Signs Of Opioid Addiction And Abuse
Common signs of opioid addiction and abuse include drowsiness, pinpoint pupils, slowed breathing, and changes in mood and hygiene.

Author Kristen Fuller, MD
Signs Of Opioid Abuse
Recognizing the signs ofopioid abuse and addiction is an important step toward getting help. While symptoms can vary from person to person, there are often clear physical, behavioral, and emotional changes that indicate a problem.
Understanding what to look for can help you identify opioid misuse early and support your loved one in finding the care they need.
Physical Signs Of Opioid Abuse
Recognizing the signs and symptoms of opioid abuse is critical for preventing potentially life-threateningoverdoses and facilitating timely entry into an appropriate treatment program.
Physical signs of opioid abuse (regardless of the route of administration or opioid used) include:
- Pinpoint pupils
- Drowsiness
- Slowed breathing
- Dizziness
- Poor coordination
- Runny nose
- Weight loss
- Incoherent and slurred speech
- Rapid changes from hyper alert to lethargic
- Itchy skin
- Falling asleep throughout the day
- Constipation
Physical signs of injecting opioids:Needle marks, bruising, wearing long sleeves, scabs, or non-healing wounds on the skin. Paraphernalia includes syringes, tourniquets, lighters, and metal spoons.
Physical signs of smoking opioids: Blisters from overuse of lighters and black fingertips from the drug, black residue around the mouth and nostrils. Paraphernalia includes lighters, a heroin pipe (hollowed out pen, straw, etc.), and aluminum foil.
Physical signs of snorting opioids: Nosebleeds and a runny nose. Paraphernalia includes rolled dollar bills, razor blades, and straws.
A person who abuses opioids may experiment with various intake methods to achieve the strongest high possible. For example, tablets can becrushed into a powder form, which is then snorted. Powders can also be dissolved in a liquid and then administered intravenously.
Depending on the type of opioid and the route administered, the signs of opioid abuse can vary. For example, someone who smokesblack tar heroin will have different signs of opioid abuse compared to someone who ingests prescriptionoxycodone.
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Behavioral Signs Of Opioid Use
Behavioral signs of opioid use can occur alongside physical symptoms and include:
- Withdrawing from social activities that were once enjoyed
- Sudden and dramatic mood swings that seem out of character
- Impulsive actions and decision-making
- Engaging in risky activities, such as driving under the influence
- Doctor shopping to obtain more prescriptions
- Change in social connections and friend groups
- Unexplained financial hardships
- Lack of motivation or interest in hobbies, work, and spending time with loved ones
- Decline in work and academic performance
- Deceptive behavior such as lying, hiding money, and disappearing without any explanation
- Irritable mood
- Decline in hygiene
Exhibiting these signs does not guarantee a person is misusing opioids, but they can be an indication that unhealthy behaviors are developing.
What Are The Signs Of Opioid Addiction?
Opioid addiction is different from opioid abuse, but these terms are often mistakenly used interchangeably.
Opioid abuse refers to taking opioids in ways other than how they were prescribed. This includes taking a higher dosage, taking them more frequently, taking them to get high, using someone else’s prescription, or obtaining opioids illegally, such as purchasing them on the street.
Opioid addiction or opioid use disorder is a medical condition where the person is no longer in control of their life and they are not able to stop using or decrease their opioid use, no matter how hard they try. The following are signs and symptoms of opioid addiction:
- Dependence (the body becomes so reliant on opioids that withdrawal will occur if the user cuts back or quits opioids)
- Tolerance (an increase in the amount of opioids needed to feel the same desired effects over time)
- Continued opioid use despite worsening physical or mental health
- Continued opioid use despite social and interpersonal consequences such as legal trouble or family conflicts
- Decreased social or recreational activities
- Opioid cravings
- Inability to decrease or stop using opioids
- Difficulty fulfilling responsibilities at home, school, or work
- Excessive time is taken to obtain or recover from taking opioids
- More opioids are taken than intended
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What Are The Signs A Loved One Has An Opioid Use Disorder?
The hallmark characteristics ofaddiction include intense drug cravings and a strong desire to obtain or use the drug, despite negative consequences that may occur. A person who has an addiction is incapable of controlling the level of their substance use. They may desperately want to quit, but they feel unable to do so on their own.
The following are signs your loved one is struggling with an opioid use disorder:
- Possessing or using drug paraphernalia
- Neglecting personal hygiene or experiencing noticeable weight loss
- Exhibiting sudden or frequent mood swings
- Withdrawing socially or changing friend groups
- Declining in productivity at home, school, or work
- Arguing or experiencing conflict with friends, family, or colleagues
- Struggling with financial problems or unexplained money issues
- Disrupting regular sleep patterns or experiencinginsomnia
- Experiencing symptoms ofopioid withdrawal
- Lying, stealing, or engaging in other deceptive behaviors
Aside from dangerous health risks, opioid addiction can also interfere with your personal life and close relationships with loved ones.
The consequences of opioid addiction often include:
- Job loss due to prioritizing substance use over work responsibilities.
- Financial issues
- Legal issues
- Damaged relationships with family members, friends, and romantic partners.
What Are The Treatment Options For Opioid Addiction?
Treatment for opioid addiction involves a comprehensive treatment plan at an opioid addiction treatment center. Your level of care (residential,partial hospitalization,intensive outpatient, andoutpatient) will depend on the severity of your addiction, yourinsurance coverage, your social support at home, and any underlyingco-occurring disorders.
Common elements found in an opioid addiction treatment program include:
Treatment Medication: Medications are used to help you overcome opioid withdrawal and reduce opioid cravings. Medications for opioid use disorder includebuprenorphine,naltrexone,Suboxone, andmethadone.
Therapeutic Intervention:Psychotherapy approaches for opioid use disorder includemotivational interviewing,contingency management,cognitive-behavioral therapy, anddialectical behavior therapy.
Social Support:Support groups such asNarcotics Anonymous andgroup therapy are beneficial for long-term treatment and community involvement.
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