Itchiness is a common side effect of opioids. How often it happens can vary a lot based on the type of opioid, the dose, and how it’s given (by mouth, through an IV infusion, or into the spine during surgery). In some settings — especially after certain hospital pain treatments — itching can be more common than people expect.

For some people with opioid use disorder (OUD), severe itch can feel as unbearable as their pain. It can significantly affect sleep and their ability to participate in everyday activities.

This article explains what experts know about opioid-related itchiness and why it happens. You’ll also learn a few short-term relief strategies you can try while recovering from OUD.

Understanding Itch and Pain

Itchiness (also known as pruritus) is caused by the stimulus of certain nerves in the skin. These special nerves send signals through the spinal cord to the brain to communicate that something is uncomfortable. Then, the brain may tell the body to do something to stop it — in this case, if nerves signal an itch, to scratch to relieve it.

The same nerves also pick up painful signals and send them to the brain, triggering a response. If you touch a flame, you’ll quickly pull away.

Currently, experts believe pain and itch signals travel along similar nerve pathways to the brain, but they aren’t sure how the body can tell the difference between the two. This knowledge gap is important to keep in mind when discussing opioids.

Is Your Itching From Opioids or Something Else?

It may be difficult to tell whether itching is a side effect of opioids or a symptom of another condition. Here are a few factors to consider:

• Timing — If your itch began around the time you started taking opioids, it may be related to the opioids.
• Skin changes — Most itchy skin conditions have visible symptoms, like hives, dryness, or bumps. Opioid-related itch is associated with skin changes from scratching, like scabs or scars.
• Other symptoms — Since mast cells can be involved in both opioid- and allergy-related itch, look for other nonitch symptoms. For example, allergic reactions may also cause sneezing and a runny nose.

If you’re unsure where your itch is coming from, keep a symptom journal for a few days or weeks. Note when your itching started, what makes it better or worse, and where you’re most affected. These notes might help you find out the cause, or you can take them to your healthcare team.

When To Talk to a Healthcare Provider

Call your doctor if you’re concerned about your itching, especially if it’s worsened or is accompanied by swelling or difficulty breathing. You may need immediate medical attention for an allergic reaction, an overdose, or a drug interaction.

Some disorders related to OUD can cause itchiness without a rash, including kidney or liver diseases and hormone dysfunction. Your doctor can help you find the root cause of the itching and develop a safe treatment plan to address both OUD and overlapping issues contributing to your itch.

It’s also important to talk to your doctor if you want to make changes to your medications because of your itching. Starting new prescription and over-the-counter medicines or supplements while being treated for OUD may cause dangerous interactions. To avoid life-threatening issues, wait for medical guidance before adjusting your treatment plan.

Join the Conversation

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

Have you experienced itching while taking opioids? What helped you find relief? Let others know in the comments below.