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NIDA

Prescription Drug Abuse

What are the possible consequences of opioid use and abuse?

Image of brain along with oxycontin and heroin chemical structures

Taken as prescribed, opioids can be used to manage pain safely and effectively. However, when abused, even a single large dose can cause severe respiratory depression and death. Properly managed, short-term medical use of opioid analgesics rarely causes addiction—characterized by compulsive drug seeking and use despite serious adverse consequences. Regular (e.g., several times a day, for several weeks or more) or longer term use or abuse of opioids can lead to physical dependence and, in some cases, addiction. Physical dependence is a normal adaptation to chronic exposure to a drug and is not the same as addiction (see textbox, Dependence vs. Addiction). In either case, withdrawal symptoms may occur if drug use is suddenly reduced or stopped. These symptoms can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements.

Opioids and Brain Damage

While the relationship between opioid overdose and depressed respiration (slowed breathing) has been confirmed, researchers are also studying the long-term effects on brain function. Depressed respiration can affect the amount of oxygen that reaches the brain, a condition called hypoxia. Hypoxia can have short- and longterm psychological and neurological effects, including coma and permanent brain damage.

Researchers are also investigating the long-term effects of opioid addiction on the brain. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations.

This page was last updated November 2014