Opioid Use Disorder: Signs, Symptoms, and Recovery Options.

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. Opioid use disorder requires a comprehensive physical and psychiatric evaluation by a qualified clinician. So, always refer to a board-certified physician or a licensed mental health specialist for diagnosis and treatment.

The Centers for Disease Control and Prevention (CDC) reports that 105,000 died from overdose in 2023, and more than 75% of these overdose deaths were related to opioids (80,000). Clearly, the opioid crisis has left a gaping hole in many communities in the U.S. It also indicates the urgency to bridge the gap between evolving needs and the right levels of care.

The encouraging news is that opioid use disorder can be effectively treated with medication-assisted treatment (MAT) and other evidence-based practices. While the relapse rates can run as high as 40% to 60%, the road to recovery can be a lasting one with personalized care that meets you where you are.

Opioid use disorder (OUD) is characterized by a chronic, uncontrolled use of opioids. Opioids are both prescription pain relievers and illicitly manufactured substances that bind to the opioid receptors in your brain to relieve pain, and they also give rise to euphoria. Opioids activate the brain’s reward pathways, reinforcing continued use and increasing the risk of dependence.

Before you know it, your mind and body become dependent on it, as it targets your brain’s chemistry - the reward system, and changes it so that you become used to its presence for normal functioning.

Opioids can be prescription pain relievers, like morphine, oxycodone, hydromorphone, tramadol, fentanyl patches, and others. They can also be illicitly manufactured, like heroin and fentanyl.

Dr. Ryan Peterson, a highly experienced physician at the NuView Treatment Center, says, “The U.S. Department of Health and Human Services (HHS) reports that over 2.1 million in the U.S. struggle with opioid use disorder; whereas peer-reviewed studies published in reputed journals show that nearly 12% of those treated with prescription opioids tend to misuse them. This is why they can be so dangerous, despite precautions and care.”

The opioid crisis is an epidemic that is gripping the U.S., as we speak. While this term may have come up recently, it is nothing new. There have been three waves of the opioid crisis, the present being the third one.

The First Wave of the Opioid Crisis

The first wave of the opioid crisis began when they became increasingly prescribed in the 1990s. While overdose deaths related to prescription opioids rose during this time, they have declined since.

The Second Wave of the Opioid Crisis

The second wave of the opioid crisis began in 2010, mainly with heroin overdoses. However, as per CDC trend reports, heroin-related overdose deaths have declined in recent years, but synthetic opioids such as fentanyl remain the leading reason behind opioid-related fatalities.

The Third Wave of the Opioid Crisis

The third wave of the opioid crisis began in 2013, with increases in overdoses related to synthetic opioids (mainly fentanyl). While the death rate rapidly rose, it decreased between 2022 and 2023. However, these deaths still continue to devastate communities.

While opioid use disorder can impact anybody, there are certain risk factors that increase this likelihood, such as:

• Family history of substance use or opioid use disorder.
• Past or present substance misuse.
• Younger age.
• Untreated mental health conditions.

The signs and symptoms of opioid use disorder are specified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). For a diagnosis of opioid use, at least two of the following signs should appear within a period of 12 months:

• Intense cravings and urges to use opioids.
• Using opioids more frequently and in higher doses than intended, or using them in other ways than prescribed.
• Spending too much time obtaining, using, or recovering from opioids.
• Persistent opioid use despite worsening physical or mental health.
• Ongoing use despite having a social or interpersonal problem because of its use.
• Neglecting responsibilities to prioritize opioid use, like education, job, or family responsibilities.
• Reduced involvement in social or recreational activities.
• The desire to, but an inability to cut down or control opioid intake.
• Developing tolerance - which means you need to consume opioids in larger quantities to achieve the desired effect.
• Experiencing withdrawal symptoms on cutting down or reducing opioid use, which leads to using more opioids to avoid withdrawal.

The commonly recognizable opioid withdrawal symptoms are as follows:

• Anxiety
• Sleeplessness
• Vomiting
• Diarrhea
• Hot and cold flushes
• Sweating
• Cramps
• Watery discharge from the eyes and nose.

For short-acting opioids, the withdrawal symptoms begin within 8-24 hours after the last dose, and last for 4-10 days. Meanwhile, for long-acting opioids, the withdrawal symptoms begin within 12-48 hours after the last dose, and last for 10-20 days.

Some lingering, albeit milder withdrawal symptoms last a few weeks or months. These symptoms are collectively known as the post-acute withdrawal syndrome (PAWS). They mainly involve symptoms like cravings, irritability, anxiety, sleep disturbances, tiredness, and so on.

Withdrawal from opioids is rarely life-threatening but can be extremely uncomfortable. However, medical supervision is strongly recommended, particularly for those with co-occurring conditions.

The three telling signs of an opioid overdose are:

• Pinpoint pupils
• Breathing difficulties
• Loss of consciousness.

Other signs can be blueish skin or fingernails, cold and clammy skin, and a slowed heartbeat.

Opioid overdose is a medical emergency. If you suspect these signs, call 9-1-1 immediately. Meanwhile, administer naloxone (Narcan), as it can reverse an opioid overdose.

Even if naloxone is administered and the person wakes up, emergency medical care is still required because naloxone’s effects may wear off.

Opioid use disorder is treated with medically supervised detoxification, medication-assisted treatment, psychotherapy, and holistic healing practices.

• Medically Supervised Detox: Opioids are slowly tapered off from your body under medically supervised conditions to minimize and control cravings and withdrawal symptoms. Typically, a board-certified physician and psychiatric practitioner will oversee your detox.
• Medication-Assisted Treatment (MAT): MAT combines FDA-approved medications and therapy for treating opioid use disorder. Medications involve methadone, buprenorphine, and naltrexone. These medications are mainly meant to reduce cravings and control withdrawal symptoms, thereby alleviating certain symptoms and preventing relapse.
• Medication selection and planning are only done under close consultation and supervision of board-certified physicians and psychiatric practitioners.
• Psychotherapy: Therapies like motivational interviewing, cognitive behavioral therapy, contingency management, and 12-Step facilitation therapies are used to target the underlying patterns leading to opioid use and equip you with healthier coping skills.
• Holistic Practices: Holistic practices, like a nutritious diet, consistent sleep, exercise, meditation, and mindfulness, are used to ensure you build healthier habits that keep opioid use at bay.
• Peer Support: Informal peer support groups like Narcotics Anonymous or SMART Recovery can provide community to motivate and encourage you through your recovery.
• Dual Diagnosis: More than 25% of the time, opioid use disorder co-occurs with other mental health conditions, which is known as dual diagnosis. Treating both simultaneously with cognitive behavioral therapy, dialectical behavior therapy, medication management, and peer support will lead to a well-rounded, lasting recovery.

Dr. Peterson says, “Opioid use disorder is a challenging substance use disorder. Still, with early diagnosis and intervention, it can be treated in both residential and outpatient settings. In fact, a significant portion of those who seek clinical care for opioid use disorder go on to achieve full recovery.”

NuView Treatment Center offers a full continuum of outpatient care that meets you where you are. With partial hospitalization programs and step-down intensive outpatient programs, and telehealth services - we ensure that you do not have to put your life on hold to focus on your recovery. We provide a safe setting, strengthened by a sense of family and community, for an empowering healing experience.

Please do not hesitate to call us (323) 307-7997 to connect with our experts today!

Can opioid use disorder be prevented?

While not all cases are preventable, risk can be reduced through safe prescribing practices, properly storing medication, avoiding non-medical opioid use, and early intervention for substance misuse.

What is naloxone?

Naloxone is an opioid overdose reversal medication that is available as a nasal spray and injection. It can be administered by anyone if they suspect an opioid overdose. It is a life-saving medication, but even so, immediate medical care will still be required.

How to avoid a fentanyl overdose?

Fentanyl is a lethal opioid, and even tiny quantities can lead to an overdose. Unfortunately, it can be illicitly mixed with other substances, too. So, carry fentanyl strips with you to test for the presence of fentanyl. While they are not foolproof, they are still an effective harm-reduction strategy.

Is treatment for opioid use disorder effective?

Yes, treatment for opioid use disorder is highly effective. A significant portion of those who seek the care they need and deserve for opioid misuse achieve full recovery.

How long does it take to recover from opioid use disorder?

While we cannot put a time on these things, it can take up to a few weeks to a few months, depending on the severity of opioid use and other unique factors.