Symptoms of Opioid Use Disorder: What to Look Out For

This disease rewires the brain + causes some obvious behavior changes.

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Treating opioid use disorder (OUD) early can be life-saving. OUD can really derail someone’s life and affect their relationships, their career, their health, and more. There is also the scary risk of a fatal opioid overdose, such as by taking opioids laced with fentanyl.

The problem is, it can sometimes be tough to recognize opioid use disorder—whether you’re the patient, a friend of a patient, or even the medical provider.

“Substance use disorders can be difficult to diagnose,” says Jonathan Avery, MD, director of Addiction Psychiatry at Weill Cornell Medicine and NewYork-Presbyterian Hospital. “As clinicians, we look for sustained use of a substance over time that’s impairing their function.”

Many of the symptoms of OUD are behavioral changes caused by the rewiring of the brain. “Once you start using, you get this incredible dopamine spike that you want to replicate,” says Dr. Avery. “Basically, your neurocircuitry gets rewired so that your brain is just motivated to use.”

Signs of OUD may include:

  • Taking opioids in increasingly larger amounts

  • Taking opioids for longer than prescribed

  • Spending a lot of time, effort, or money to obtain opioids

  • Not being able to fulfill responsibilities due to opioid use

  • Losing interest in other hobbies or relationships

  • Continuing to use opioids despite consequences

  • Experiencing withdrawal symptoms

“Opioid withdrawal is a very unpleasant state and it’s often the reason that people keep using once they’ve started using,” says Dr. Avery. “You feel anxious, … your nose runs, you can have uncomfortable stomach symptoms, feel cold or shiver.” These opioid withdrawal symptoms can be powerful enough to motivate someone with OUD to continue using.

Getting Help and Fighting Stigma

If you know someone who you believe needs help for OUD, it’s important to remember that OUD is a disease that “deserves sensitive, compassionate medical treatment,” says Dr. Avery.

“Folks with addiction aren’t bad people becoming good, but they’re sick people becoming well,” says Dr. Avery. “I think that’s the proper way to think about addiction and substance use disorders, and not as something that we need to arrest our way out of or punish.”