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Signs of Opioid Use Disorder (OUD)

The opioid crisis has become a major concern in recent years because it is causing harm to individuals, families, and communities. In the United States, over 130 people are dying every day from opioid overdoses.[1] Opioid Use Disorder (OUD) is when someone can’t stop using opioids, causing harm or distress. Recognizing the signs of OUD is the first step for early intervention and treatment.

What is Opioid Use Disorder (OUD)?

OUD is a chronic disorder defined by a problematic pattern of opioid use despite negative consequences. OUD is an intense focus on obtaining and using opioids, even when they are not medically necessary. It affects all aspects of one’s life, including physical health, mental well-being, relationships, and day-to-day responsibilities.

What Are Opioids?

Opioids are a class of drugs best known for pain relief and include both prescription medications, as well as illegal drugs like heroin and fentanyl. Despite their ability to reduce pain, opioids have a high potential for misuse and addiction. Common opioids include:

  • Hydrocodone
  • Oxycodone
  • Oxymorphone
  • Morphine
  • Codeine
  • Heroin
  • Fentanyl

How Do You Develop OUD?

Taking opioids puts anyone at risk of developing opioid addiction, just like with any substance use disorder.

Opioids trigger the release of endorphins or the ‘feel good’ chemical in the brain, helping to reduce pain while increasing pleasure. This sensation is why opioids are highly addictive, and one may seek these sensations as soon as the drug wears off, which is how the cycle of opioid use disorder begins.

Signs of Opioid Addiction

Opioid addiction has physical, behavioral, social, and psychological effects. However, these signs and severity of symptoms can vary depending on various factors, including personal history, period of use, genetic factors, and co-occurring mental health disorders.

Being able to recognize the signs of OUD is vital for effective intervention, as opioid misuse can have negative consequences on one’s daily life and result in harmful consequences, including opioid overdose and even death. Identifying the disorder early improves the chances of successful treatment and recovery.

The most common signs of opioid addiction and misuse include:[2]

Physical Signs of OUD

  • Changes in Appearance: Individuals with OUD may exhibit noticeable changes in their physical appearance, including weight loss, neglect of personal hygiene, and a generally unkempt appearance.
  • Pupil Constriction: A common sign of opioid use is constricted pupils, especially in well-lit environments where pupils would normally be dilated.
  • Track Marks and Bruising: Those who inject opioids might have visible needle marks or bruises on their arms and other parts of the body.
  • Frequent Flu-like Symptoms: Chronic opioid users often experience flu-like symptoms, including nausea, vomiting, sweating, and a runny nose.
  • Drowsiness: Opioid users may appear drowsy, lethargic and have slurred speech or impaired coordination.
  • Withdrawal: Those with OUD may experience withdrawal symptoms when long-term opioid use suddenly stops, including heightened anxiety and irritability, muscle pain, and severe cravings.

Behavioral Signs of OUD

  • Isolation: A person struggling with OUD may isolate themselves from friends and family to keep their addiction a secret.
  • Doctor Shopping: Individuals with OUD may visit multiple doctors in a short period of time to obtain prescriptions for opioids.
  • Neglecting Responsibilities: Individuals suffering from opioid addiction may neglect day-to-day responsibilities at work, school, or home.
  • Financial Problems: Individuals with OUD may borrow money frequently, sell belongings, or even engage in illegal activities to fund their addiction.
  • Mood Swings: Those with OUD may experience changes in mood, including increased irritability, anxiety, and depression.

Psychological Signs of OUD

  • Obsessive Thoughts: A person with OUD will often have obsessive thoughts about obtaining and using opioids, making it hard to focus on other tasks.
  • Continued Use Despite Harm: Individuals with OUD continue to use opioids even when faced with negative consequences such as physical harm or decline in social and personal relationships.
  • Increased Tolerance: Those with OUD may develop a tolerance to opioids over time, requiring higher doses to achieve the same effects, which may lead to overdose.

Social Signs of OUD

  • Changes in Social Circles: Individuals with OUD may distance themselves from friends and family and begin surrounding themselves with those who also use drugs.
  • Legal Issues: Those who turn to illegal activities to obtain opioids or as a result of impaired judgment may face legal consequences such as arrest.
  • Relationship Strain: One of OUD’s most common negative consequences is the harmful strain on relationships with family, friends, and colleagues.

Treatment for Opioid Use Disorder

Treatment programs for opioid use disorder involve a comprehensive plan that focuses on identifying the root cause of the drug addiction, as well as the physical, mental, and social aspects that are unique to each individual.[3] Typically, these treatment plans include a combination of medication-assisted treatment (MAT), behavioral therapy, and ongoing support services.

Medication-Assisted Treatment (MAT):

Addiction specialists may give medications such as methadone and buprenorphine to opioid users going through detox to help reduce cravings and withdrawal symptoms.

Behavioral Therapy:

  • Cognitive-Behavioral Therapy (CBT): CBT helps identify and change negative thought patterns and behaviors associated with opioid use by providing coping skills to manage cravings, helping to identify triggers, and managing stress.
  • Motivational Interviewing (MI): MI helps individuals explore their hesitancy to change and increases their motivation to seek treatment and recovery.
  • Group Therapy: Group therapy sessions such as Narcotics Anonymous (NA) provide peer support, encouragement, and accountability for individuals in recovery to share experiences, connect with others, and develop coping mechanisms.

Get Help Today

Opioid Use Disorder is a complex condition that requires understanding, empathy, and a proactive approach for effective management and treatment. If you, your family member, or a loved one is suffering from OUD, it’s not too late to get help.

Here at Mandala Healing Center, our dedicated team of addiction experts and therapists is dedicated to providing a holistic approach, helping you heal from the inside out. Reach out to us today and learn more about our opioid treatment programs and start the journey to a healthier, happier life.


  1. Health Resources & Services Administration (HRSA): Opioid Crisis
  2. American Society of Addiction Medicine (ASAM): DSM-5 Criteria for Diagnosis of Opioid Use Disorder
  3. National Institutes of Health (NIH): Opioid use disorder and treatment: challenges and opportunities