The opioid epidemic has been in full swing in the United States for years, and has only been exacerbated by the COVID-19 pandemic, with opioid overdose deaths increasing dramatically. For this reason, it is important to be aware of the risks of opioid and opiate abuse and addiction. This is true even if you or your loved ones are prescribed opioids but do not abuse them: up to 12% of people on opioids for chronic pain end up eventually developing an opioid use disorder.

What Are Opiates and Opioids?

Opiate and opioid are terms that are often used interchangeably. The main difference between opiates and opioids is how they are made. In technical terms, the word opiate refers to drugs that are naturally derived from the opium poppy, while opioid refers to synthetic or semi-synthetic drugs which are man-made. However, many people use the terms without paying heed to that distinction. 

Prescription painkillers often fall into the category of opiate or opioid. They both act on the mu opioid receptors of the brain and the central nervous system of the user in an identical manner, and they also have a high potential to be habit-forming. Opioid and opiate abuse is an issue that is plaguing the entire country.


Opiates are natural analgesics that are derived from the opium poppy. They include natural narcotics like:

  • Opium
  • Morphine
  • Codeine
  • Heroin


Opioids are made, at least in part, in a lab. Some opioids are semi-synthetic, meaning that they are partially derived from opium and partially man-made, and include drugs such as:

  • Hydrocodone
  • Hydromorphone
  • Oxycodone
  • Oxymorphone

Other opioids are fully synthetic, meaning they are entirely made in a lab environment. These opioids include:

  • Methadone
  • Fentanyl
  • Tramadol

Understanding Opioid and Opiate Addiction

To understand opioid and opiate addiction, it is important to first understand the impact the drugs have on your brain. 

When an opioid enters your brain, it binds to mu opioid receptors. Many of these are located in your brain’s reward system. This triggers a release of a flood of dopamine, a feel-good chemical in your brain. This can cause a euphoric high. Due to this impact on your brain’s reward center, your brain wants to continue seeking out the drug that triggered the good feelings. This represents the first step on the path to addiction.

As an opioid addiction develops, that distort thinking and behavior. This can make it very difficult for someone to quit taking the opioid, even as they suffer negative consequences.


What is tolerance?
What is physical dependence?
What is a psychological addiction?

Signs of Opioid & Opiate Abuse

It can be tough to spot an opioid problem until abuse or full-blown addiction are occurring. However, as with other substances, some of the earliest signs of opioid abuse are often related to lifestyle and behavior. Common signs of substance abuse include:

  • Spending excessive time with new friends or alone
  • Avoiding spending time with family and old friends 
  • Loss of interest in their favorite things and activities
  • Hygiene problems, like not taking showers, changing clothes, or brushing teeth
  • Mood changes 
  • Appetite changes
  • Changes in sleep habits
  • Missing important appointments or deadlines
  • Having problems at work, school, or with the law
  • Having problems in personal or family relationships

Opioid and Opiate Addiction Symptoms

As a person continues to struggle with opioids, the signs can become even clearer to their friends and loved ones as an addiction takes hold. Opioid and opiate addiction signs may include:

  • Doing risky or illegal things to get more drugs
  • Unsuccessfully trying to stop using opioids 
  • Making opioids a priority
  • Using increasingly higher doses of opioids
  • Faking pain or injuries to get opioids
  • Going to different doctors or pharmacies to try to get opioid prescriptions
  • Stealing opioids from loved ones

Opioid Short-Term Side Effects

Many of the side effects related to the use of opioids are due to the effects these drugs have on the brain and body. Over the short term, opioid effects include not only pain relief, but also a sense of euphoria in the user, which is often then followed by intense relaxation or drowsiness.

Other opioid side effects include:

  • Nodding off intermittently
  • Heaviness of the extremities
  • Flushing
  • Small pupils
  • Nausea and vomiting
  • Itchiness
  • Confusion
  • Constipation
  • Slowed breathing

The side effects of opioids can range from relatively mild, particularly when someone first starts using them, to very severe and deadly, such as coma and overdose. No matter how long a person has been taking opioids, the risk of abuse and addiction remain high. 

Opioid Long-Term Effects

Using opioids chronically over the long term can cause a variety of harmful effects. These effects are distinct from the short-term effects of opioids and can impact both a person’s health as well as their mental status.

Physical Effects

Some long-term physical effects of opioid use include:

Sleep apnea and other breathing problems during sleep

Injuries like falls and accidents

Constipation and intestinal blockages

Sexual problems like impotence and infertility


Dry mouth, which may lead to dental problems like tooth decay

Muscle twitching

Psychological Effects

Long-term opioid use causes a psychological burden for a person’s mental well-being. Psychological effects of long-term opioid use include:

Sleep problems, including both excessive sedation and trouble sleeping

Heightened sensitivity to pain




Social Effects

Opioid Overdoses

Opioid overdoses can occur when a person takes an excessive amount of an opioid, or pairs it with another drug that can increase the opioid’s effects, like alcohol or other central nervous system depressants. Opioid overdoses can also occur in people who have recently quit taking opioids and are unaware that their opioid tolerance has decreased.

Some of the opioid overdose signs and signs of opioid toxicity include:

  • Very slow or shallow breathing
  • A bluish tint to fingernails or lips
  • Extreme confusion
  • Convulsions
  • Sleepiness
  • Delirium
  • Limp body
  • Clammy skin
  • Vomiting
  • Slowed breathing

An opioid overdose is a medical emergency. If left untreated, an opioid overdose can be fatal.

Opioid Overdose Treatment

If you suspect an opioid overdose, it’s essential to give naloxone (Narcan) if it’s available and immediately seek emergency medical attention. Signs of opioid intoxication should never be ignored or diminished. You will not get in legal trouble for saving someone’s life by seeking help for an overdose.

Drug overdose can be fatal. If you suspect someone is experiencing an opioid overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Colorado Poison Center for online assistance.

Factors that Affect Susceptibility to Opioid Addiction

Many factors can impact a person’s susceptibility to substance abuse, including opioid addiction. While it can be hard to change some of these risk factors, being aware of them can help a person be vigilant to the risks that opioids may pose. 

Some risk factors for substance abuse include:

  • Living in an economically depressed area
  • Racial or cultural minority status
  • Family instability, including history of abuse or neglect
  • Family history of substance abuse
  • Social isolation and lack of support
  • History of physical or mental health problems
  • Behavior problems in childhood and adolescence

How are Opioid and Opiate Addiction Diagnosed?

Opioid addiction is often diagnosed based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The DSM-5 is considered the gold standard of diagnosing many mental health problems, including addictions. 

To be diagnosed with an opioid use disorder, at least 2 symptoms of opioid use disorder need to have occurred within a 12 month period. Symptoms include:

  1. Taking more opioids than intended, or for a longer period of time than intended
  2. Unsuccessful efforts to cut back on opioids
  3. Spending a lot of time obtaining or using the opioid or recovering from being high
  4. Craving opioids
  5. Problems at work, school or home related to opioid use
  6. Social or interpersonal problems due to opioid use
  7. Stopping other activities because of opioid use
  8. Using opioids in hazardous situations
  9. Remaining on opioids despite ongoing problems exacerbated by opioids
  10. Tolerance to opioids
  11. Having gone through opioid withdrawal, or taking opioids to avoid withdrawal symptoms

Treatment and Resources for Opioid & Opiate Addiction

Realizing that you struggle with opioids is scary but is the first step on the road to recovery. Once you are able to admit you have a problem, you are then able to seek help. Fortunately, many treatment strategies exist to help a person quit opioids for good. These include the following.

Medical Detox
Drug Rehab
Medication-Assisted Therapy

Outlook for Opioid & Opiate Addiction

Recovery from an opioid addiction can be challenging. It is important to remember that addiction is a chronic disease and, therefore, is a long-term journey. Although the path towards sobriety can sometimes include lapses and relapses, these are expected parts of the recovery journey. 

Treatment like detox, rehab and aftercare can help to put you on the road to recovery. Taking a multi-pronged, whole-health approach to your well-being, focusing both on your mental and physical health, can help increase your chances of success.

Find the Help that You or Your Loved One Needs

If you or a loved one struggle with opioids, it is common to feel overwhelmed. But help is here. Contact our opioid addiction experts at The Recovery Village At Palmer Lake: we will help set you on the path to an opioid-free life. Don’t wait, call today.

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Editor – Nicole LaNeve
Nicole leads a team of passionate, experienced writers, editors and other contributors to create and share accurate, trustworthy information about drug and alcohol addiction, treatment and recovery for The Recovery Village and all Advanced Recovery Systems sites. Read more
Medically Reviewed By – Jenni Jacobsen, LSW
Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has seven years of experience working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more

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Centers for Disease Control and Prevention. “Overdose Deaths Accelerating During COVID-19.” December 17, 2020. Accessed May 2, 2021.

Centers for Disease Control and Prevention. “Commonly Used Terms.” January 26, 2021. Accessed May 2, 2021.

Oregon Alcohol and Drug Policy Commission. “Opiates or Opioids — What’s the difference?” n.d. Accessed May 2, 2021

American Psychiatric Association. “What Is a Substance Use Disorder?” n.d. Accessed May 2, 2021.

Raypole, Crystal. “Everything You Need to Know About Psychological Dependence,” Healthline, May 28, 2020. Accessed May 2, 2021.

Ghoshal, Malini. “Understanding Drug Tolerance,” Healthline, November 21, 2019. Accessed May 2, 2021.

National Institute on Drug Abuse. “What are some signs and symptoms of some[…]h a drug use problem?” n.d. Accessed May 2, 2021.

U.S. Department of Justice, Drug Enforcement Administration. “Drugs of Abuse.” April 2020. Accessed May 2, 2021.

Oregon Pain Guidance. “Medical Risks of Long-Term Opioid Use.” May 2016. Accessed May 2, 2021.

State of Hawaii Department of Health. “Risk Factors.” n.d. Accessed May 2, 2021.

American Psychiatric Association. “Opioid Use Disorder.” November 2018. Accessed May 2, 2021.

Medical Disclaimer

The Recovery Village at Palmer Lake aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.