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Why Are Opioids Addictive?

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Last Updated on July 16, 2026

person taking opioids
Why are opioids addictive?
Opioids are highly addictive because they flood the brain with endorphins and dopamine, which produce feelings of pleasure, satisfaction, and euphoria. The “high” is so powerful and unlike any natural rush of endorphins and dopamine that the only way a person can experience those feelings again is by using opioids. There are several other genetic, environmental, and lifestyle factors that all contribute to the likelihood of developing an opioid addiction.

What are Opioids?

Opioids are a class of drugs that include synthetic opioids, prescription painkillers, and heroin.1 These drugs are all chemically related and interact with the same opioid receptors in the brain and body. Their effects result in feelings of euphoria, which encourages opioid abuse, dependence, and addiction.

The terms “opiates” and “opioids” are often used interchangeably. But, there is a difference between the two. An opiate is a drug that is naturally derived from the opiate poppy plant. An opioid is a broader term that refers to natural or synthetic substances that bind to the body’s opioid receptors.

Opioids are classified as controlled substances by the DEA and their current scheduling is as follows:

Opioid Drug Scheduling
Schedule I Heroin
Schedule II Demerol (meperidine)

Dilaudid (hydromorphone)


Dolophine (methadone)


Duragesic or Sublimaze (fentanyl)Morphine


Opium


OxyContin

Percocet (oxycodone)

Vicodin

Other hydrocodone medications

Schedule III Buprenex

Subutex


Suboxone

Temgesic

Other buprenorphine products

Schedule IV  
Schedule V Some codeine medications (e.g., Robitussin AC)

Source: https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

Side Effects of Opioid Use

Prescription opioid drugs provide effective relief from moderate to severe pain when they’re used properly. However, when opioid drugs are abused, they can cause some short-term side effects, like:

  • Depressed breathing
  • Drowsiness
  • Constipation
  • Nausea
  • Unconsciousness
  • Coma2

 Long-term opioid abuse can also cause:

  • Tolerance
  • Physical dependence
  • Opioid withdrawal
  • Addiction2

Causes of Opioid Addiction

If a person is addicted to opioids, he or she may feel like they are impossible to live without. An addicted person may also experience irresistible cravings for opioids and succumb to uncontrollable, compulsive opioid use. There is no single cause of opioid addiction, rather, the factors that contribute to opioid addiction often include a person’s genetics, environment, and lifestyle factors.

Researchers believe that many of the genes involved in the body’s reward and pleasure center also play a role in addictive behaviors and opioid addiction. According to the U.S. National Library of Medicine, the genes that are responsible for making opioid receptors may vary, which lead to differences in the opioid receptors’ structure and function. In turn, this also influences how the body responds to opioid drugs.3

There are also several environmental and lifestyle factors that may cause opioid addiction. They include:

  • A history of substance abuse
  • Depression
  • Psychiatric disorders
  • Childhood abuse/neglect
  • Personality traits like impulsivity and sensation-seeking
  • Poverty
  • Associating with people who abuse opioids

Generally, a combination of all the factors listed above determines a person’s likelihood of developing an opioid addiction.

What Are Opioid Addiction Risk Factors?

Any opioid use, even short-term, can lead to tolerance, dependence, addiction, and overdose. Therefore, anyone who takes opioid drugs is at risk of becoming addicted to them. Although it is impossible to determine who will become addicted and who will not, here are some of the most common risk factors for opioid addiction:

  • Personal or family history of substance abuse
  • History of criminal activity and/or legal problems
  • History of severe depression and/or anxiety
  • Previous drug or alcohol rehabilitation
  • Association with drug users or high-risk environments
  • Learn more about the short- and long-term consequences of drug use.
  • Mental disorders/psychiatric problems
  • Young age
  • Thrill-seeking behaviors
  • Heavy tobacco use
  • Poverty/unemployment
  • Stressful life circumstances4

Opioid Addiction Statistics

Opioid addiction is common in America and it doesn’t discriminate based on gender, social class, profession, race, age, or any other social standing or class. Here are some recent opioid addiction statistics that illustrate the growing opioid abuse problem in the U.S.

  • More than 130 people die every day from opioid-related drug overdoses.5
  • The estimated total economic burden of prescription opioid abuse in the U.S. is $78.5 billion a year.5
  • 47,600 people died from opioid overdoses in 2017.6
  • 886,000 people used heroin in 2017.6
  • 81,000 people used heroin for the first time in 2017.6
  • 15,482 deaths were attributed to heroin overdoses in 2017.6
  • 11.4 million people misused prescription opioids in 2017.6
  • 2 million people misused prescription opioids for the first time in 2017.6
  • 2.1 million people had an opioid use disorder in 2017.6
  • 28,466 deaths were caused by synthetic opioid overdoses other than methadone in 2017.6
  • An estimated 23 percent of people who use heroin will develop opioid addiction.7
  • In 2017, the number of overdose deaths involving opioids was 6 times higher than in 1999.8

Treatment and Prevention for Opioid Addiction

Unfortunately, opioid addiction can’t always be prevented. But there are several ways people can protect themselves from prescription drug abuse and opioid addiction.

  • When you take prescription opioid drugs, closely follow the instructions provided by the pharmacist.
  • Be aware of potentially dangerous drug and alcohol combinations and interactions.
  • Talk to a doctor before you change your dosage.
  • Not taking anyone else’s prescription opioids or sharing yours.
  • Storing prescription opioid drugs safely.9

If you or a loved one is addicted to opioid drugs, there is a way out and you can recover with the right support. Evidence-based treatment methods in detox, rehab, and aftercare are ideal. This type of treatment can help ensure a full recovery from addiction and produce positive behavioral changes, attitudes, and healthy social interactions with sober peers.

The first step to getting better is admitting you’re addicted and you need help. It’s a difficult step, but it’s important. Call (512) 605-2955 to speak with a Nova admissions representative today to find out how we can help you take hold of a fresh start and begin your new life in recovery.

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Dr. Robert Ulrich

Dr. Robert Ulrich

Medical Director | Nova Recovery Center

Dr. Robert Ulrich serves as Medical Director at Nova Recovery Center, bringing more than two decades of clinical neurology experience to the treatment of substance use disorders. He is board-certified in neurology by the American Board of Psychiatry and Neurology and completed his neurology residency at UT Southwestern Medical Center in Dallas, where he served as Chief Resident.

Throughout his career in neurology, Dr. Ulrich observed that many patients with neurological conditions also faced challenges related to substance use. In late 2022, he shifted his clinical focus toward addiction medicine, applying his extensive knowledge of brain function, neurochemistry, and the central nervous system to support individuals in recovery.

As Medical Director, Dr. Ulrich provides clinical leadership and helps guide the medical services delivered at Nova Recovery Center. His background in neurology allows him to approach addiction treatment with a detailed understanding of the neurological, physical, and behavioral factors that influence substance use and recovery.

Dr. Ulrich works closely with the clinical team to support individualized, evidence-based treatment plans designed to promote patient safety, stability, and long-term recovery.

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