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Opioid Side Effects: Risks & Complications

Opioids can cause a range of side effects, such as tiredness, confusion, slowed breathing and heart rate, and constipation, and may lead to serious harm if misused. They need to be conscientiously prescribed by doctors, and patients must use them carefully.

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What Are Opioids?

Opioids are a class of drugs that act on opioid receptors on cells in the brain, spinal cord, and other organs. When opioids attach to these cells, they block pain signals and also cause the body to release much more dopamine, a chemical that plays a key part in what makes key activities, such as eating or having sex, feel rewarding.

What Opioid Medications Do

Through the mechanism described above, opioid medications can be a powerful option for combatting moderate to severe pain. While not without downsides (discussed more later), opioids can significantly reduce the amount of pain a person is feeling. 

Opioids are often used for pain relief after surgeries, where a patient may experience severe but temporary pain in the early stages of recovery. 

One opioid in particular, methadone, is also sometimes used to combat opioid use disorder (OUD). While it isn’t intuitive, the careful and highly controlled application of an opioid can help to reduce a person’s opioid drug cravings and greatly reduce the chance that they engage in drug misuse. Methadone treatments can and have helped many people avoid much more dangerous uncontrolled opioid use. 

Side Effects of Opioids

In addition to the pain relief opioids provide, the excess dopamine released can also cause a person to experience a sense of calm and euphoria. Some more harmful side effects that opioids can commonly cause include the following:

  • Drowsiness
  • Confusion
  • Constipation
  • Nausea
  • Slowed breathing

Dangers of Opioids

Of the dangers associated with opioid use, especially opioid misuse, two of the most significant are the risk of overdosing on opioids and the fact that opioids can be highly addictive. Opioids should only ever be taken as prescribed. You should talk with your doctor if you experience symptoms that seem unusually severe, or you feel drawn to abuse your prescription. 

An opioid overdose is characterized by the following:

  • Extreme paleness
  • Clammy skin
  • A blue or purple tint around the lips and fingernails
  • Vomiting or gurgling noises
  • Slowed or stopped breathing
  • An inability to awaken or difficulty speaking

An opioid overdose, or signs a person may be reaching the point where they’re overdosing even if you’re not completely sure, is a medical emergency. This overdose can be life-threatening, usually as a result of hypoxia, which is when too little oxygen is reaching the brain. This has the potential to cause short-term and long-term psychological and neurological effects, including brain damage and death. 

If available, the drug naloxone should be administered immediately if an opioid overdose is suspected. Naloxone can counteract the effects of opioids, essentially reversing the overdose. 

Opioids are highly addictive, in large part due to the euphoric effect associated with their use. The brain can essentially become reliant on the way opioids make it feel. 

Addiction is generally characterized in part by the body developing a physical dependence on a drug, where a person develops strong cravings for a drug when not using it. In the case of opioids, a person will experience flu-like withdrawal symptoms if they go too long without using the drugs once dependence has formed. 

Addiction isn’t guaranteed with opioid use, but it becomes much more likely if someone is not taking opioids as prescribed. Even when taking opioids as instructed by your doctor, both you and your doctor need to carefully monitor how opioids make you feel for signs that you may be developing physical or psychological dependence.

Complications & Interactions

Doctors have to be careful prescribing opioids. These drugs are not without risks, and the country is currently in the middle of an opioid use epidemic, where many people are struggling with addiction to opioids. 

With regular use, opioids can potentially cause health complications, such as these:

  • Constipation
  • Disordered breathing during sleep
  • Increased risk of fracture
  • Hypothalamic-pituitary-adrenal dysregulation

Opioids have a number of potentially dangerous interactions with other drugs, including other opioids, which a person should be aware of if taking these medications. In fact, it is usually best to talk with a doctor before mixing the use of an opioid with any drug, either recreational or medicinal, unless you’re certain there are no potentially harmful interactions that might occur.

Drugs that affect the same systems as opioids, especially the respiratory system, shouldn’t be mixed with opioids without the express permission of a doctor. Depressants, which include alcohol, can depress the respiratory system further than opioids already do, greatly increasing the risk that a person might overdose.

Drugs that can counteract some of the effects of opioids, notably stimulants, are also generally dangerous to take with opioids. A fairly common occurrence with illicit drug use is that a person mixes a stimulant like cocaine with an opioid like heroin (a speedball) in an attempt to reduce the negative side effects of opioid use. 

However, this sometimes causes a person to take more opioids than they intend. Then, the stimulant can wear off before the opioids do, and the person is hit with the full effect of their opioid use, potentially causing them to overdose.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated October 17, 2023
  1. Prescription Opioids. (June 2021). National Institute on Drug Abuse.
  2. Opioid Misuse and Addiction. (April 2018). National Library of Medicine.
  3. A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner’s Guide. (June 2012). The Primary Care Companion for CNS Disorders.
  4. Pain Pills/Opioids Frequently Asked Questions. UConn Health.
  5. Influence of Opioid-Related Side Effects on Disability, Mood, and Opioid Misuse Risk Among Patients With Chronic Pain in Primary Care. (March/April 2017). PAIN Reports.
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