And opioid addiction – or opioid use disorder, as it’s known to doctors – is a disease that can kill. Opioid-related deaths have surged in recent years, and today, an average of 115 Americans die every day because of opioid overdose, according to the Centres for Disease Control and Prevention.
But by learning to recognise the signs of an opioid use disorder, you may be able to help a person fighting addiction get treatment – and get better.
“It can take a few years for it to go from when people start misusing opioids to when people really develop the addiction, so along the way there are a few signs and symptoms that family members can be on the lookout for,” addiction expert Dr. Yngvild Olsen, medical director at REACH Health Services in Baltimore and a distinguished fellow of the American Society of Addiction Medicine, told INSIDER.
“I don’t think anyone expects family members to be the experts in making the diagnosis, but family members are the ones who very often will notice that something is not right,” she added. “And when it’s your loved one, you want to really make sure that person is going to get the help they need.”
INSIDER spoke with Olsen to learn more about the potential signs of opioid use disorder. Here are six signs to watch for – and what to do if you notice them.
1. Major changes in behaviour
Olsen said major shifts in someone’s behaviour may be one signal of addiction.
“Let’s say somebody is typically pretty outgoing, seems happy, and then all of a sudden they start getting really irritable and will end up spending a lot of time in their room … That’s a biggie to look out for,” she said.
She added that self-imposed isolation – for instance, staying out of the house for long stretches and doing everything possible to avoid interaction with family members – is another potentially troubling behaviour change.
2. Not meeting obligations
“If someone is missing school or work, or they were once an A student and now they’re barely getting by – those are some warning signs,” Olsen said.
3. The presence of certain objects, like needles and bottle caps
Drug paraphernalia, unsurprisingly, can be one major indicator of addiction.
When it comes to opioids specifically, Olsen said loved ones may find objects like tin foil, needles, matches, and charred spoons or bottle caps. (The latter two can be used for cooking drugs.)
4. Going through an opioid prescription faster than expected
The current opioid crisis in the US traces all the way back to the 1990s, according to the US National Institute on Drug Abuse (NIDA). At the time, pharmaceutical companies assured the medical community that opioid painkillers weren’t addictive, and as a result, doctors began to prescribe the pills to more and more people.
This led to widespread misuse of the drugs – and climbing rates of opioid overdoses.
Today, 21 to 29% of patients prescribed opioids for chronic pain end up misusing them, while between 8 and 12% develop an opioid use disorder, according to NIDA.
In people who have been prescribed the pills for pain, there are additional signs of addiction to look out for, Olsen explained.
“If people complain that, ‘Oh I ran out of my opioids, I need to go back and get more,’ or if the prescription they received was [meant] to last two weeks and three days into it, the bottle’s empty, that’s kind of concerning,” she said.
5. Intense sleepiness
“If you find that someone is coming home sedated or sleepy, or you go into someone’s room and you have a hard time waking them up, those are concerns that the person might actually be taking so much of an opioid that they may be at risk for overdosing,” Olsen said.
On a related note: If you live with someone who’s at risk for overdosing, many experts recommend keeping naloxone – the drug that can safely reverse opioid overdose – in your house.
“Having naloxone in the in the home can be lifesaving,” Olsen said.
In many states, you can purchase it at a pharmacy without bringing in a prescription. NIDA’s website offers more information on how to find naloxone in your area.
6. Withdrawal symptoms
Olsen explained that once an addiction has been established, people using opioids may go through cycles of getting high, then experience withdrawal – a collection of unpleasant, sometimes severe symptoms that crops up when someone abruptly stops using a drug they’re addicted to.
“The withdrawal from opioids can be pretty pronounced. So their eyes run, their nose runs, they yawn a lot, they get belly pain, diarrhoea, body aches, they feel like they have the flu,” Olsen said. “That also can be another set of things to look for, particularly if there are other warning signs present as well.”
Some of these signs may signal other health problems.
It’s good to remember that not all of these signs are exclusive to opioid use disorder.
“I think the message is that, no matter what the diagnosis might be, when people are noticing changes in their loved ones, it’s important to get professional attention,” Olsen said. “Talk to the individual and express your concerns, but then get some professional input.”
Even it turns out your loved one doesn’t have an opioid use disorder, they may still be fighting a serious condition that requires medical attention.
If someone you love has an opioid addiction, talk to them in a non-judgmental way.
If you do discover that a loved one is addicted to opioids, the first thing to do is talk to them without assigning any blame.
“No one wakes up one morning and says, ‘You know, I think I’m going to give myself an opioid addiction,'” Olsen said. “In fact, it can be quite painful and people are often extremely ashamed and fearful of letting their family members know what’s going on.”
But showing empathy and concern rather than judgment may encourage the individual to open up about their addiction, rather than shutting you out, she explained.
“Acknowledge that this is a disease, it’s not your fault, we want to get you help, we want you to feel better, we love you, and we are here to help you,” Olsen added.
Seek help from a medical professional.
“Once you talk to the individual, the best thing is if you can get them to agree to see a healthcare provider who can do an assessment,” Olsen said. “And if the person is unwilling to go and see someone, a family member could talk to a healthcare provider individually first and get some thoughts about how to best approach the situation.”
There are treatments available for opioid addiction, including the medications methadone and buprenorphine, which suppress withdrawal symptoms and drug cravings, and naltrexone, which blocks the effects of opioids in the brain.
These medicines are used in combination with behavioural counseling to form an approach known as medication-assisted treatment(MAT). MAT has been shown to reduce opioid overdose deaths and help patients stay in treatment, according to NIDA.
There’s a popular misconception that these medications simply substitute one addiction for another, but experts say that’s not true. When used properly, they simply help patients manage an addiction so they can recover, the ASAM explains.
Unfortunately, MAT can be difficult to access because not every treatment center offers it. To find available treatment options near where you live, use the US Substance Abuse and Mental Health Services Administration’s (SAMHSA) Behavioural Health Treatment Services Locator online. You can also call SAMHSA’s National Helpline (1-800-662-4357) for referrals to treatment facilities in your area. It’s free, confidential, and available 24/7.
Take care of yourself, too.
The effects of addiction reach beyond the individual fighting the disease. It can negatively impact that person’s family and friends, too.
Opioid addiction may cause individuals to behave in ways that disrupt family life, or even threaten or traumatize their loved ones, Olsen said, and dealing with these behaviours can be traumatic. If someone you love is addicted to opioids, remember that you could benefit from external support, too.
“[Don’t] go it alone,” Olsen said. “Getting help for yourself as a family member and for other people in the family is really important.”
That help may come from support groups or community-based organisations or some other outlet. SAMHSA’s National Helpline (1-800-662-4357) also provides assistance for family members of people with substance use disorders. It can help you find services like these in your area.