Opioid Addiction

Opioid addiction is a form of prescription drug addiction. The opioid group includes codeine, dihydrocodeine, tramadol, prescription painkillers and fentanyl, as well as heroin.

For many people, the problem didn’t begin with wanting to get high. It began with pain: an injury, an operation, back pain or an ongoing condition. They took medication as directed, and over time, the line between treating pain and needing the medication became harder to see.

Abbington House supports people and families affected by opioid use, including where it began with prescribed medication, codeine bought over the counter, stronger opioids, other substances or mental health difficulties.

When it started as a prescription

This is the part that makes opioids different from most other things people come to us about. A lot of people reading this would never use the word addiction about themselves, because they were prescribed the medication by a doctor and have only ever taken what they were given.

That doesn’t make it less real, and it doesn’t make it your fault. Dependence on opioids can develop gradually, even when the medication is taken exactly as prescribed. The body adjusts to the drug over time, so the same dose does less, and stopping or cutting down starts to produce withdrawal. The NHS is clear that this can happen to people taking opioids as directed, and that many people don’t realise they have become dependent until they try to stop.¹

So the question is usually not whether you’ve done something wrong. It’s whether the medication has started to take up more space than the pain it was meant to treat.

If pain medication is where this began, our page on painkiller addiction looks specifically at dependency that develops through treating long-term pain.

What opioid dependence can look like

Opioid problems tend to build over time, which is part of why they are easy to miss. Some of the things people recognise, in themselves or someone close to them:

• Needing more of the medication than before to get the same relief
• Taking it for reasons that have drifted beyond the original pain
• Running out before a prescription is due, or topping up from other sources
• Feeling unwell, anxious or unsettled when a dose is late or missed
• Knowing you want to stop, but finding that stopping feels difficult

None of these mean the situation is hopeless, but that the medication has become harder to manage alone than it used to be.

When a prescription ends

For some people, the difficulty becomes clearest when a prescription stops. The pain may still be there, the body has grown used to the medication, and the pull to find something that fills the gap can be strong. Some people find themselves looking for the same medication elsewhere or turning to stronger drugs.

If that’s where you are, it’s worth knowing this is a recognised pattern, not a personal failing, and it’s one of the points at which support matters most. Speak to your GP or a professional service rather than managing it alone.

Why stopping suddenly isn’t the answer

If you’ve been taking opioids for more than a few weeks, this is the most important thing on this page. Do not stop suddenly on your own.

After a period of regular use, stopping abruptly or reducing the dose too quickly can bring on withdrawal, which can be physically and emotionally difficult and, for some people, unsafe.² Coming off opioids is something to do gradually and with support, not alone and not overnight. The NHS advises that if you have been taking opioids long term and want to stop, you should speak to your GP, who can help you reduce safely.¹

Our page on opioid withdrawal explains what to expect and how long it tends to last.

If you’re struggling and unsure where to turn, you can contact your GP, call NHS 111, or speak to a pharmacist. If you’re worried that stopping has become something you cannot manage on your own, that’s exactly the point at which it helps to have medical support around you.

When opioid use sits alongside something else

For a lot of people, opioids are not the only thing going on. Pain and low mood often travel together. Some people are managing anxiety, depression or the after-effects of trauma at the same time, and the medication has quietly become part of how they cope with more than the physical pain.

Where opioid use sits alongside a mental health difficulty, treatment usually needs to account for both at once, rather than treating one and leaving the other. We cover how that works on our page on dual diagnosis.

What support can involve

Stopping is one part of treatment, and for opioids, it usually needs to be done with medical support. But stopping on its own rarely holds, because the reasons the medication came to matter so much still need attention.

Support for opioid use brings the medical side and the underlying work together: a supervised reduction or detox where it is needed, alongside therapy that looks at the pain, the coping, and what the medication had come to manage.

You can read more about what that involves on our page on opioid rehab, and about how treatment is delivered as a residential stay on our residential rehab page.

If more than one substance is involved, treatment needs to look at the whole picture rather than the opioid use alone.