Opioids are a type of medication doctors primarily prescribe for relieving pain associated with surgery, cancer, or injuries.
Opioids can provide a lot of therapeutic benefits, but they do come with some side effects. While their short-term effects are relatively well known, the effects and risks of long-term opioid use are less clear.
This is partly because there’s no formal definition of what’s considered “long-term” use. Some
Here’s a closer look at what experts do — and don’t — know about the effects of long-term opioid use.
Before getting into the effects of long-term opioid use, it’s important to understand how opioids work in your body.
Your body’s cells contain receptors. These receptors are a lock of sorts. Certain molecules can unlock them. Opioid receptors are found in nerve cells in your brain, spinal cord, stomach, and some other body parts.
Opioids activate these opioid receptors. In response, the opioid receptors block the transmission of pain signals from the nerve, providing significant pain relief.
Examples of opioids include:
Opioid receptors have pain-relieving abilities, but they cause other effects on the body, too. These include:
- feelings of euphoria
- slowed breathing rate
If you take opioids as prescribed by a healthcare professional, these side effects typically aren’t a cause for concern. But taking more than prescribed, or more than your body is accustomed to, can result in an overdose (more on this later).
Experts don’t fully understand the effects of long-term opioid use, partly because there’s no agreement about what constitutes long-term use.
Some potential effects associated with long-term opioid use include:
- adrenal insufficiency
- central sleep apnea
- worsening gastroesophageal reflux disease (GERD) symptoms
Some research also suggests that some opioid medications may suppress your immune system, increasing your risk of infection.
Tolerance and dependence
Over time, your body may develop a tolerance to opioids. That means you will need to take an increasingly higher dose of opioids to feel the same effects you once did with a lower dose.
Eventually, your body may also develop a dependence on opioids to function. If you stop taking opioids after developing a dependence, you will experience withdrawal symptoms.
Opioid use disorder
Opioid use disorder (OUD), sometimes called opioid addiction, can happen with or without dependence.
OUD involves repeated use of opioids despite significant negative effects. These effects may be physical, psychological, or social.
Potential symptoms of OUD include:
- difficulty decreasing your opioid use despite a desire to do so
- experiencing strong urges to take opioids
- continuing to take opioids despite negative impacts on your obligations at work or home
- spending significant time trying to obtain opioids or recovering from their effects
- experiencing withdrawal symptoms when you stop taking opioids
- developing a tolerance to opioids
Keep in mind that the “Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5)” doesn’t consider withdrawal or tolerance to be symptoms of OUD if you’re taking opioids as prescribed by a healthcare professional.
It’s also worth noting that OUD occurs on a spectrum that ranges from mild to severe, depending on your symptoms.
If you think you might be experiencing OUD, talk with a healthcare professional about treatment options. Medication-assisted therapy (MAT) is a particularly effective option. It involves a combination of medication and therapy.
Medications that might be used in MAT include:
It’s possible to experience opioid overdose regardless of how long you’ve been taking opioids. That said, long-term opioid use is linked to a higher risk of overdose.
Signs and symptoms of an opioid overdose include:
- small pupils
- slow or ragged breathing
- blue or gray fingertips
- a loud, rattling snoring sound when breathing
- nausea or vomiting
- pale or ashen, clammy skin that’s cool to the touch
- dozing off, even when trying to stay awake
If you suspect someone is having an opioid overdose, call 911 or your local emergency number right away. Stay with the person until help arrives.
You may also want to consider keeping some naloxone nasal spray around and making sure someone close to you knows how to administer it. Naloxone (Narcan) can reverse an opioid overdose.
Ask your pharmacist about naloxone availability in your area. NEXT Distro can also help you find naloxone in your area and even send you some by mail.
It’s especially important to have naloxone on hand if you or a loved one takes opioids from a nonpharmaceutical source. These opioids may be contaminated with strong synthetic opioids that can increase your risk of overdose.
Here are a few other tips to keep in mind while taking opioids:
- Avoid mixing opioids with other substances that act as depressants on your central nervous system, like alcohol and benzodiazepines.
- Keep your doctor in the loop about your pain levels and side effects.
- Don’t increase or decrease your prescribed dose without talking with your doctor first.
There’s no formal distinction of what constitutes long-term opioid use. Plus, everyone reacts to opioids differently. As a result, it’s difficult to get a complete picture of the effects of long-term opioid use. However, long-term use does appear to be linked to a range of health effects.
If you’re concerned about how long you’ve been taking opioids or feel like you want to cut back your dose, talk with your prescribing doctor. They can help you find an alternative medication or work with you to taper down your dose.
You can also reach out to one of the following free and confidential resources: