Opioid Addiction: Effects, Withdrawal, & Treatment

Opioid misuse means using these drugs in a way other than prescribed, such as by:^3,4

• Taking opioids in higher doses or more often than prescribed.
• Taking someone else’s prescription.
• Combining opioids with alcohol or other drugs to amplify the subjective effects.
• Taking opioids in ways other than prescribed (see below).

Some people who use opioids to get high may attempt to intensify the euphoria by taking them in ways other than as prescribed. For example, OxyContin is an extended-release opioid intended for the treatment of moderate to severe pain by steadily releasing opiates into the body after being taken orally, however, people who misuse it may crush the pill to bypass the time-release mechanism and snort or inject it instead.

Opioid Misuse Statistics

According to the 2022 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated:¹

• 2% of Americans 12 years old or older misused opioids in the past year.
• The majority of opioid misuse (94.8%) involved prescription painkillers.
• 8% of people who misuse opioids use heroin.

Potentially adverse short-term effects of opioids include:⁴

• Drowsiness.
• Confusion.
• Nausea.
• Constipation.
• Slowed breathing.

In overdose, the breathing may slow to extreme levels or stop completely. This may lead to a lack of oxygen to the brain (hypoxia) which may result in coma, brain damage, or death.³

Opioid overdose is a medical emergency. In the event of an overdose, call 911 and administer Narcan (naloxone) if it is available.³

Potential Effects of Long-Term Opioid Use

The precise impact that prolonged, chronic opioid use has on someone’s life will depend on a number of variables, but many people will be at increased risk for several types of unfavorable outcomes.

The signs and symptoms of opioid addiction will vary, but potential adverse consequences of opioid addiction include:^7,8

• A decline in social and interpersonal relationships.
• Difficulty meeting schoolwork obligations.
• Problems with job performance or loss of a job.
• Debt from increased substance-related spending or loss of income.
• Decreased time for previously enjoyed recreational activities.
• Increased risk of disease contraction or other drug-related physical health issues. (e.g., HIV, tuberculosis, viral hepatitis, endocarditis, skin and soft tissue infections).
• Intoxication-related injuries.
• Increased risk of opioid-related respiratory depression and overdose death.

People who have consistently used opioid drugs eventually develop physiological dependence and will likely experience withdrawal when they reduce or quit their opioid use.

Opioid withdrawal, while seldom fatal, may involve many unpleasant symptoms. Medical detox can help stabilize a person in withdrawal and make this inevitable hurdle to recovery much more comfortable and bearable.¹⁰

Early Opioid Withdrawal Symptoms

Some of the earliest symptoms of opioid withdrawal include:⁹

• Insomnia.
• Anxiety.
• Agitation.
• Muscle aches and pains.
• Sweating.
• Increasing tearing and runny nose.
• Yawning.

The precise duration and intensity of withdrawal will vary among individuals and will be influenced by the type of opioid having been used; in some cases, the characteristic withdrawal symptoms may change over the course of a somewhat stepwise progression.

Late Symptoms of Opioid Withdrawal

As an example, some of the later-stage symptoms of opioid withdrawal may include:⁹

• Nausea.
• Vomiting.
• Abdominal cramping.
• Diarrhea.
• Dilated pupils.
• Goosebumps.

Though opioid withdrawal can be intensely unpleasant, it is seldom life-threatening; with the right withdrawal management care in place, many progress comfortably through this earliest stage of treatment and come out on the other side re-invigorated and ready to begin additional recovery efforts.

As part of medical treatment for opioid use disorder, physician staff may administer opioid agonist medications like methadone and buprenorphine to stabilize people in withdrawal and maintain them through longer-term recovery. Clonidine may additionally be used to manage opioid withdrawal symptoms, as well as other adjunctive pharmacotherapies for better management of symptoms such as insomnia, body aches and pains, and headaches.^10,11 At some point after being stabilized on an opioid agonist regimen, the choice may be made to taper the recovering individual off the maintenance drugs in a slow, controlled manner, though many people remain on maintenance therapy for longer periods of time.