4 Signs of Opioid Addiction

Sad Teen Sitting On A Bench In A Tunnel

Opioid addiction, also known as Opioid Use Disorder (OUD), has reached epidemic levels in the United States.1 Around three million AmOpioids vs. opiates are simiericans struggle with opioid abuse, 500,000 of whom are dependent on heroin. 

Since the opioid epidemic is still ongoing, it’s important to know how to spot the signs of opioid addiction. When you know how to identify them, you can understand your own symptoms or help loved ones you suspect are suffering before it’s too late. 

So, what are the signs of opioid addiction? Below, we’ll explain what opioids are and review the common signs of opioid use disorder. 

What Are Opioids?

Opioids vs. opiates are similar, however, the latter is naturally derived. Opioids are synthetic and are often prescribed to treat severe or chronic pain. Many people start taking these pain relievers after surgery for a severe injury or during cancer treatment.2 Some common types of opioids are:3

  • Oxycodone
  • Hydrocodone
  • Fentanyl
  • Morphine
  • Heroin
  • Codeine

These drugs relieve pain by blocking pain signals between the brain and spinal cord.4 They do so by attaching to opioid receptors within the body, which naturally bind with endorphins.5 

While opioids are effective pain relievers, they can also become highly addictive with prolonged use.6 The reason? Over time, the body can develop a tolerance to opioids and a physical dependence on them.7 In turn, some people may need to take larger doses of opioids to get the same amount of pain relief. 

At this stage of use, cutting back can induce intense withdrawal symptoms.

Risk Factors of Opioids

Anyone can develop an addiction to opioids, regardless of age, ethnicity, or socioeconomic  status—in other words, these drugs don’t discriminate.

With that being said, some risk factors may make someone more likely to develop opioid use disorder.

Genetic Factors

People with family members who have struggled with opioid addiction or other substance abuse disorders are at a greater risk of developing it too. Studies have shown that relatives with opioid addictions often share specific genetic markers.8

Environmental Factors 

Someone’s environment may push them to take opioids. For instance, if someone lives in a community where opioid use is prevalent, they may be more inclined to try them and develop an addiction.

Living in a stressful environment may also prompt someone to take opioids to get some relief. Environmental stressors can include poverty, violence, trauma, and unemployment.

Lastly, people who are prescribed opioid painkillers for an accident, injury, or surgery may end up developing an opioid addiction. Studies suggest that a third of people who take prescription opioids abuse them.9 Over 10% develop an addiction down the line.9

A Better Approach To Substance Abuse Treatment. Learn More!

Psychological Factors 

People who struggle with mental health are more prone to developing addictions, including opioid use disorder. That’s because they may self-medicate with opioids in an attempt to relieve their psychological distress.

Some psychiatric conditions that often co-occur with opioid addiction include:10

  • Depression
  • Anxiety
  • Personality disorders
  • Psychotic disorders
  • Bipolar disorder
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Post-traumatic stress disorder (PTSD)

Age-related Factors

While people can develop an opioid addiction at any age, teenagers and people in their early twenties who use opioids are at greater risk of becoming addicted, especially those who tend to engage in thrill-seeking behavior.9 

Signs of Opioid Addiction

Now that you understand the risk factors for opioid use disorder, you may be wondering how you can tell if someone you love is struggling with it. 

The signs of opioid addiction can fall into four categories:

#1 Behavioral Signs

People who become addicted to opioids may initially hide their use from friends and family. Thus, you may not notice a change in their behavior right away. However, as they fall deeper into their addiction, you may notice that your loved one:11

  • Isolates themselves more than usual
  • Falls behind at work or school
  • Exhibits changes to their sleeping patterns
  • Has unexplained financial issues

You may also discover that a loved one is lying to healthcare providers about their pain levels to obtain more opioid prescriptions. They may even see several doctors at a time to multiply their prescriptions. 

If these methods fall short, people suffering from opioid addiction may resort to stealing from their friends or family members to purchase illicit opioids on the streets. 

#2 Physical Signs

Prolonged opioid use can take a noticeable toll on the body. If you suspect that a loved one is abusing opioids, you should watch out for these opioid use disorder symptoms:11

  • Constricted pupils
  • Unexplained weight loss
  • Slow motor skills
  • Poor coordination
  • Frequent digestive problems
  • Nausea
  • Scabs or puncture wounds near veins
  • Flushed skin
  • Deteriorating hygiene

#3 Cognitive Signs

Along with the body, opioids can alter the function of the brain. In turn, people with opioid use disorder may exhibit the following cognitive signs:12

  • Slowed cognition
  • Impaired judgment
  • Poor problem-solving skills
  • Poor concentration levels

#4 Psychosocial Signs

Lastly, coping with opioid addiction can cause people to lash out at those they love, especially when they’re low on opioids or experiencing early stages of withdrawal. 

For this reason, you may notice that your loved one has:13

  • Intense mood swings
  • Sudden outbursts
  • Paranoid thoughts
  • Increased irritability
  • Bouts of depression

Signs of Opioid Overdose

Opioid overdoses have been on the rise in recent years.14 Knowing how to identify when someone is overdosing may potentially save their life.

Some signs of opioid overdose are as follows:15

  • Slow, shallow breathing
  • Slow pulse
  • Blue or ashen skin tone
  • Blue or purple lips and fingernails
  • Vomiting
  • Inability to talk 
  • Unconsciousness
  • Delayed responses to stimuli
  • Body limpness
  • Muscle spasms
  • Seizures
  • Clammy, pale skin
  • Gurgling

If you suspect that someone you love is abusing opioids, you may want to keep some naloxone on hand. Naloxone is an opioid antagonist.16 In turn, it can bind to opioid receptors, effectively reversing an overdose. It’s available as a nasal spray or an injectable solution. You can administer naloxone if your loved one exhibits the symptoms listed above. After administering naloxone, you should call 911 right away.

Effects of Opioid Addiction

Opioid addiction can have devastating effects on the person struggling and their loved ones. Untreated opioid use disorder can lead to:

  • Job loss
  • Strained relationships
  • Social isolation
  • Financial problems
  • HIV infection (from sharing needles)
  • Respiratory issues
  • Collapsed veins
  • Heart failure
  • Homelessness
  • Overdose
  • Death

People who use illicit opioids, like heroin, are at greater risk of dying from their addiction. That’s because these unregulated substances can be laced with dangerous contaminants or other opioids, such as fentanyl. Fentanyl is 50 to 100 times more potent than morphine.17 If someone ingests it unknowingly, it can cause an unexpected overdose. 

Getting treatment as soon as possible can help people suffering from opioid addiction evade these consequences if they haven’t experienced them yet. 

Opioid Withdrawal Symptoms

Once someone is physically dependent on opioids, they will likely experience withdrawal symptoms when they stop taking them. Some of these symptoms can include:18

  • Anxiety
  • Agitation
  • Restlessness
  • Insomnia
  • Muscle and bone pain
  • Diarrhea
  • Nausea and vomiting
  • Increased heart rate
  • High blood pressure
  • Sweating
  • Chills
  • Intense cravings for opioids

These withdrawal symptoms can range from uncomfortable to agonizing, depending on the duration and severity of someone’s addiction.

How long does opioid withdrawal last? Luckily, acute withdrawal symptoms only last up to ten days or so.23 Medical management and the right medications can make opioid withdrawal much more bearable.

Treatment For Opioid Addiction

Overcoming opioid addiction is possible. In order to do so safely and effectively, it’s a good idea to seek professional treatment. 

Opioid treatment can include:

  • Medically-monitored detox – The first step of opioid recovery is breaking physical dependency. This step can be accomplished through a carefully monitored and properly medicated detox.19
  • Inpatient treatment – After opioid detox, the real work of recovery begins. During treatment, patients can restore their physical health and emotional well-being through exercise, good nutrition, and supportive counseling. They can also learn what caused their addiction and develop skills to cope with stressors in healthier ways. After doing this deep work, people can check out of treatment and confidently take on the next stages of recovery.
  • Ongoing support – Inpatient treatment programs typically last 30 to 90 days. Once a patient checks out of their program, it’s time to start practicing what they learned in their day-to-day life. Staying sober is easier with ongoing support. This support can take the role of professional counseling and addiction support groups. A counselor or support group sponsor can help someone in recovery stay on track and make decisions that are in alignment with their sobriety. 

See related: How Long Do Opioids Stay in Your System?

Overcome Your Opioid Addiction At Elevate Rehab

If you suspect that a loved one is struggling with opioid abuse (whether that’s through opioid dependence vs. addiction), you may be wondering what you can do to help them. At Elevate Rehab, our professional intervention services can help you address your loved one’s issue compassionately and productively. 

We can reassure your loved one that they don’t need to endure opioid withdrawal or recovery on their own. Through participation in our holistic rehab program, they can heal from their addiction in a supportive environment and enjoy access to all of the resources they need to thrive post-treatment. 

Are you ready to help your loved one suffering from opioid addiction? Discover how Elevate Rehab can help lift your loved one out of their addiction today. 

A Better Approach To Substance Abuse Treatment. Learn More!


  1. NIH. Opioid Addiction. https://www.ncbi.nlm.nih.gov/books/NBK448203/
  2. Cleveland Clinic. Opioids. https://my.clevelandclinic.org/health/articles/21127-opioids
  3. CDC. Prescription Opioids: The Basics. https://www.cdc.gov/rxawareness/information/index.html
  4. American Society of Anesthesiologists. What Are Opioids? https://www.asahq.org/madeforthismoment/pain-management/opioid-treatment/what-are-opioids/
  5. Cleveland Clinic. Endorphins. https://my.clevelandclinic.org/health/body/23040-endorphins
  6. American Society of Anesthesiologists. Opioid Abuse. https://www.asahq.org/madeforthismoment/pain-management/opioid-treatment/opioid-abuse/
  7. MayoClinic. How opioid addiction occurs. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372
  8. NIH. Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747085/
  9. MayoClinic. How to tell if a loved one is abusing opioids. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-tell-if-a-loved-one-is-abusing-opioids/art-20386038
  10. PCSS. Opioid Addiction with Psychiatric Comorbidities. https://pcssnow.org/resource/opioid-addiction-psychiatric-comorbidities/
  11. Johns Hopkins Medicine. Opioid Use Disorder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/opioid-use-disorder
  12. SpringerLink. The role of the opioid system in decision making and cognitive control: A review. https://link.springer.com/article/10.3758/s13415-019-00710-6
  13. MentalHealth.gov. Mental Health and Substance Use Co-Occurring Disorders. https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders
  14. NIH. Overdose Death Rates. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
  15. National Harm Reduction Coalition. Recognizing Opioid Overdose. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/recognizing-opioid-overdose/
  16. NIH. What is naloxone? https://nida.nih.gov/publications/drugfacts/naloxone
  17. NIH. Fentanyl. https://nida.nih.gov/research-topics/fentanyl
  18. NIH. Opioid Withdrawal. https://www.ncbi.nlm.nih.gov/books/NBK526012/
  19.  NIH. Withdrawal Management. https://www.ncbi.nlm.nih.gov/books/NBK310652/
Scott Friend Msw M.s. Medical Review E1609434230277
Medically reviewed by
Scott Friend, MSW, M.S.

  • Overcome Addiction at Elevate Addiction Services

    Elevate is currently offering immediate enrollment in inpatient, outpatient, or telehealth programs. Reach out today to learn more.
  • This field is for validation purposes and should be left unchanged.

Elevate Locations

Treatment Resources

elevate addiction services logo
Is an accredited drug and alcohol rehabilitation program, that believes addiction treatment should not just address “how to stay sober” but needs to transform the life of the addict and empower him or her to create a more meaningful and positive life. We are dedicated to transforming the despair of addiction into a purposeful life of confidence, self-respect and happiness. We want to give recovering addicts the tools to return to the outside world completely substance-free and successful.
elevate addiction services logo
Is an accredited drug and alcohol rehabilitation program, that believes addiction treatment should not just address “how to stay sober” but needs to transform the life of the addict and empower him or her to create a more meaningful and positive life. We are dedicated to transforming the despair of addiction into a purposeful life of confidence, self-respect and happiness. We want to give recovering addicts the tools to return to the outside world completely substance-free and successful.