From the Guidelines
Opiate use is associated with a range of symptoms, including euphoria, pain relief, drowsiness, constricted pupils, nausea, vomiting, constipation, and itching, as well as serious symptoms like respiratory depression, which can lead to death in overdose situations. These symptoms can be categorized into short-term and long-term effects. Short-term effects include:
- Euphoria and pain relief
- Drowsiness and constricted pupils
- Nausea, vomiting, constipation, and itching
- Respiratory depression, which can lead to death in overdose situations 1
Long-term effects include:
- Tolerance, requiring higher doses to achieve the same effects
- Physical dependence, leading to withdrawal symptoms when stopping, such as anxiety, muscle aches, insomnia, sweating, diarrhea, vomiting, and strong drug cravings 1
- Reduced sex drive, immune system suppression, and increased sensitivity to pain (hyperalgesia) 1
It is essential to recognize these symptoms to identify potential opiate use or misuse, as these drugs have high addiction potential. If someone is suspected to be experiencing an opiate overdose, marked by unresponsiveness, slow/stopped breathing, and blue lips/fingernails, administering naloxone if available and seeking emergency medical help immediately is crucial 1. Naloxone is a useful antidote for the reversal of opioid-induced respiratory and CNS depression, but it should be administered cautiously to avoid precipitating acute opioid withdrawal syndrome in opioid-tolerant patients.
From the FDA Drug Label
The signs and symptoms of opioid withdrawal in a patient physically dependent on opioids may include, but are not limited to, the following: body aches, diarrhea, tachycardia, fever, runny nose, sneezing, piloerection, sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, abdominal cramps, weakness, and increased blood pressure In the neonate, opioid withdrawal may also include: convulsions, excessive crying, and hyperactive reflexes.
The symptoms associated with opiates include:
- Opioid withdrawal symptoms:
- Body aches
- Diarrhea
- Tachycardia
- Fever
- Runny nose
- Sneezing
- Piloerection
- Sweating
- Yawning
- Nausea or vomiting
- Nervousness
- Restlessness or irritability
- Shivering or trembling
- Abdominal cramps
- Weakness
- Increased blood pressure
- Neonatal opioid withdrawal symptoms:
- Convulsions
- Excessive crying
- Hyperactive reflexes 2
From the Research
Symptoms Associated with Opiates
The symptoms associated with opiates include:
- Nausea and vomiting 3, 4, 5, 6
- Sedation 3, 5
- Respiratory depression 3, 7, 5, 6
- Constipation 3, 5, 6
- Tolerance and addiction/abuse liability 3, 5
- Dizziness 5
- Delayed gastric emptying 5
- Hyperalgesia 5
- Immunologic and hormonal dysfunction 5
- Muscle rigidity 5
- Myoclonus 5
Severity and Prevalence of Symptoms
- Nausea and vomiting are experienced by approximately 40% and 15%-25% of patients, respectively, after opioid administration 4
- Constipation has a very high incidence and can be difficult to manage, frequently requiring opioid discontinuation 5
- Respiratory depression is a potentially fatal side effect, particularly in the post-operative setting 7, 6