Are you wondering if you or someone you love is struggling with an opioid addiction? Even thinking about that as a possibility can feel scary and overwhelming. However, there are some warning signs and symptoms you can look for.

None of these signs alone prove someone has an opioid addiction, but knowing what to look for can help. If you notice several of these signs together, talk with a healthcare provider about a substance use evaluation. If an opioid addiction is present, the doctor can diagnose opioid use disorder (OUD) and help you choose an opioid treatment program to help you or your loved one heal and enter recovery.

Psychological Changes

Some changes linked to opioid misuse affect a person’s thoughts and mental health. You may notice:

• Cravings — If someone feels like they need opioids to function and keeps wanting them even when they cause problems, it may be a sign of addiction.
• A focus on the use of opioids — Someone living with substance misuse may focus much of their time, energy, or money on getting more. This is as true for opiates as it is for other drugs.
• Mood swings — People struggling with opioid use may have sudden or intense mood swings. They may become suddenly joyful or angry, for example.

If you or someone you love has any of these changes, it may be a sign of opioid addiction.

Behavioral Changes

A person with an opioid addiction may also change the way they act. People change all the time, but many of these changes will focus on getting and using opioids. A person may:

• Take more opioids than prescribed — They may take higher doses of medication, take doses more frequently, or take it for longer than their doctor told them to.
• Have trouble fulfilling responsibilities — They may struggle to keep up with work, school, or responsibilities at home.
• Stop participating in activities — Some people with an opioid addiction will do fewer activities or stop participating in activities they enjoy. If someone who’s usually social suddenly wants to be alone or begins avoiding family and friends, this can be a sign of misusing opioid drugs.
• Change their self-care habits — Opioid addiction can cause a person to change the way they sleep, eat, exercise, care for their body, have sex, and more.
• Make poor decisions — Opioid misuse can cause impaired decision-making. This may cause someone to put themself or other people in danger.
• Start stealing — Opioids can be expensive. Some people will start stealing from family, friends, work, and even strangers, so they can buy more.
• Have new financial problems — A person may spend all their money on opioids and develop financial issues.
• Try to borrow medication — People looking for more opioids may ask friends or family if they have some to lend.
• Seek out opioid prescriptions — Someone living with an opioid addiction may try to get prescription opioid painkillers from more than one doctor or renew their prescription too many times.
• Find new reasons to take opioids — They may say they need them to sleep, relax, or stay alert, even if those reasons aren’t medical.

Many of these changes can be caused by other conditions or life experiences, so it’s important not to jump to conclusions. However, if you see several of these signs or if the changes you notice revolve around opioids, it’s time to talk with a doctor about a possible opioid addiction.

Physical Changes

Someone misusing opioids often experiences physical changes. The effects of opioids can lead to changes in how they look and how their body works. Possible changes include:

• Tiredness — Opioids can cause a person to be drowsier than usual.
• Very small pupils — The pupil is the very center part of the eye. Using opioids can cause pinpoint (extremely small) pupils.
• New injuries — These may be from intravenous drug use or scratching their skin. A person may wear long sleeves or generally hide their arms to cover wounds.
• Unusual behavior — Taking too many opioids can affect how someone talks or acts. They may seem confused or not make sense when they speak.
• Weight changes — An opioid addiction can cause relatively fast weight gain or loss.

If you notice these changes and think opioid addiction may be the cause, talk with a healthcare professional right away.

Symptoms of Opioid Withdrawal

When a person with an opioid addiction doesn’t have opioids regularly, their body will go into withdrawal. Many withdrawal symptoms may resemble the flu. A person in opioid withdrawal may experience:

• Nausea
• Vomiting
• Sweating
• Chills
• Achy muscles
• Anxiety
• Agitation for no reason
• Stomach cramps
• An inability to sleep
• Pain throughout the body
• Diarrhea
• Higher-than-normal blood pressure and heart rate

When a person is quitting opioids, these symptoms will get worse for about 72 hours and then improve. Unlike withdrawal from some other substances, opioid withdrawal is usually not life-threatening. However, it can be very uncomfortable.

People who are still dependent on opioids will also experience these symptoms if they can’t get the drug. Avoiding these symptoms may be part of what drives them to continue getting and taking opioids.

Signs of an Opioid Overdose

Using too many opioids can cause a person’s breathing to slow, which may be life-threatening if left untreated. The symptoms below may indicate that a person has overdosed on opioids and needs urgent medical help. Someone who has overdosed on opioids may:

• Seem to fall asleep or lose consciousness in a way that’s out of their control
• Have extremely small pupils
• Make choking or bubbly sounds when they breathe or try to breathe
• Start vomiting
• Breathe extremely slowly or shallowly — or both
• Go limp throughout their body
• Have purple fingernails and/or lips
• Have either very pale or slightly blue skin
• Have a very faint heartbeat

If you think someone is overdosing — or if you believe you may be overdosing — use naloxone right away if it’s available. This lifesaving medication quickly blocks opioids from working and can help return breathing to normal.

Naloxone is a safe medication. According to the American Psychiatric Association, even if it’s given to someone who isn’t experiencing an overdose, it will do no harm. You can purchase naloxone without a prescription, and many organizations and government programs distribute it for free. If you or someone you know is at risk of overdosing, consider learning how to use naloxone and keeping it in your home, car, purse, or pocket.

If you see any of these overdose signs, call 911 right away and give naloxone as soon as possible. Time is critical in an overdose situation.

Talk to a Doctor

If you notice these signs and symptoms of opioid overuse in yourself or someone you love, get medical advice right away. Someone with OUD may not believe they have a problem or may not feel ready to get help. You may have to take them to a doctor or even go without them to start the process.

Talk with the healthcare team about what you’re seeing and experiencing. Take note of the symptoms you see. It may help to keep a written log of symptoms and when they occur. This can make it easier to talk with a healthcare provider.

When you or your loved one is ready to get help, health professionals can point you toward resources for recovery. They can help you choose the best addiction treatment option based on your insurance coverage, the severity of the addiction, and other factors. They can also help other family members get the support they need for their own well-being as they help a person recover from opioid addiction.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioids, get advice, and find support from others who understand.

Have you or a loved one dealt with opioid use disorder? Let others know in the comments below.