Signs and Symptoms of Opiate Addiction

Learn about opiate addiction and substance abuse

Opioids are narcotic painkillers that work by reducing the intensity of pain signals that reach the brain in addition to affecting areas of the brain responsible for emotional regulation. Opiate narcotics are known for their ability to bind to and influence naturally-occurring opiate receptors on cell membranes throughout the body. There are three distinct types of opiate narcotic classes:

Naturally-occurring opiates are derived from the opium poppy and include morphine, codeine, and thebaine.

Semi-synthetic opioids are chemically synthesized using compounds isolated from natural sources, such as plants, as starting components. Semi-synthetic opioids include heroin, oxycodone, hydrocodone, and oxymorphone.

Synthetic opioids are made using total chemical synthesis and include buprenorphine, methadone, and fentanyl.

All three classes of opiates produce varying levels of analgesia for people who are experiencing pain that is not controlled by over-the-counter painkillers. As these drugs cause feelings of euphoric bliss in addition to pain management, prescription narcotics are rapidly becoming a drug of choice for many. While most people go to the doctor for a legitimate pain-related diagnosis to obtain a prescription for opiate narcotics and take the medication for the intended duration, then stop when the medication runs out, others may not. The pleasurable feelings cause by opiates can lead some people to begin to abuse these powerful, controlled prescription medications. While addiction to opiate narcotics can change virtually every facet of an addict’s life, there is hope. With proper detox, treatment, addiction recovery techniques, and long-term recovery planning, people addicted to prescription opiates can learn the tools necessary to maintain a life free of painkillers.

Opiate addiction statistics

In a shocking twist, the U.S. Substance Abuse and Mental Health Services (SAMHSA) discovered that next to marijuana, the nonmedical abuse of prescription opiate narcotics is the second most common form of illegal drug abuse. SAMHSA reported that in 2007, 5.2 million people – or 21% of people over the age of 12 – admitted to having used an opiate narcotic for a nonmedical purpose; the United States DEA believes that number to be closer to 7 million people. The Drug Abuse Warning Network (DAWN) found that in 2006, about 324,000 visits to the emergency department involved opiate narcotic abuse.

Causes and risk factors for opiate addiction

Addiction is a complex disease that is characterized by an ongoing pattern of drug abuse, including opiates, despite the negative consequences. Researchers in the field agree that addiction is not the result of a single root factor, rather it is the product of environmental, genetic, and physical risk factors working together. The most commonly cited causes and risk factors for opiate addiction include:

Genetic: It’s been long understood that addiction is a family disease; people who have a first-degree relative, such as a parent or sibling, who struggles with addiction are at a higher risk for developing addiction themselves. However, there are a number of individuals who develop an addiction without a family history and, conversely, there are a number of people who have a significant family history of addiction that do not develop an addiction.

Physical: Ongoing use of opioid narcotics changes the structure and function of the brain, which can lead to addiction. As opiates saturate the brain, the levels of neurotransmitters such as dopamine and GABA are affected, which can lead to physical dependence and addiction to opiates.

Environmental: People who grow up in homes in which addiction was present learn through modeling that using drugs or alcohol is the way to handle life stresses. In addition, people who first experiment drugs at younger ages are more prone to addiction than others.

Risk Factors:

• Being male
• Co-occurring, comorbid mental health disorders
• Peer pressure
• Lack of familial involvement
• Anxiety, depression, loneliness

Signs and symptoms of opiate addiction

Signs and symptoms of opiate addiction vary among individuals based upon genetic makeup, amount used, frequency of abuse, method of administration, and usage of other drugs. The most common signs and symptoms of opiate addiction include the following:

Behavioral symptoms:

• Frequent trips to the ER for pain maladies
• “Losing” prescriptions for opioids
• Sudden financial problems
• Borrowing or stealing narcotics from friends and family
• Lying about amount of narcotics used
• Hiding opiates in various places around the house, car, and office
• Doctor shopping, or visiting a number of doctors to obtain more prescriptions for opiates
• Compulsive use and abuse of opiates despite negative consequences
• Slurred speech
• Lowered inhibitions
• Risk-taking behaviors

Physical symptoms:

• Constipation
• Bloodshot eyes
• Difficulties urinating

• Decreased respiratory rate
• Withdrawal symptoms if drug discontinued
• Itching
• Flushed skin
• Liver disease
• Jaundice
• Pupillary constriction
• Sleepiness
• Analgesia
• Coma
• Death

Cognitive symptoms:

• Confusion
• Poor judgment
• Decreased ability to pay attention
• Short-term memory loss

Psychosocial symptoms:

• Depression
• Irritability
• Elation
• Relaxation
• Psychological dependence
• Hallucinations
• Delusions
• Paranoia
• Anxiety
• Anger
• Addiction
• Self-harm
• Suicidal ideation

Effects of opiate addiction

Long-term opiate abuse will wreak havoc lead in almost all areas of an individual’s life. Complications of opiate abuse will vary depending upon the length of abuse, route of administration, frequency of use, individual genetic makeup, and abuse of other drugs. Common effects of opiate abuse include:

• Liver disease
• Dehydration
• Abscesses
• Infection of cardiac valves
• Pneumonia
• Cirrhosis
• Cardiac dysrhythmias
• Increased respiratory infections
• Anxiety
• Irritability
• Addiction
• Suicidal thoughts and behaviors
• Overdose
• Seizures
• Stroke
• Heart attack
• Coma
• Death

Effects of opiate withdrawal & overdose

An opiate overdose occurs when a person consumes too many opioids at once or combines prescription narcotics with other drugs or alcohol. Opiate overdose is a life-threatening emergency that requires immediate medical attention. In the United States, opiate overdose is responsible for more deaths than heroin and cocaine combined. Common symptoms of opiate overdose include:

• Decreased level of consciousness
• Pinpoint pupils
• Decreased heart rate
• Decreased or slowed respiratory rate
• Cyanosis of lips and nails
• Muscle spasms
• Seizures
• Respiratory arrest
• Cardiac arrest
• Coma
• Death

Withdrawal occurs after an individual who has become physically dependent upon opiates suddenly reduces or discontinues their opiate habit. Withdrawal symptoms can be highly unpleasant and, upon occasion, dangerous, so it’s recommended that withdrawal from opiates is performed under the supervision of a trained medical professional. Common symptoms of opiate withdrawal include:

• Anxiety
• Irritability
• Strong drug cravings
• Respiratory acceleration
• Goosebumps
• Lack of appetite
• All-over body aches
• Nausea, vomiting, diarrhea, and abdominal cramping
• Enlarged pupils
• Confusion
• Tremors
• Paranoia
• Restlessness
• Malaise
• Seizures

Opiate addiction and co-occurring disorders

Many people who are addicted to opiates struggle with other substance abuse problems or co-occurring mental illnesses. The most common co-occurring, comorbid mental illnesses include:

• Depressive disorders
• Anxiety disorders
• Abuse of other drugs
• Alcoholism
• Bipolar disorder
• Schizophrenia