The Signs and Symptoms of Opioid Abuse

The term “opioids” doesn’t refer to just one drug. It encompasses a variety of legal, illegal, natural, and synthetic drugs. Different types of opioids include:

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

Many of these drugs, like hydrocodone and oxycodone, are prescribed by doctors to treat pain. Morphine and fentanyl are also used for pain relief during surgeries and other medical procedures. Heroin is an illegal opioid that has no therapeutic use.

All types of opioids carry a large potential for addiction, and many people become addicted to opioids after having them prescribed by a doctor. Once they start taking more than the prescribed dose, opioid use can quickly spiral out of control and take over their life. Opioid users who start this way often progress from pills to heroin and fentanyl.

Opioid abuse is extremely dangerous. Over 46,000 people in the U.S. died from an opioid overdose in 2018. Between February 2018 and February 2019, 69,029 people died from drug overdoses in general, and 7 out of 10 of those were from opioids. Almost half of all overdose deaths in that time were due to fentanyl. Fentanyl is the most deadly opioid. It’s 50 to 100 times more powerful than morphine.

Because of the danger of opioids, it’s important to be able to tell when you or someone else is abusing them. Learn about the signs of opioid abuse below.

Physical Opioid Addiction Symptoms

The physical signs of opioid use vary depending on the type of opioid used. IV heroin use, for instance, has different physical effects than taking pills. Also, crushing and snorting pills have different effects than swallowing pills. The following are a few signs and symptoms common to all or most opioids.

Short-term physical signs of opioid addiction include:

  • Nausea
  • Constipation
  • Opioid cravings
  • Flu-like symptoms
  • Decreased desire for sex
  • Slowed breathing
  • Slurred speech
  • Loss of coordination
  • Sweating
  • Shaking
  • Pupil constriction

Long-term physical signs of opioid addiction include:

  • Weight loss
  • Collapsed veins
  • Cardiovascular issues
  • Breathing problems
  • Sexual dysfunction

Behavioral Symptoms of Opioid Addiction

The behavioral effects of opioid use may be subtler than other drugs, which can make it hard to know how to tell if someone is under the influence of opiates. One of the main signs of opioid use is slower movements and speech. Other behaviors associated with severe addiction should become more obvious over time, as the addiction gets worse.

Short-term behavioral signs of opioid addiction include:

  • Poor hygiene
  • Irritability
  • Sleeping more than usual
  • Sleeping at odd times, or lack of a sleeping schedule
  • Impulsivity
  • Poor decision-making

Long-term behavioral signs of opioid addiction include:

  • Isolation from family and friends
  • Forming new friendships all at once
  • Financial troubles
  • Legal troubles
  • Drop in performance at work or school
  • Lying about pain

Mental/Emotional Signs of Opioid Abuse

The mental and emotional effects of opioid use can best be described as a general “slowing-down.” Opiates cause someone to think and move much more slowly. They will have a harder time reacting to questions and keeping up with conversations.

Short-term mental and emotional signs of opioid addiction include:

  • Mental fog
  • Drowsiness
  • Anxiety
  • Paranoia
  • Difficulty concentrating
  • Impaired judgment

Long-term mental and emotional signs of opioid addiction:

  • Depression
  • Developing tolerance, meaning they need more of the drug to achieve the same feeling

Environmental Signs of Opioid Abuse

If you suspect a loved one is abusing opiates, pay careful attention to their living space. There may be drug paraphernalia that indicates drug use is happening there.

Paraphernalia will differ depending on the type of opioid they’re using. Pills generally leave little evidence unless they’re crushed. Heroin, which is usually injected, involves more paraphernalia.

Keep an eye out for:

  • Prescription bottles with the labels ripped off
  • Needles or syringes
  • Balloons or bloodied cotton swabs
  • Cut straws or hollowed-out pens
  • Burnt tin foil
  • Lighters
  • Small plastic baggies with white residue
  • Baggies containing unlabeled pills

Other Features of Opioid Use

Risk of Overdose

One of the reasons abusing opioids is so dangerous is because being intoxicated and overdosing are similar in many ways. Someone could easily slip from breathing slowly to not breathing at all without anyone noticing. Sweating is a common reaction to an opioid high, but clammy skin is a sign of overdose.

“Doctor Shopping”

Many people who are addicted to opioids obtain them legally from a doctor. But they make up symptoms or conditions that call for the use of prescription opioids. Or they might really have a medical condition but exploit it for prescriptions, claiming it’s not being treated well enough. They may go to doctor after doctor until they find one who prescribes an opioid. Or they may go to multiple doctors and not tell them they already have an opioid prescription from someone else.


Opioid addiction comes with powerful withdrawal symptoms that begin just a few hours after the drug wears off. Commonly known as being “dope sick,” opioid withdrawal can feel like the flu, with symptoms like muscle aches and vomiting. People can easily become addicted to opioids simply because stopping can mean fighting off opioid withdrawal symptoms.

Don’t Wait to Get Your Loved One Help for Opioid Addiction

There are many highly effective methods of treatment for opioid addiction. Detoxing from opioids is made easier by medication-assisted treatment, or MAT, in a medical detox setting. Buprenorphine, methadone, and naltrexone are medications used to treat opioid addictions. They bind to your brain’s opioid receptors but prevent you from feeling high. By decreasing the amount of the medication over time, they break your body of its dependency. They can also be used long-term to prevent someone from being able to feel high after taking opioids.

There are other important components of treatment for opioid addiction, such as therapy to help learn what drove the addiction in the first place. Some type of treatment, whether it is outpatient or residential rehab, is necessary for long-term sobriety. Before you approach your loved one about starting substance abuse treatment, become knowledgeable about what’s available in your area.

At Footprints to Recovery, we offer several programs to accommodate different severities of addiction. They include:

If you or a loved one is struggling with opioid addiction, give us a call. We’ll help you decide which option is right for you and give you information about how to get started. Calls are free and confidential. We look forward to helping you begin your recovery journey.



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