Are you wondering if you or someone you love is dealing 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.

While none of these signs are definitive on their own, it’s helpful to know what to look for when it comes to a serious condition like opioid addiction. If you see a cluster of several of the symptoms listed here, talk to a healthcare provider about doing a substance abuse 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 of the changes that occur when a person is dealing with opioid misuse are psychological. The way they think, their mental health, and the thoughts that motivate their actions can change. You may see:

• Cravings — If a person feels like they need opioids to function and wants them a lot even when using them has negative consequences in their life, an opioid addiction may be present.
• A focus on the use of opioids — Someone dealing with substance misuse may focus a lot of their time, energy, or money on getting more. This is true for opiates as it is for other drugs.
• Mood swings — People struggling with their opioid use may experience significant and extreme mood swings. They may become suddenly joyful or angry, for instance.

If you or your loved one is experiencing any of these changes, you should consider whether an opioid addiction is present.

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 they’re prescribed — They may take higher doses of medication, take doses more frequently, or take it for longer than the doctor told them to.
• Have trouble fulfilling responsibilities — People who are misusing opioids may not be able to do what needs to be done at work, at school, or at home because of their drug use.
• Stop participating in activities — Some people with an opioid addiction will do fewer activities or stop participating in activities they love altogether. If someone who is usually social suddenly wants to be alone or begins avoiding their 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 — Similarly, a person may spend all of their money on opioids and develop financial issues.
• Try to borrow medication — People looking for more opioids may ask their friends or family if they have some they can borrow.
• Seek out opioid prescriptions — Someone living with an opioid addiction may try to get prescription opioid painkillers from more than one doctor or renew them too many times.
• Find other reasons to take opioids — A person with an opioid addiction may say that they’re taking them to sleep well, feel less tense, stay alert, or make up other reasons.

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

Physical Changes

When someone is misusing opioids, they’ll often experience 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 more drowsy 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 (IV) drug use or from scratching their skin. They may wear long sleeves or generally hide their arms to cover wounds.
• Extra energy — Although opioids typically lower a person’s energy, using too many can cause them to speak quickly, speak in a way that does not make sense, or generally appear to have more energy than normal.
• Weight changes — An opioid addiction can cause a person to lose or gain weight relatively quickly.

If you see these and you think there might be an opioid addiction present, find 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. This includes a variety of withdrawal symptoms that can look like they have the flu. A person in opioid withdrawal may experience:

• Nausea
• Vomiting
• Sweating
• Chills
• Achy muscles
• Anxiety
• Feeling agitated without reason
• Stomach cramps
• An inability to sleep
• Pain throughout the body
• Diarrhea
• Higher blood pressure and heart rate than normal

A person who is quitting opioids will experience these symptoms. They’ll get worse for about 72 hours, and then they will improve. Unlike withdrawal from some other substances, withdrawal from opioids usually isn’t life-threatening, though it can be extremely uncomfortable or distressing.

People who intend to continue opioid use but don’t have access to the drug will also experience these symptoms. 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, extremely shallowly, or both
• Go limp throughout their body
• Have purple fingernails and/or lips
• Have skin that is cold and either very pale or slightly blue
• Have a very faint heartbeat

If you know or suspect that someone has an opioid addiction and you see any of the above symptoms — or if you use opioids and you believe you may be experiencing an overdose — you can use an emergency overdose treatment called naloxone (sold under several brand names, including the nasal sprays Narcan, Rezenopy, and Kloxxado, and the injectable solution Zimhi). This lifesaving medication immediately 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 is 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 know or suspect that someone has an opioid addiction and you see any of the above symptoms, call 911 or an emergency help number immediately, regardless of whether you have used naloxone. Because time is of the essence in an overdose situation, you should administer naloxone first, then immediately call for help.

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. A person with an OUD may deny that there’s a problem or struggle to believe that they need help to recover. You may have to take them to a doctor or even go without them to start the process.

Talk to 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 you see them. This can make it easier to talk to 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.

Talk With Others Who Understand

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Have you or a loved one dealt with opioid use disorder? What were the first signs you noticed that something was off? Share your experience in the comments below, or start a conversation by posting on your Activities page.