When someone uses opiates, particularly if they use them for a prolonged period of time or they’re a heavy user of these drugs, ultimately almost every part of their body is impacted. One common question often asked is, “Are opiates bad for your kidneys?” People often wonder if their use of opiates will impact their renal function, and if so, how.

Along with just generally wondering are opiates bad for your kidneys, people often have concerns if they already have renal problems and they’re prescribed opioid painkillers. They’re unsure if the medication they’re prescribed will worsen their existing kidney function issues.

The following are some key things to know regarding the question of whether or not opiates are bad for your kidneys.

How The Kidneys Function

Before thinking about whether opiates are bad for your kidneys, below are some facts about kidneys and their functionality.

The kidneys filter blood and then ultimately create urine of the waste and extra fluid. Your kidneys work to keep electrolyte levels stable and make sure that waste and fluid don’t build up in your blood. When you take drugs or drink alcohol, these substances must be filtered through the kidneys as well.

Some of the issues that can cause problems with how kidneys function include toxin exposure, hypertension, diabetes, aging and conditions like kidney stones.

If someone is on opiates and they don’t have optimal kidney function, this can be a problem because the effects of the drug are magnified. If a person has bad kidneys, their body cannot effectively cleanse the drug from their system, which puts them at high risk of sedation and overdose. As a result, the person may need smaller or less frequent doses of the opioid. So, the answer to “Are opiates bad for your kidneys?” is that damaged kidneys cannot effectively control the effects of opioids.

There are also specific ways that the actual use of opiates can contribute to kidney problems.

Heroin and the Kidneys

One example of how opiates are bad for your kidneys is the impact of heroin. Heroin is a dangerous opioid, and it leads to wide-ranging medical effects. If someone were to overdose on heroin, this could lead to rhabdomyolysis, which is a condition in which muscle and tissue begin breaking down and then proteins are released into the blood.

When this happens, there is the potential for damage to the kidneys.

Essentially what happens with rhabdomyolysis is a breakdown of tissue during an overdose-related coma because the person has been not moving for an extended period. The muscles start to disintegrate and that produces chemicals, which then go into the bloodstream and set off other damaging reactions throughout the organs. This is one of the number one reasons for kidney failure. During this situation, heart damage and heart attack can also occur.

Also, people who use heroin intravenously may be more likely to contract infections that can lead to kidney inflammation, and for people who inject heroin under the skin, there’s an increased chance of getting secondary amyloidosis. This is a buildup of protein in organs and tissues that can lead to kidney failure.

The Effects of Painkillers on Your Kidneys

Also relevant to the conversation of whether opiates are bad for your kidneys is the combination of many opioid painkillers with something called acetaminophen. Acetaminophen is found in over-the-counter painkillers like Tylenol, and it’s also combined with many opioid painkillers including Vicodin and Percocet. Acetaminophen kidney toxicity is rare, but it may be associated with an acetaminophen overdose.

When kidneys become damaged, people tend to be unable to regulate their own hormone levels or excrete waste properly. If the damage is severe, the person may have to undergo dialysis in which a body then does the work kidneys are meant to do naturally, including filtering waste through a system. Eventually, a kidney transplant can be required.

So, the answer to “are opiates bad for your kidneys” is yes. Opioids like heroin are directly bad for your kidneys and can have severely damaging effects, and then there are other indirect effects including the exposure to acetaminophen that can also lead to kidney damage.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.