“Opioid use disorder is a chronic relapsing disease characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disease because opioids change the brain—its structure and how it works.”
National Institute on Drug Abuse (NIDA), National Institutes of Health2
Key Points
- Opioid addiction (OUD) is a chronic disease with recognizable symptoms. Recognizing these signs is the first step to seeking help.
- Symptoms span behavior, body, and mind. Including deceitful actions, physical changes like pinpoint pupils and withdrawal, and intense cravings.
- OUD disrupts daily life and health. It leads to neglected responsibilities, social withdrawal, and both physical and mental health decline.
- If multiple symptoms are present, professional help is crucial. Evaluation and treatment are essential for recovery from opioid addiction.
Behavioral Symptoms of Opioid Addiction
Behavioral changes are often the earliest and most noticeable signs of opioid addiction. These symptoms reflect the way opioid use becomes the central focus of an individual’s life, disrupting routines and responsibilities. Individuals struggling with opioid addiction may exhibit deceptive behaviors to obtain and conceal their drug use.
According to SAMHSA, these behaviors can include doctor shopping (seeking prescriptions from multiple doctors), forging prescriptions, or stealing medications from family and friends.
Lying about drug use, minimizing the problem, or becoming secretive about activities are also common behavioral indicators.
Neglecting responsibilities is another key behavioral symptom. Opioid addiction can impair an individual’s ability to maintain commitments at work, school, or home. This may manifest as decreased performance, absenteeism, missed deadlines, or neglecting childcare or household duties. Social withdrawal is also frequently observed. As opioid use becomes more compulsive, individuals may withdraw from social activities, relationships, and hobbies they once enjoyed, prioritizing drug seeking and use over social engagement.5 Changes in social circles, associating with new or different friends who may also use drugs, can be another behavioral red flag. Financial difficulties, often arising from the costs of obtaining opioids, can also become apparent, with individuals potentially borrowing money, selling possessions, or engaging in other desperate measures to fund their addiction.
Physical Symptoms of Opioid Addiction
Physical symptoms of opioid addiction arise from the direct effects of opioids on the body and the body’s adaptation to chronic opioid use. Pupil constriction, or pinpoint pupils, is a classic physical sign of opioid intoxication. Opioids affect the nervous system, causing the pupils to become smaller. Drowsiness and lethargy are also common, as opioids depress the central nervous system, leading to slowed reactions, nodding off, and excessive sleepiness even during the day.
However, in some cases, individuals may experience periods of agitation or hyperactivity, particularly during withdrawal or when seeking the drug. Changes in appearance and hygiene can also be indicative of opioid addiction. Individuals may neglect personal grooming, exhibit poor hygiene, and have a general decline in physical appearance as their focus shifts away from self-care and towards drug use.8
Tolerance and withdrawal are hallmark physical symptoms of opioid dependence. Tolerance develops as the body adapts to the presence of opioids, requiring increasingly higher doses to achieve the desired effect. This is a dangerous phenomenon as escalating doses increase the risk of overdose. Withdrawal symptoms occur when opioid use is reduced or stopped abruptly, as the body reacts to the absence of the drug it has become dependent on. Opioid withdrawal is often described as intensely unpleasant and flu-like, with symptoms such as muscle aches, nausea, vomiting, diarrhea, abdominal cramping, sweating, goosebumps, runny nose, and watery eyes.9 The severity of withdrawal can vary depending on the type of opioid, duration of use, and individual factors, but the discomfort often drives continued drug use to avoid these symptoms.
Psychological Symptoms of Opioid Addiction
Psychological symptoms of opioid addiction are intertwined with the neurobiological effects of opioids on the brain and the emotional and cognitive consequences of compulsive drug use. Changes in mood and mental state are frequently observed. Opioid addiction can exacerbate or trigger mental health issues such as anxiety and depression.
Individuals may experience increased irritability, mood swings, and emotional lability.Cognitive impairments, including confusion, difficulty concentrating, and memory problems, can also arise from chronic opioid use. These cognitive effects can impact daily functioning, decision-making, and overall mental clarity.
Intense cravings are a defining psychological symptom of opioid addiction. Cravings are characterized by an overwhelming urge to use opioids, often triggered by environmental cues, stress, or withdrawal symptoms. These cravings can be intrusive and persistent, dominating thoughts and behaviors and making it extremely difficult to resist drug use.
According to the National Institute on Drug Abuse (NIDA), cravings are a key factor in the compulsive nature of addiction and contribute significantly to relapse.11 The psychological dependence associated with opioid addiction is powerful, driving individuals to continue using opioids despite negative consequences and a desire to stop.
Seeking Professional Help for Opioid Addiction Symptoms
It is crucial to understand that experiencing some of these symptoms does not automatically equate to opioid addiction. However, the presence of multiple symptoms across behavioral, physical, and psychological domains should raise concern and warrant professional evaluation.
