Opioid Use Disorder: Diagnosis, Signs, Causes & Treatment

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Opioid Use Disorder (OUD) is the official name for addiction to opioid drugs, which is a chronic brain disease. Opioids include illegal drugs like heroin, as well as prescribed pain medications like Oxycodone, hydrocodone or morphine. 

OUD is more commonly referred to as opioid addiction, opiate addiction, heroin addiction, or pill addiction and falls under Substance Use Disorder.

Table of Contents

Opioid Use Disorder Diagnosis & Symptoms

A doctor may diagnose opioid use disorder if a person has two or more of the following symptoms: 

Healthy vs. Opioid-Addicted Brain Scans

healthy brain showing much more DA D2 availability

Opioid Withdrawal Symptoms

The symptoms of opioid withdrawal vary depending on the amount and the length of time the person has been taking opioids.

The most common symptoms of opioid withdrawal include:

  • Anxiety or agitation
  • Muscle aches or pains
  • Insomnia or fatigue
  • Dizziness and headache
  • Runny nose
  • Abdominal cramps, nausea, vomiting or diarrhea 
  • Fever or sweating
  • Increased heart rate


Symptoms of opioid withdrawal usually peak within the first few days and begin to improve within a week. However, some people experience symptoms for several weeks or even months known as post-acute withdrawal symptoms.

Learn more about opioid withdrawal:

Signs of Opioid Abuse (for Loved Ones)

Behavioral symptoms are often the earliest signs:

  • Being on the defensive
  • Blaming others
  • Lack of eye contact
  • Isolation and being secretive
  • Changing to a new group of friends
  • Unpredictability (like not showing up without notice)
  • Abandonment of daily routines or important activities
  • Lack of care in personal hygiene and appearance


Opioids also take a toll on the body and physical symptoms include:

  • Drowsiness
  • Changes in physical appearance, like weight gain or loss
  • Pinpoint (constricted) pupils
  • Slowed breathing
  • Constipation
  • Decrease or increase in sexual desire
  • Needle marks on arms, hands or feet
  • Decreased appetite


Psychological symptoms 
may have fueled the drug use in the first place or arise because of the addiction, including:

  • Sudden mood swings from irritability to euphoria
  • Depression
  • Anxiety
  • Psychosis
  • Decreased motivation


The most telling signs are environmental symptoms but these can be hard to catch:

  • Doctor shopping (ex: obtaining prescriptions from different doctors, claiming they lost their prescription or needing a stronger prescription)
  • Drug-related legal problems
  • Paraphernalia (ex: medication bottles with labels removed, burned tinfoil, bloodied cotton swabs, syringes/ needles, bent spoons or rolled up dollar bills)

The Opioid Epidemic

Opioid epidemic is a term used to describe the sharp increase in the use of prescription and non-prescription opioids in the U.S. in the 1900s. The second wave of the opioid epidemic began in 2010 and continues to be a serious public health crisis.

How many people have opioid use disorder?

There are an estimated 2.1 million people in the United States with opioid use disorder. And, opioids are involved in around 70% of all fatal drug overdoses.

Demographics of Opioid Use Disorder

Pie charts showing 60% male gender 50% age 18-34

Causes of Opioid Use Disorder

There is no known cause of opioid use disorder. Many factors contribute.  What makes opioid addiction more likely is:

  • Genetics: At least half of a person’s susceptibility to drug addiction is linked to genetic factors.
  • Chronic pain: Opioids are used to stop physical pain.
  • Social factors: Those in poverty, identifying as LGBTQ+ or exposed to alcohol or opioids at a young age have a statistically higher rate of addiction.
  • Mental health struggles: Opioids are used to self-medicate mental pain like depression, anxiety, bipolar or trauma.

Treatment for Opioid Use Disorder

Treatment for Opioid Use Disorder usually involves a combination of medication and behavioral therapies.

The FDA approved three medications for treating opioid use disorder: 

1. Naltrexone (common brand name Vivitrol)

2. Buprenorphine (common brand name Suboxone)

3. Methadone (common brand name Methadose)

Therapy for OUD can be provided at inpatient rehabs, inpatient hospitals or outpatient clinics. Intensive Outpatient Program (IOP) is a common outpatient method.

To learn more about the treatment for Opioid Use Disorder, read:

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Symetria has addiction treatment clinics across Illinois and Texas. You can likely get scheduled TODAY — medications or therapy.