• How to tell if a loved one is abusing opioids

a man in a counselling session looking sad and depressed with concerned people sitting around him

Signs of opioid abuse may be hard to see clearly, especially in someone you love.

“Evidence of opioid abuse can be very difficult to determine, especially early on in the disease," says Dr. Holly Geyer, a Mayo Clinic addiction medicine specialist. "Some things that might be warning signs to friends and family members include change in behaviors, change in interest level of normal everyday activities, and perhaps starting to let go of some of the activities they used to engage in on a regular basis.”

Even if you can't put your finger on anything specific, Dr. Geyer says it's worth taking stock of your concerns. Ask yourself some questions about your loved one's personal risk of addiction and the changes you may have noticed. If your answers point toward a possible addiction, reach out to your loved one's health care provider. He or she is a critical partner if you determine it's time to take action. If your instincts are right, speaking up could save the life of someone dear to you.

What are the chances my loved one could be addicted?

People who take potentially addictive drugs as prescribed rarely abuse them or become addicted. But not taking them as prescribed or for an extended period of time increases the risk of misuse and addiction. Studies suggest that up to one-third of people who take opioids for chronic pain misuse them, and more than 10 percent become addicted over time.

Watch: Dr. Holly Geyer discusses how to tell if a loved one is abusing opioids.

Journalists: Broadcast-quality sound bites with Dr. Geyer are in the downloads.

"Everyone is technically at risk, and when we select for the right populations to provide these medications, the risk is low – well under 10 percent," says Dr. Geyer. "If you have the right risk factors, meaning the right age, the right predisposition, the right personal or family history, the risk goes up. And, so, it’s imperative that health care provider work with the patient to make sure the dose is correct for the right time length and for the right diagnosis.”

Common signs include a patient’s disinterest in normal everyday activities, changes in behavior. And frequently individuals will try to hide evidence of this early on in the course. "Inevitably, it will start to manifest in other ways," says Dr. Geyer. "Many times, family members find their loved ones unwilling to participate in things they used to do before. Sometimes, they find them hoarding drugs. Sometimes, they find them 'doctor shopping.' And if you’re seeing signs and symptoms like that, notify your loved one's health care provider.”

Your loved one is at increased risk of addiction if he or she obtains opioids without a prescription. And using opioids illegally increases the risk of drug-related death. Drugs that pass hands illegally, such as fentanyl, may be laced with life-threatening contaminants or much more powerful opioids. And people who use opioids illegally often turn to heroin, a cheap replacement with similar effects.

“As this disease progresses, what we might see is more desperate behavior related to individuals seeking out medications from other sources and/or drugs off the street," says Dr. Geyer. "If you find evidence of them using other substances on top of previously prescribed medications, if you see evidence of individuals going to excessive measures to obtain new opioids and/or other drugs, and, ultimately, if you’re seeing secondary effects from law enforcement getting engaged, all of these can be major warning signs and should be addressed.”       

Your loved one is at increased risk of opioid addiction if he or she:

  • Is a younger age, specifically teens or early 20s
  • Is living in stressful circumstances, including being unemployed or living below the poverty line
  • Has a personal or family history of substance abuse
  • Has a history of problems with work, family and friends
  • Has had legal problems in the past, including charges of driving under the influence
  • Is in regular contact with high-risk people or  environments where there's drug use
  • Has struggled with severe depression or anxiety
  • Tends to engage in risk-taking or thrill-seeking behavior
  • Uses tobacco heavily

A number of additional factors — genetic, psychological and environmental — play a role in addiction, which can happen quickly or after many years of opioid use. Anyone who takes opioids is at risk of becoming addicted, regardless of age, social status or ethnic background.

This article is written by Mayo Clinic staff. Find more health and medical information on mayoclinic.org.

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