Opiate Overdose Signs, Symptoms & Treatment

There is an issue in this country that affects people of every age and ethnicity. States nationwide spend billions of dollars annually to stop the opioid epidemic, but the prognosis is not good.

To better know how this plague affects people, it is vital to understand opioids. Despite working on similar receptors in the human brain, opioids and opiates differ. Many assume these terms have the same meaning, but key differences exist. There may not be much variance in how they affect us, but how they originate is another matter.

Opioids are manufactured drugs produced in laboratories or processing facilities for illicit drug-trade purposes. They can be categorized as fully or semi-synthetic, but regardless of designation, opioids are chemically manufactured by nature. Some familiar and newer examples of opioids include: 

• Hydrocodone
• Oxycodone
• Carfentanil
• Fentanyl

Opiates, on the other hand, are produced from naturally occurring opium poppies. Besides opium itself, alkaloids found within the plant are the basis for pain-relieving drugs like morphine and codeine, but also illegal substances like heroin. Technically, morphine, codeine and heroin are considered opioids and opiates. The term opioid is a blanket term for all naturally occurring opiates and manufactured opioid drugs. As a general rule of thumb, all opiates are opioids, but not all opioids are opiates.

Opioid overdoses are a daily occurrence in the U.S. Identifying the signs and symptoms of an opioid overdose can put you or a loved one on the right path toward treatment.

What Is an Opiate

An opiate is a naturally occurring opioid. Because opiates affect the body the same way as manmade opioids, the terms opioids and opiates are used interchangeably, even among healthcare professionals. Opiates are naturally derived from the poppy plant, while opioids are made in a lab. 

Opiates include:

• Morphine
• Codeine
• Opium

Opioids can be either entirely or partially manufactured. Partially manufactured opioids are called semi-synthetic and include:

• Oxycodone
• Hydrocodone
• Hydromorphone
• Oxymorphone
• Heroin

Fully manmade opioids are called synthetic and include:

• Fentanyl
• Methadone
• Tramadol

Opiates vs Opioids: Is There a Difference?

Other than the difference in their origin, there is little difference between opiates and opioids. Doctors use the term opiate and opioid interchangeably despite their minor difference in origin. The origin of an opioid or opiate generally has no bearing on its place in therapy or whether a doctor would choose one agent over another to prescribe.

Opioid Overdose Symptoms

Despite their inherent differences in origin, opiate and opioid overdose symptoms are interchangeable. Whether discussing opiates or opioids, overdose symptoms occur because of the drug’s impact on the brain’s brainstem, an area at the back of the skull. The brainstem controls breathing, specifically proper inhalation and exhalation. The brainstem also controls the size of the pupils in the eyes and plays a role in nausea and vomiting. Opioid overdose signs and symptoms are directly related to the impact that opioids have on the brain, especially the brainstem.

Opioid Overdose Signs

Knowing when a recreational experience with opiates is devolving into an emergency could save a life. Perceptible warning signs of an opiate overdose include:

• Pale or clammy skin
• Limp muscles
• Purple or blue nails or skin
• Vomiting or gurgling noises
• Inability to wake up
• Slowed or stopped breathing and heart

Three pervasive signs are commonplace during an opiate overdose: unconsciousness, contracted pupils and respiratory depression. Collectively, this may be referred to as an opioid overdose triad. Referencing these symptoms during an overdose triage situation is imperative.

There is no catch-all when it comes to overdose signs. Any sign could be indicative of an overdose. Just because multiple signs do not present themselves doesn’t mean the scenario is less dire. When lives are at stake, assuming the worst is good. It means someone can receive the best possible outcome if treatment is needed.

If you suspect someone is having an opioid overdose, you should give naloxone (Narcan) if available and call 911.

Causes and Risk Factors for Opioid Overdose

While an opioid overdose can happen to anyone, certain factors can increase your chances of falling victim to an overdose. For this reason, it is vital to practice opioid safety if you or a loved one are taking an opioid. Overdose risk factors include:

• Taking your opioids more often than prescribed by your doctor
• Taking more pills than prescribed by your doctor
• Mixing your opioids with other central nervous system depressants like alcohol or benzodiazepines
• Taking your opioids with illicit drugs — even stimulants like cocaine
• Taking someone else’s opioid medication
• Buying opioids off the street
• Not properly disposing of unused opioids, which especially increases the risk of overdose in children and pets
• Mental or physical health problems or emotional trauma
• A history of overdose
• Unstable housing or being homeless
• Having an opioid addiction but not seeking treatment

How To Stop Opioid Overdose Withdrawal Symptoms

When you take opioids regularly, your body adapts to their presence. Over days to weeks, your body can become dependent on opioids, adjusting its biology to the presence of the drug. This means if you suddenly stop taking the opioid, your body will struggle to adjust, leading to uncomfortable withdrawal symptoms.

The best way to avoid or minimize withdrawal symptoms is to seek medical help before quitting opioids. Your doctor or addiction specialist may help slowly reduce or taper your opioid dose to avoid withdrawal. In some cases, your doctor may offer you medication-assisted treatment (MAT) with methadone or buprenorphine to help ease withdrawal symptoms and help you stay sober from opioids over the long term.

How Long Does Opioid Withdrawal Last?

Opioid withdrawal can last for varying lengths depending on the person and the type of opioid you take. Opioids are divided into short-acting and long-acting agents, and the duration of opioid withdrawal reflects which type of drug a person is taking. There is no set timeline for the withdrawal symptoms, which can occur at any point in the withdrawal period.

Withdrawal symptoms include:

• Muscle aches
• Sleep problems
• Runny eyes and nose
• Sweating
• Yawning
• Enlarged pupils 
• Abdominal cramps
• Diarrhea
• Goosebumps 
• Nausea or vomiting
• Agitation
• Anxiety

In some cases, a person may experience protracted withdrawal symptoms that last for weeks or months. In the case of opioids, the most common protracted withdrawal symptoms are:

• Anxiety
• Depression
• Sleep disturbances
• Fatigue
• Emotional changes
• Irritability

Opioid Overdose Abuse Statistics

The Centers for Disease Control and Prevention (CDC) keeps track of opioid overdose statistics. Overall, more than 932,000 people have died since 1999 from opioid overdoses. During the 12 months ending in January 2023, there were almost 80,000 opioid overdose deaths — close to a new record. Some overdoses were due to multiple types of opioids taken at the same time. Of the nearly 80,000 overdoses during that time:

• More than 72,000 were due at least in part to synthetic opioids like fentanyl.
• More than 14,000 were due at least in part to natural opiates like heroin or semi-synthetic opioids like oxycodone.
• Almost 5,500 were due to heroin.
• More than 3,000 were due to methadone.

Opioid Overdose Treatment

Qualified medical professionals should treat suspected opiate overdoses. There is no alternative to swift and effective care. However, some steps can be taken to prolong life and make medical intervention more likely when an overdose is suspected. As always, dialing 911 is the first step to any emergency, overdose or otherwise.

Once first responders are contacted, one must determine whether the victim is experiencing an opioid overdose as opposed to another drug. Opioid overdoses can be halted by the drug naloxone (brand-name Narcan). This anti-overdose compound is a stabilizer; it won’t cure or treat the overdose but will give people time to seek proper treatment.

However, naloxone use has repercussions. Many opiate overdose victims find the days or weeks following being revived with naloxone to be extremely uncomfortable as they will be in acute withdrawal if they don’t start taking opioids again. The downside of Narcan use is that some people may assume they can be revived if necessary. This nonchalant attitude can raise a person’s risk of a fatal overdose.

With opiate addiction currently scouring the country, it is problems like these that society will have to face more and more in the years to come. But, any life saved from the overdose epidemic today is another opportunity to fight the epidemic tomorrow.

Opioid Treatment Options & Rehab

When you take the brave step to stop taking opioids, a continuum of care is available to help you achieve an opioid-free life. Every step of the way, your addiction specialists can help you put one foot in front of the other for your recovery. Treatment options include:

• Medical detox: In a medically supervised detox setting, you are gently weaned from opioid use using medication-assisted treatment (MAT) with buprenorphine if medically appropriate
• Inpatient: Following medical detox, rehab begins. Rehab involves intensive therapy to explore why you started to rely on opioids and begin to learn new coping mechanisms and healthy lifestyle skills.
• Outpatient: In outpatient rehab, you transition to living at home in a sober living environment, continuing your therapy for support. 
• Aftercare: Once rehab is complete, aftercare keeps your focus on recovery through alumni groups or support groups like Narcotics Anonymous.

Short-Term Effects of Opioid Addiction

In the short term, an opioid overdose can significantly impact your health and well-being. These include the potential for:

• A fatal overdose
• Uncomfortable withdrawal symptoms from naloxone being given
• Worry from family and friends who may have witnessed or heard about the overdose
• Medical bills from treating the overdose

Long-Term Effects of Opioid Overdose

An opioid overdose can have far-reaching consequences even if the person survives it. Some long-term effects of an opioid overdose include:

• Higher risk of a subsequent fatal overdose, even in the first few days to a month after the overdose
• Severe medical complications, including rhabdomyolysis, seizures, lung problems and cardiovascular issues, which can have chronic consequences
• Mental health consequences relating to the overdose and having a near-death experience

Opiate & Opioid Overdose Treatment

At The Recovery Village, an overdose is a red flag that you might struggle with an underlying opioid use disorder. As such, we help you try to overcome your opioid struggles by supporting you every step of the way. We offer a continuum of care, including medical detox to help wean you off opioids and rehab to help keep you opioid-free for good. Don’t wait: contact us today to see how we can help.

Editor – Theresa Valenzky

Theresa Valenzky graduated from the University of Akron with a Bachelor of Arts in News/Mass Media Communication and a certificate in psychology. She is passionate about providing genuine information to encourage and guide healing in all aspects of life. Read more

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