Signs and Symptoms of Opioid Use Disorder

Opioid use disorder (OUD) is a fast-growing epidemic in the United States. OUD can affect anyone, regardless of age, gender, or income level. OUD occurs when someone cannot control their use of opioids, even when it harms their physical and mental health. But OUD is treatable. Recognizing the signs and symptoms is the first step toward getting help.^1,2

Warning signs of opioid use disorder

Warning signs of OUD may not always be obvious. However, certain behaviors may signal the condition. These behaviors can include:^1,2

• Taking opioids more often or in larger amounts than prescribed
• Spending a lot of time trying to get opioids
• Neglecting work, school, or family responsibilities
• Losing interest in hobbies or activities once enjoyed
• Continuing to use opioids despite problems in relationships or at work
• Hiding opioid use from others
• Being dishonest to family or friends
• Increased lethargic behavior, like being overly sleepy or slow-moving

If you notice these behaviors in yourself or someone else, get medical help as soon as possible. You can also get support by calling the Substance Abuse and Mental Health Services Administration’s national helpline at 1-800-662-HELP (4357).^1,2

Physical and behavioral symptoms of OUD

Opioids affect both the body and the mind. Over time, they can cause noticeable physical and mental changes. These symptoms can range from mild to severe. They may vary depending on the person and the severity of their condition.^1,3

Physical OUD symptoms may include:³

• Drowsiness or falling asleep at unusual times
• Slurred speech
• Pinpoint pupils (very small pupils)
• Slow or shallow breathing
• Weight loss or weight gain
• Constipation
• Poor hygiene or lack of self-care
• Flu-like symptoms such as nausea, vomiting, chills, or sweating

Behavioral OUD symptoms may include:^1,3

• Mood swings or irritability
• Depression or anxiety
• Trouble concentrating
• Feeling a strong urge or craving to use opioids

As OUD progresses, symptoms can become more severe. Signs that opioid use is becoming more serious can include:^1-4

• Increased tolerance, meaning a person needs more opioids to feel the same effect
• Physical dependence, where the body cannot function normally without opioids
• Frequent infections, such as skin infections or abscesses
• Financial or legal problems

Symptoms of opioid withdrawal syndrome

If someone with OUD suddenly stops taking opioids, they may experience withdrawal within 6 to 24 hours. This is also known as opioid withdrawal syndrome. Symptoms of withdrawal can include:^1,4

• Anxiety or agitation
• Muscle aches
• Sweating or chills
• Insomnia or trouble sleeping
• Stomach cramps
• Runny nose or watery eyes
• Nausea, diarrhea, or vomiting
• Intense cravings for opioids

Withdrawal symptoms are very uncomfortable and can be quite severe. But withdrawal is typically the first step toward detoxing the body and getting treatment. Opioid withdrawal syndrome is not usually life-threatening. Still, it is important to seek medical help for withdrawal, as medicines can make it more tolerable and improve the likelihood of completing the detox.^1,4

When to see a doctor

If you or someone you know is showing signs of OUD, talk to a doctor. Early intervention can prevent OUD from getting worse.^1,4

You should see a doctor if:¹

• You cannot stop using opioids on your own.
• You experience withdrawal symptoms when you try to stop.
• Your opioid use is interfering with your daily life.
• You are worried about a loved one’s opioid use.

Doctors can help by diagnosing OUD and creating a treatment plan. This may include medicine, counseling, therapy, or support groups. There is no shame in seeking help. Recovery is possible with the right care and support.^1,4

Be prepared

OUD is a challenging condition. But recognizing the signs and symptoms is a critical first step. If you are concerned about your or someone else’s opioid use, do not wait to reach out for help. Talk to a doctor or a trusted professional. Consider keeping naloxone (Narcan®) on hand. Naloxone is a drug that reverses the effects of an opioid overdose and saves lives.^1,4