Opioid use disorder (OUD) is a serious condition. People with OUD may have several distinct types of symptoms that can affect behavior, physical health, and mental health.

Opioid use disorder (OUD) is when a person becomes dependent on opioid drugs. They feel that they cannot stop using them, despite negative consequences.

People may develop OUD from the use of prescription or illegal opioids.

A person with OUD can have several symptoms, including changes to the way they act, feel, and think. Recognizing these symptoms can be the first step toward professional OUD diagnosis and recovery.

This article discusses the behavioral and physical symptoms of OUD. It also discusses its cognitive and psychological symptoms, the DSM-5-TR diagnostic criteria for OUD, and signs of opioid overdose. Finally, it outlines how to find support for OUD and the side effects of the opioid crisis.

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People with OUD generally have a pattern of using opioids. This pattern can interfere with and cause problems in their daily life.

An individual may behave in certain ways or experience certain behavioral symptoms. These symptoms can include taking more than the prescribed dose of opioid medication. If a person then runs out of their prescription, they may take other opioid medications instead. They may also take medication for reasons other than those the drug was prescribed for.

People with OUD may try to obtain more medication than prescribed in alternative ways or with illegal or deceptive methods. They may go to healthcare facilities in non-emergency situations to do so or trade medications for opioids with others.

Having OUD may also lead a person to develop behaviors that interfere with their daily activities. They may prioritize taking opioids over work, home, or school activities.

People with OUD may also continue to take opioid medication despite increasing physical, interpersonal, or psychological problems.

People with OUD may have physical withdrawal symptoms when they suddenly stop using opioids, including:

They may also take opioids or related substances to relieve or avoid these symptoms. People with OUD also have an increased tolerance for opioids. They may have tolerance symptoms, such as needing increased amounts of opioids to produce the same effects. They may also experience reduced effects when using the same amount of opioids.

Using opioids reduces a person’s perception of pain. They can also cause physical symptoms that include:

High doses of opioids can slow a person’s breathing, which may be fatal.

Cognitive symptoms are changes in how a person thinks, learns, and understands.

Opioids interfere with how a person’s brain functions. Using them excessively over time can also damage certain parts of the brain. People with OUD may have particular cognitive symptoms, such as weaknesses in their:

  • executive functions (how a person does certain tasks), including:
    • time management
    • planning
    • organizing
    • multitasking

They may also have weaker or poorer:

  • attention
  • memory
  • information processing
  • communication skills
  • decision-making skills

People with OUD often develop ongoing psychological problems caused or worsened by opioids.

Using opioids over time can make people more likely to experience symptoms of conditions including:

  • depression, such as low mood or loss of pleasure and interest in activities
  • dysphoria (significant feelings of unease or dissatisfaction)
  • anxiety
  • irritability

People with OUD may also develop symptoms of psychosis. These can have a range of symptoms, including:

  • hallucinations
  • delusions
  • muddled thoughts and speech
  • loss of interest in daily activities
  • avoiding other people and friends
  • feeling disconnected from their emotions or feelings
  • not wanting to look after themselves or their needs, such as personal hygiene

People with OUD may also have increased affective impulsivity. This is how much a person experiences rapid and intense mood swings they may find difficult to manage.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) is the handbook mental health and healthcare professionals use to diagnose mental health conditions.

To have a professional diagnosis of OUD, a person must meet the criteria defined in DSM-5-TR. It defines people with OUD as having repeated opioid use in 12 months, leading to problems or distress.

A person also must have two or more of the following 11 criteria:

  • continuing to use opioids despite worsening physical or psychological health
  • continuing to use opioids despite social or interpersonal consequences
  • decreased social or recreational activities
  • having difficulty fulfilling their work or educational duties
  • taking excessive time to obtain opioids or recover from taking opioids
  • taking more opioids than intended
  • having opioid cravings
  • not being able to reduce the amount of opioids they use
  • developing opioid tolerance
  • continued opioid use despite increasing problems from them
  • withdrawal symptoms, or continuing to use opioids to avoid withdrawal

An opioid overdose can be fatal. People should seek immediate emergency medical attention if they or someone around them has any of the following symptoms:

  • their face is extremely pale, feels clammy to the touch, or both
  • their body goes limp
  • their lips or fingernails are purple or blue
  • they start to vomit or make gurgling noises
  • they cannot be woken up or are not able to speak
  • their breathing or heartbeat slows or stops

People with OUD can find and access support and effective treatment in multiple ways.

Support organizations

Several organizations also offer support for people with OUD. They can find confidential and anonymous resources and facilities for OUD treatment at FindTreatment.gov.

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a guide for people seeking treatment for substance use disorders. People with OUD can use the guide to complete the necessary steps for effective OUD treatment.

Treatment for opioid use disorder

Effective treatments for OUD include several medications, counseling, and behavioral therapy. These treatments help people with OUD to stop using opioids, get through withdrawal, and manage opioid cravings.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

The opioid crisis refers to the rapid increase in the number of fatal overdoses in the United States since the 1990s. According to the Centers for Disease Control and Prevention (CDC), there were nearly 645,000 fatal overdoses involving opioids from 1999 to 2021.

Also called the opioid epidemic, the crisis has caused several negative consequences and effects, including increased:

  • homelessness
  • strain on healthcare resources
  • rates of opioids as the leading cause of accidental death among males
  • access to opioids for some populations

People with OUD may have several physical symptoms of opioid use or withdrawal symptoms. They may also experience psychological symptoms or changes in the way they think and behave.

Healthcare professionals use specific criteria to diagnose a person with OUD. They can provide effective treatment and support. People with OUD can also find support from various organizations.

Opioid overdoses can be fatal. If a person or someone around them has signs or symptoms of an overdose, they should seek immediate emergency medical attention.