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When taking opioids it is very important to always follow your doctor’s instructions carefully and consistently. The risk of developing physical dependence (addiction) is high if you use this type of medicine for longer than intended.

What are opioids?

Opioids are (very) strong painkillers and are only available by prescription. This type of medicine is used for severe or chronic pain, breakthrough pain, after surgery, in cancer treatments and as a supportive drug in the last phase of life.

Besides pain relief, opioids, especially in high doses, also work euphorically. That kind of use creates an intoxication. For this reason, opioids are also sometimes used as recreational drugs.

In that situation, they have a high risk of developing an addiction. Heroin and fentanyl are the most well-known opioid types used as drugs.

This is how opioids work

Opioids are painkillers whose active chemical acts on the opioid receptors in our brains, giving them their narcotic effect. These receptors can also be activated naturally. In fact, the human brain can also produce its own bodily painkiller: endorphins.

Endorphins are chemicals (neurotransmitters) produced in response to something unpleasant, to:

  • relieve pain;
  • numb;
  • reduce stress;
  • and experience pleasure.

This happens, for example, when you:

  • suffer an injury;
  • you have made a physical effort;
  • need to flee or;
  • You are with someone for whom you feel love, security and trust.

Opioids mimic the action of endorphins, but can do so in a much more powerful way that also lasts much longer.

Different types of opioids

The action of opioids (mimicking our natural, body’s own painkiller endorphins) is the same for all types of opioids. The main distinction between the different types is in their strength, the speed at which they work and their duration of action.


It is used as an analgesic after surgery, for acute and chronic nerve and muscle pain, or for severe pain after an injury. Tramadol is often the first opioid prescribed when an NSAID painkiller such as aspirin, ibuprofen or diclofenac fails.


Oxycodone is used as a painkiller after surgery, hernias, in cancer treatments and as a narcotic in the last stage of life.


Morphine is a powerful opioid that is mainly administered intravenously (through an infusion), directly into the bloodstream. This makes morphine highly suitable for the anaesthesia of acute trauma, but it is also used as a sedative in the last phase of life.


It is a chemically processed variant of morphine and is about 80 to 100 times stronger than morphine. Fentanyl is often used in patch form, but can also be swallowed as a tablet. It works very quickly in that form, making it especially effective for breakthrough pain.


Methadone is prescribed for people with (very) severe pain in whom other opioid painkillers do not work well. This occurs in people who have been taking other opioids for a long time or are addicted to heroin. Methadone is also best known as an aid to heroin withdrawal in drug treatment and addiction services.

Side effects of opioids

Opioids have strong effects on the body. The most common side effects are:

  • Drowsiness and fatigue
  • Numbness
  • Nausea and vomiting
  • Constipation (blockage of the bowels)
  • Itchy skin
  • Headache
  • Dry mouth
  • In high doses, opioids can also lead to psychological symptoms in some cases, such as feelings of depression, restlessness, confusion and anxiety.

Are opioids addictive?

Your body quickly gets used to using an opioid. You need more and more active substance to achieve the same effect. It also affects the dopamine system in your brain.

Reward system

The dopamine system is the body’s reward system: when you undertake an activity, eat something or perform something that makes you happy and joyful, that feeling is caused by an increase in dopamine in your brain.

Your brain is trained to remember and repeat behaviour that releases dopamine, and thus makes you feel good. Opioids artificially increase dopamine levels in your brain, which causes you to feel an increasing urge to take tramadol in the long run.


This process is at the root of all addictions. Every addiction affects the reward system and the amount of dopamine in the human brain. Medications and drugs that artificially increase dopamine levels are therefore among the most addictive substances.

This quickly gives you a strong temptation to use again and again and again. These are called ‘cravings’ and are synonymous with cravings, cravings and hunger.


Your body gets used to the signal that opioids send to your brain. You need an increasingly higher dose of benzos to achieve the same effect as a result of this ‘tolerance’. This is a strong risk factor for developing an addiction.

Help for problematic opioid use

Misuse of opioids can thus result addictive behaviour. People with high addiction susceptibility are particularly at risk and should be careful when taking this type of medication.

Do you notice that you have been taking an opioid medicine for (much) longer than actually intended? Are you unable to stop or reduce your use? Or are you experiencing withdrawal symptoms? Contact Hacienda Paradiso to get professional guidance.

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