Early Signs And Symptoms Of Opioid Dependence Or Abuse

J.P. suffers from opioid addiction, either to prescription pain relievers (such as oxycodone, percocet, and vicodin) or to illegal substances (like fentanyl and heroin).

12/21/20224 min read

J.P. suffers from opioid addiction, either to prescription pain relievers (such as oxycodone, percocet, and vicodin) or to illegal substances (like fentanyl and heroin). He has been doing well in recovery for 9 months after participating in a program where he is taking buprenorphine/naloxone (Suboxone), an opioid addiction medicine.

He is currently working full-time as an auto mechanic and is considering returning to school. J.P. had no idea what he was getting himself into. "I had dreams and aspirations while I was in high school." I never intended to become hooked to opioids." Unfortunately, J.P. tore his rotator cuff while playing football as a junior in high school. He had surgery, and his doctor prescribed oxycodone to help him cope with the discomfort. J.P. had been on oxycodone for three months when things began to go wrong.

"I grew depressed after being forced to stop playing football." I quickly found myself using oxycodone to self-medicate my depression. I started taking more and more— whenever I felt melancholy, worried, or even lonely. My doctor eventually stopped giving them to me. When I didn't have oxycodone, I would experience withdrawal symptoms such as sweating, muscle aches, and agitation, so I looked for them on the street. However, because oxycodone isn't cheap, I ended up depleting my bank account and even lying to my family and friends to gain money to buy more. "I wasn't in the best of moods."

J.P. was fortunate in that his family was aware of his addiction early on and pushed him to seek treatment.

So, How Can You Know Whether You're Addicted to Opioids? Or, How Can You Know Whether a Member of Your Family is Suffering From an Opioid Addiction?

It's crucial to first grasp a few definitions:


Your body has developed an addiction to the opiate. Because the opioid is always present in your body, you will suffer withdrawal symptoms if it is no longer present:

  • Muscle ache

  • Diarrhea, vomiting, and abdominal cramps are all symptoms of a stomach bug.

  • agitation, perspiration, and yawning

  • Anxiety or depression

  • Pupils that are dilated (and big!)

  • Your skin is covered in goose bumps.

  • Insomnia

  • Tremor


The opioid becomes "habitualized" in your body. The dose that previously made you feel good is no longer sufficient, and your body need increasingly bigger doses to achieve the same results.


Dysfunction. The opioid takes over your life; you crave it, take increasingly higher amounts, and are unable to quit. AND Consequences. You suffer the consequences: devoting all of your time to obtaining more opioids, placing yourself in dangerous situations as a result of opioids, losing your job and being unable to fulfill other responsibilities, giving up hobbies, destroying relationships with family and friends, and losing their trust.

"It is vital to clarify the distinction in some of these medical terminologies," says Dr. Brian Clear, Chief Medical Officer (CMO) of Suboxone clinic, a telemedicine firm that treats patients battling with opioid addiction with buprenorphine/naloxone (Suboxone). "Addiction is not the same as dependence or tolerance." "If I put someone on oxycodone for several months and then took it away, they'd have withdrawal symptoms like muscle aches, sweating, runny nose, nausea, and vomiting—this is dependence," he explains.

Your body may become accustomed to the dose I prescribed, and you may request a higher dose to achieve the same level of relief; for example, if 5 mg of oxycodone prescribed three times a day previously worked to treat your pain, you may require 10 mg three times a day after a year to achieve the same level of pain relief - this is tolerance."

"While people living with addiction may have both dependence and tolerance," he continues, "what separates addiction from other disorders is the dysfunction and its consequences."

Dr. Clear Likes to Break Addiction Down into What He Calls "The 4 C's of Addiction":
  • Craving

  • Control Abandonment

  • Obsessive usage

  • Consequences

"What we typically observe," Dr. Clear says, "is that when people develop an opiate addiction, it takes over their lives." While the prescription was first recommended for pain, patients frequently begin using it for other reasons, such as stress or depression, and they become addicted to the opioids. We know it’s become an addiction when we observe people losing control and the opioids start interfering with their daily functioning – school, employment, family, friends.”

If you or a loved one suspects you or a loved one has acquired an opioid addiction, here is a list of signs and symptoms to look for:

  • Poor (and inexplicable) academic or professional performance
  • Isolating oneself from family and friends (concealing drug use from loved ones)

  • "Doctor shopping" is visiting a variety of doctors and medical facilities in order to obtain painkillers.

  • At doctor's consultations, exaggerating pain symptoms

  • Taking opiate medication that has been prescribed to you by someone else (unexplained disappearance of opioids in the household).

Physical Description

When the person is going through withdrawal (when there are no opioids in their system):

  • Irritability

  • Pupils that are bigger

  • Nausea/vomiting

  • Muscle aches and pains

  • Sweating

When there are opioids in a person's system:

  • Slowing down your thoughts

  • (Tiny) pupils can be pinpointed

  • As if sedated or inebriated, there is a loss of coordination.

  • If you're injecting drugs, keep your arms covered or expose any sores or injection marks.

Mood symptoms include
  • Problem-solving or slowed thinking

  • Disconnected from others and their surroundings

  • Concentration issues

  • Swings in mood

  • Sleeping problems

  • Depressions

  • (Worried about being "caught"/trying to hide use) paranoia

"It's critical to assist people in starting treatment," Dr. Clear says. "Opioid addiction leads to a high rate of overdose and mortality if left untreated. However, evidence-based pharmacological treatments are now available that can make a substantial impact in people's lives, not just by preventing overdoses but also by assisting patients in resuming fulfilling and meaningful lives."

So, What Can You Do to Seek Assistance or Assist Someone You Care About?

If you think you could be suffering from opioid addiction, talk to your Doctor and receive the care you need.

The best treatment combines scientifically-proven drugs like buprenorphine/naloxone (Suboxone), Methadone, or Naltrexone (aka Vivitrol) with behavioral counseling and support from others going through the same thing to help lessen cravings, withdrawal, and prevent overdoses. Your doctor can assist you in enrolling in a drug and therapy program.

The most crucial thing you can do if you are a loved one of someone who may be battling with opioid addiction is to be direct and supportive

  • Let them know you care about them and are willing to assist them.

  • Don't pass judgment; people who are battling with addiction are often ashamed of their problems, and they need to stand by their side as an ally and support.

  • Accept compassion and patience as virtues. It's important to remember that patients can relapse even after they've recovered. This is a side effect of a long-term chronic medical condition, but you can help them get back on their feet.

  • Direct them to more therapy options. Encourage them to get treatment for their opioid addiction that includes both medicine and counselling.