understand treatment options, check your insurance, and support you as you navigate recovery and opioid cravings.