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What Are the 12 Key Signs of Opioid Addiction?

These days, if you watch the news or pick up a paper, you’ll likely see some alarming news about the opioid epidemic in America. About 21.5 million Americans have a substance use disorder. That number is more than the total combined populations of Wisconsin, Minnesota and Michigan.

Why is it called an epidemic? The Centers for Disease Control and Prevention says since 1999 the number of overdose deaths involving opioids (including prescription opioids and heroin) has quadrupled. In America, more than 91 people die of an opioid overdose every single day. 

What are opioids? Opioids are a class of drugs that includes prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl and others. Illegal drugs such heroin are also opioids. Opioids interact with nerve cells in the brain and central nervous system to relieve pain and produce pleasurable effects.

Many people have an inaccurate picture of the victims of drug addiction. One study estimated that 90 percent of heroin users were white men and women. The CDC estimates that 21,000 adolescents used heroin in the past year. About three-quarters of heroin users started their opioid use with a prescription drug like OxyContin.


What Is Drug Addiction?

The National Institute on Drug Abuse says drug addiction is a chronic, relapsing brain disease that’s characterized by compulsive drug seeking and use – despite harmful consequences.

Addiction is considered a brain disease because drugs like opioids change the brain’s structure and how it works. The changes can be long term.

Diseases such as heart disease disrupt the healthy functioning of the underlying organ. Addiction disrupts the healthy functioning of the brain — the underlying organ involved in drug addiction.


How Does Drug Addiction Start?

Addiction often begins with a person who has a prescription for an opioid pain reliever. Opioids can be prescribed to relieve chronic pain, such as after an injury.

Over time, opioids generally become less effective. The person with a painful injury may start to take a dosage larger than directed to attain the same level of pain relief.

As the escalation in dosage continues, the individual may have trouble getting more of the prescription medicine to satisfy their larger self-dosage. Since heroin can be less expensive and easier to get than prescription opioids, the person may turn to heroin as a pain reliever.

As tolerance and dosages increase, the person can easily overdose on a prescription medication or a drug such as heroin. Without immediate medical care, an overdose can quickly be fatal. Studies show nearly half of all U.S. opioid overdose deaths involve a prescription opioid.


What Are the Signs of Addiction?

Since addiction reaches into families of all incomes and backgrounds, it’s wise to know what to watch for among the people you care about. When there’s an addiction problem, you may notice one or more behavior changes:

  • Sleep habits change. The person may sleep more or less than normal.
  • Drowsiness. The person may nod off unexpectedly in the middle of a conversation, during a meal or while watching TV.
  • Flu-like symptoms appear frequently. The person may have nausea, fever and headache. This is caused by the opioid, not a virus.
  • Unplanned weight loss. Opioids can cause a change in a person’s metabolism.
  • A reduction in energy level or physical activities such as exercise. It’s common that regular exercisers reduce or stop their workout routines.
  • Changes in personal hygiene. Things like shaving or hair care may fall to the wayside.
  • Old habits may reappear. For example, individuals who quit smoking in the past may start smoking again.
  • Work routines change. The person may show up late or skip work all together.
  • Libido (sex drive) diminishes. Testosterone and estrogen levels may change, which can alter a person’s interest in sex.
  • Relationship changes. The person may spend less time with friends who were important in the past.
  • Spending becomes erratic. Household cash may unexpectedly disappear. Unusual credit card charges may start appearing on the monthly statement.
  • The addicted person starts to steal things. Items around the home or workplace may disappear. These are often pawned to raise cash to support the drug addiction.

In Case of an Overdose, Call 911 Immediately

One common but tragic end of addiction can be an overdose. Watch for these signs of an opioid overdose:

  • Face becomes extremely pale and/or feels clammy
  • Body goes limp
  • Fingernails or lips have a purple or blue color
  • Person vomits or makes gurgling noises
  • Person cannot be awakened or is unable to speak
  • Breathing or heartbeat slows or stops

Do not delay if you notice these signs. Call for professional help right away.


Treatment Is Effective — And Can Save a Life

People who are struggling with substance abuse can return to a healthy, productive life. Programs to treat substance abuse are readily available. For example, acupuncture shows great promise as an effective pain management tool that can help stop the addiction cycle. Treatment specifically for opiate recovery is also available, including the use of medication assisted treatment.

If you have questions about drug addiction, ask your health care provider. If you need a doctor, you can find a qualified professional online anytime. For concerns about opioid addiction, search under the specialty “Chemical Dependency Services.”


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Meet the Author

Lance P. Longo, MD has been recognized as one of the area's top psychiatrists for treating addictions. He has a concentration in general psychiatry and addictive disorders with a specialty in pharmacological interventions for substance abuse. He also specializes in working with anxiety, depression, bi-polar disorder and thought disorders. In addition to being board-certified by the American Board of Psychiatry and Neurology with added qualifications in addiction psychiatry, Dr. Longo is certified in addiction medicine by the American Society of Addiction Medicine.

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The information presented in this site is intended for general information and educational purposes. It is not intended to replace the advice of your own physician. Contact your physician if you believe you have a health problem.

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