4 Signs of Prescription Opioid Abuse and Addiction

Prescription opioids are a group of drugs prescribed by physicians to help manage pain. There are many different types of opioids, such as hydrocodone (Vicodin), oxycodone (Percocet, OxyContin), morphine, and methadone. Some opioids are stronger than others, but all produce similar side effects. Another characteristic all prescription opioids have in common is their potential for diversion, abuse, and addiction.

Since the late 1990s, rates of opioid abuse and addiction have continued to increase. In 2019 alone, more than 70,000 people died from opioid overdose and more than 1.6 million were thought to struggle with opioid use disorder. While proper treatment for prescription opioid addiction can be successful, it is often difficult to get individuals to agree to get help. In the end, it is left up to family members and friends to convince their loved ones to go to rehab. As a result, it’s important to be able to spot when a person is abusing or addicted to prescription opioids.

Here are four signs of prescription opioid abuse and addiction.

1. Pinpoint Pupils, Flushed Skin, Nodding Off, and Other Physical Symptoms of Opioid Abuse

Sometimes, the easiest way to spot opioid abuse is to look for the physical signs. Opioids are central nervous system (CNS) depressants, which means they slow down bodily functions and cause feelings of relaxation or calmness. People who are under the influence of opioids may seem tired, drowsy, or even begin “nodding off” –  a term used to describe opioid users who drift in and out of a state of consciousness.

Another easily identifiable sign of opioid intoxication is pinpoint pupils. When people are high on opioids, their pupils become constricted.[1]

This may be especially noticeable in people with blue or green eyes because much more of their Iris is exposed.

Other physical symptoms produced by opioids include:

• Loss of coordination
• Nausea or vomiting
• Constipation
• Flushed or pale skin
• Slow or shallow breathing
• Itching of the face or arms

People who exhibit these physical symptoms on a regular or frequent basis may be struggling with prescription opioid addiction.

2. Doctor Shopping – Because One Opioid Prescription Is Never Enough

Addiction is often defined as a disease of “more.” Whether a person is addicted to alcohol, opioids, shopping, or food, they always want more of whatever it is they are addicted to. If a person is addicted to prescription opioids, they may engage in a risky and illegal act called doctor shopping to maintain a steady supply of their drugs.

Doctor shopping is when a person visits multiple doctors, often across state or county lines, without telling each doctor about the other one. They do so in hopes of obtaining multiple opioid prescriptions to hold them over until their next refill. And, when their doctors no longer agree to refill their medications, these individuals often turn to the streets to buy their drugs illegally.

Overall, between 21-29% of patients who are prescribed opioids for pain abuse them – and 80% of people who are addicted to heroin first started using prescription opioids.[2]

3. Inability to Function Without Opioids, Withdrawal Symptoms

People can develop a physical dependence on some opioids in as little as 7 days. Regardless of what type of prescription opioid is being abused, all are habit-forming and can cause withdrawal symptoms when stopped abruptly.

Many people who suffer from prescription opioid addiction continue using opioids simply to avoid going into withdrawal. They find it difficult to function on a day-to-day basis without their drug. And, when they try to stop using, they suffer painful, flu-like withdrawal symptoms, such as:[2]

• Muscle aches
• Restlessness
• Anxiety
• Runny eyes and nose
• Sweating
• Cold chills
• Difficulty sleeping
• Excessive yawning
• Diarrhea
• Abdominal cramping
• Nausea and vomiting
• Dilated pupils
• Rapid heartbeat
• High blood pressure
• Drug cravings

While these symptoms are generally not life-threatening, they can be extremely uncomfortable without medical assistance.

4. Behavioral Changes and Obsession With Opioid Drugs

Behavioral changes are often one of the clearest indicators of prescription opioid abuse or addiction. As opioid use becomes more frequent or compulsive, individuals may begin to show noticeable shifts in mood, daily habits, and decision making. These changes can affect sleep patterns, appetite, memory, and overall emotional stability.

Common behavioral signs associated with prescription opioid addiction include:

• Lying to friends or family about whereabouts, substance use, or related activities
• Withdrawing from social relationships and isolating from loved ones
• Stealing or engaging in risky or deceptive behaviors to obtain opioids
• Legal problems, including driving under the influence or drug related offenses
• Searching through friends’ or family members’ medicine cabinets for opioid medications
• Spending excessive time obtaining, using, or recovering from the effects of opioids
• Neglecting work, school, or household responsibilities
• Losing interest in hobbies or activities that were previously important or enjoyable

When concerns are raised about their substance use, individuals struggling with addiction may respond with defensiveness, anger, or hostility. Denial is also common, even when clear consequences are present. These behavioral patterns often reflect the growing control opioids have over the individual’s thoughts and actions and are important warning signs that professional help may be needed.