Common Signs and Symptoms of Opiate Addiction

Opiate addiction is at an epidemic level in the US and worldwide. Three million Americans have had or currently suffer from opioid addiction, which includes opiates like heroin, codeine, and morphine.[1] According to the National Institute on Drug Abuse, opioid-involved overdose deaths rose from 21,089 in 2010 to 80,411 in 2021.[2]

The rates at which people are dying from opiate addiction are alarming and may feel overwhelming, but knowing the common symptoms and signs of opiate addiction can help prevent overdose deaths.

Signs of Opiate Addiction

The physical signs of opiate addiction include:

• Physical dependence: One of the common signs of opiate addiction is physical dependence, which means the body becomes accustomed to the drug. If the person cuts back on opiate use or stops completely, they will experience withdrawal symptoms.
• Drowsiness: Opiates are analgesics, a class of drugs that work to relieve or suppress pain. They achieve this by attaching to the Mu1 and Mu2 opioid receptors in the brain, which affect the sensation of pain. Opioids don’t differentiate between the two Mu receptors and will bind to the Mu2 receptor as well, causing effects of sedation and suppression of the respiratory system. Drowsiness, or “nodding out,” often occurs, which can be dangerous.
• Extreme weight fluctuations: One of the most common signs of opiate addiction is dramatic weight loss as the person neglects nutrition in favor of using and spending money on opiates. Regular opiate abuse can cause nausea and vomiting as well, leading to weight loss. Weight gain can occur if the person becomes sedentary and begins to crave more food.
• Poor personal hygiene: When addicted to opiates, a person may neglect their personal hygiene and health routines, such as showering less or wearing dirty clothes for extended periods. People often neglect to brush their teeth regularly as well, leading to bad breath and tooth decay.
• Small pupils: Constricted pupils are an obvious sign of opiate use. Pupils typically respond to the presence or absence of light, but drug use causes pinpoint pupils in darkened areas. This is due to the effect opiates have on the autonomic nervous system, leading the pupils to shrink.
• Persistent scratching: Opiate addiction can cause compulsive scratching, particularly of the same areas of the body, which is known as dermatillomania. This is due to a particular isoform in opiates that reacts with the body, triggering an immune response and an itching sensation.
• Marks and scars: If the person uses opiates intravenously, there will be physical signs like track marks and fresh puncture wounds around the veins from needle use. This is usually seen on the forearm, but people may inject in other areas. Other methods of use may have different signs, such as a runny nose or nosebleeds from snorting or burns on the lips and fingers from smoking.[3]

The behavioral signs of opiate addiction include:

• Unusual behavior: A person using opiates may behave suspiciously or out of character. They may isolate themselves from friends and family, give up on hobbies, fail to make engagements, or wear long-sleeved shirts in hot weather to hide marks and scars.
• Financial issues: Opiate use can be expensive. Someone addicted to opiates will show signs of financial trouble, such as always being broke, making frequent trips to the ATM, asking to borrow money often, or missing important bills like mortgage, rent, or utilities.
• Stealing: As supporting an opiate addiction becomes more expensive, the person may start stealing from family members or friends. This can include actual cash or items of value, such as electronics or jewelry. They may also steal pills or shoplift.
• Neglecting responsibilities: As opiate addiction becomes more severe, more and more time is spent getting and using drugs. The person may start missing work or school excessively, show up late, or leave early. They’ll avoid social events, including family functions.
• Mood swings: Opiate addiction often comes with extreme mood swings. As the drug’s effects wear off, the person may become irritable or aggressive. Then, once they use opiates, they may become cheerful and carefree. Depression and anxiety are also common, leading to symptoms like sadness or nervousness.[4]

These signs are often seen with opiate addiction, but they can vary from person to person. If you suspect someone has an opiate addiction, it’s important to confront the issue and encourage them to seek help. Opiate addiction is time-sensitive and can be fatal.

Opiate Addiction Symptoms and Diagnostic Criteria

Opiate addiction is clinically known as opioid use disorder, which includes natural, semi-synthetic, and synthetic opioids. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), opioid use disorder is a problematic pattern of opioid use that leads to problems or distress. For a diagnosis, at least two of the following must occur within a 12-month period:

• Taking opiates in larger amounts or for longer periods than intended.
• A persistent desire to cut back or control opiate use.
• Spending a lot of time obtaining or using opiates or recovering from them.
• Experiencing intense cravings for opiates.
• Problems fulfilling obligations at home, work, or school.
• Continued opiate use despite recurring social or interpersonal problems.
• Giving up activities once enjoyed for opiate use.
• Using opiates in dangerous situations.
• Continued opiate use despite ongoing problems.
• Tolerance, or the need for increased dosage to achieve the same effects.
• Experiencing withdrawal symptoms when reducing or stopping opiate use.[5]

Treatment for Opiate Addiction

Opiate addiction is a dangerous and growing problem, but treatment can be effective to overcome addiction and prevent relapse. Treatment programs are individualized, but they usually begin with medical detox to relieve cravings, manage withdrawal symptoms, and prevent relapse.

After detox, counseling and behavioral therapies in an inpatient or outpatient setting are often used alongside medications like Suboxone.[6] This is not to cure the addiction or replace one drug with another but to promote better outcomes by minimizing withdrawal symptoms and blocking the euphoric effects of opiates. Additional interventions, such as mutual support groups and family therapy, may also be used.

Get on the Path to Recovery from Opiate Addiction

Recognizing the signs and symptoms of opiate addiction – either in yourself or a loved one – can be the first step to seeking help and overcoming the devastating effects of addiction. If you or a loved one needs treatment for opiate addiction, Recovery Unplugged is standing by. Contact our admissions team to discuss your options.