Signs & Symptoms of Opioid Addiction

Learn about opioids and substance abuse

The category of opioids contains several powerful and highly addictive substances, including both legal and illegal drugs. Common examples of opioids include morphine, heroin, fentanyl, oxycodone (the active ingredient in OxyContin), and hydrocodone (the active ingredient in Vicodin). When used for legitimate medical purposes, opioids are most commonly prescribed to treat symptoms associated with mild to severe pain, both chronic and acute. Opioid use usually produces a sense of euphoric relaxation, enhanced mood, and improved sense of wellbeing.

The analgesic, or painkilling, properties of opioids are the result of how these substances interact with receptors in the brain that are associated with both pain and pleasure. These receptors are located in an area of the brain that also controls automatic functions such as respiration and heart rate, so overdose can have catastrophic results. This is a particular concern for individuals who abuse opioids for recreational purposes, as they may be incapable of determining the quality, potency, and appropriate amount of the drug to ingest.

In addition to the immediate dangers that are associated with overdose, individuals who use opioids are also at risk for becoming dependent upon these substances. Dependence can occur both in individuals who are taking opioids for legitimate medical purposes and in people who are engaging in recreational opioid abuse, though as with overdose the risk is significantly greater among recreational abusers.

Opioid dependence, which is also known as opioid use disorder, can have a profoundly negative impact on an individual’s life and can be extremely difficult to overcome in the absence of effective professional intervention. However, with appropriate treatment, people who have developed opioid use disorder can end their dependence upon these dangerous substances and learn how to live healthy drug-free lives.

Opioid addiction statistics

According to the American Psychiatric Association (APA), about 0.37 percent of the adult population in the United States will have experienced opioid use disorder in a given 12-month period. The 12-month prevalence of opioid use disorder is higher among adult males (0.49 percent) than among adult females (0.26 percent) for non-heroin opioids. For heroin, males become dependent about three times more often than females do. With a 0.82 percent 12-month prevalence, adults between the ages of 18 and 29 have the highest age-based rate of developing opioid use disorder.

Causes and risk factors for opioid addiction

Opioid abuse and an individual’s potential for developing opioid use disorder may be influenced by a variety of factors, including the following:

Genetic: The American Psychiatric Association reports that genetics play a strong direct and indirect role in the development of opioid use disorder.  Having a family history of opioid use disorder increases the likelihood that a person will also struggle with opioid dependence. Certain heritable personality and temperamental traits may also put a person at increased risk for opioid use disorder.

Risk Factors:

• Being male
• Being age 29 or younger
• Impulsivity and novelty seeking
• Family history of opioid abuse and addiction
• Family or personal history of mental health disorders
• Associating with individuals who abuse opioids
• Ease of access to opioid substances
• Experiencing chronic or acute pain

Signs and symptoms of opioid addiction

Behavioral symptoms:

• Withdrawal from family and friends
• Lying or secretiveness regarding whereabouts and/or activities
• Using opioids in situations that are known to be dangerous, such as driving
• Continuing to abuse opioids after experiencing negative repercussions
• Decline in performance at work or in school
• Doctor shopping (visiting multiple doctors to illicitly acquire multiple prescriptions)

Physical symptoms:

• Constricted pupils
• Cellulitis
• Insomnia
• Psychomotor agitation and retardation
• Severe constipation
• Peripheral edema
• Sexual dysfunction

Cognitive symptoms:

• Poor judgment
• Memory problems
• Inability to concentrate and/or focus

Psychosocial symptoms:

• Mood swings
• Depression
• Lack of interest in significant activities

Effects of opioid addiction

The protracted abuse of opioids can inflict considerable damage on an individual’s physical, mental, and social wellbeing. The following are among the potential effects of untreated opioid use disorder:

• Vision problems
• Damage to kidneys and liver
• Cardiovascular distress
• Tuberculosis
• HIV/AIDS and hepatitis C (if abusing opioids via injection)
• Family discord
• Marital strife, separation, and divorce
• Diminished or destroyed interpersonal relationships
• Academic failure and expulsion
• Occupational failure, job loss, and unemployment
• Financial problems
• Legal problems, including arrest and incarceration
• Academic or occupational failure
• Homelessness
• Suicide

Opioid addiction and co-occurring disorders

Individuals who develop opioid use disorder may be at increased risk for experiencing the following co-occurring mental health disorders:

• Other substance use disorders
• Depressive disorders
• Posttraumatic stress disorder (PTSD)

Effects of opioid withdrawal and overdose

Effects of opioid withdrawal: When a person has developed opioid use disorder, attempting to stop or significantly limit one’s opioid abuse can prompt the onset of painful withdrawal symptoms, including the following:

• Dilated pupils
• Watery eyes
• Excessive perspiration
• Fever
• Diarrhea and vomiting
• Aching muscles
• Disrupted sleep patterns
• Dysphoria

Effects of opioid overdose: One of the characteristics of opioid use disorder is the development of tolerance, which means that individuals need to consume increasingly larger or more potent doses in order to achieve the desired effect. Taking greater amounts or more powerful opioids can also increase the risk of overdose, which may be indicated by the following symptoms:

• Dizziness
• Confusion
• Slow, shallow, and/or labored breathing
• Dangerously low heart rate
• Headache
• Cold and clammy skin
• Loss of consciousness
• Seizure