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Side Effects of Taking Opioids

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. 

How Do Doctors Use Opioids?

Per the 2022 Centers for Disease Control and Prevention (CDC) guidelines, doctors should prescribe opioids at the lowest effective dose for the expected time frame of pain that requires medications. Doctors should also discuss the risks and benefits of this therapy within one to four weeks of starting it or increasing the dose.

Statistics from the CDC suggest that opioid prescribing rates are declining. In 2022, the prescribing rate was 39.5 prescriptions dispensed per 100 people. In 2019, the rate was 46.8 per 100 people.

Safe Opioid Use

Some people need prescription painkillers to help them recover or deal with injuries or illnesses. If your doctor says you need these drugs, you must do your part to take them safely.

The U.S. National Library of Medicine recommends the following steps:

  • Read the instructions before you take your dose.
  • Take your medication exactly as prescribed.
  • Do not take extra doses.
  • Do not break, chew, crush, or dissolve opioid drugs.
  • Don’t drive or use machinery while using these medications.
  • Contact your doctor if you experience side effects.
  • Use the same pharmacy for all your medication.

Questions to Ask Your Doctor About Opioids

You’re an active partner in your treatment plan, including your opioid use. If your doctor says opioids should be part of your care plan, hold an honest conversation and ensure you know what to do.

Consider asking the following questions:

  • Are there other therapies that might help to treat my pain?
  • Why are opioids the best choice?
  • What are the risks of using these opioids?
  • Are opioids safe with the other medications and supplements I use?
  • How should I take the medication?
  • How long will I take it?
  • What opioid side effects are possible?
  • What should I do if side effects happen?
  • How will I stop when it’s time to quit them?

Opioid Side Effects

Opioid painkillers can cause side effects, even when people take them as directed by a doctor. Understanding opioid side effects can help you learn more about what to expect and how to keep yourself safe.

This chart contains details about opioid side effects based on data from the CDC:

Common Side EffectsSerious Side Effects
Tolerance, meaning you need more for the same pain reliefOverdose risks
Withdrawal symptoms when you try to quit (such as nausea and vomiting)Addiction
Increased sensitivity to painAbuse
Low levels of testosterone 

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

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

  • Constipation
  • Sleep problems
  • Broken bones
  • Hormone issues
  • Overdose

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 May 3, 2024
  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.
  6. The 2022 CDC Opioid Prescription Guideline Update: Relevant Recommendations and Future Considerations. (December 2023). JAAD International.
  7. Opioid Dispensing Rate Maps. (October 2023). Centers for Disease Control and Prevention.
  8. Safe Opioid Use. (March 27, 2024). U.S. National Library of Medicine.
  9. Prescription Opioids. (August 29, 2017). Centers for Disease Control and Prevention.
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