Opioid use disorder (OUD) is defined as continued use of opioid substances outside of prescribed use by a doctor in spite of negative consequences associated with use. Any use of heroin or fentanyl, which are illicit substances, is considered opioid use disorder, and any nonprescription use of painkillers like Vicodin, OxyContin, and others is also seen as OUD.
Opioid Misuse By The Numbers
If you believe that your loved one may have anOUD, you are not alone. In 2019, more than 10 million people misused an opioid, according to the 2019 National Survey on Drug Use and Health (NSDUH). Visits to the emergency room due to opioid overdose increased by 30% in 2017 compared to the year prior, according to the Centers for Disease Control (CDC).
All death rates associated with opioids are on the rise. The CDC reports that deaths caused by all opioids have increased by 6%, driven mostly by the 15% increase in deaths caused by synthetic opioids that have offset the 7% and 6% decreases in prescription opioid and heroin-related deaths, respectively.
The good news is that there are a number of incredibly effective treatment options for OUD. With help, individuals with OUD can begin living a life that does not revolve around the use of substances.
Know the Signs
It’s important to identify the signs of opioid misuse as early as possible. Early identification leads to early treatment, which in turn cuts down on the risk of opioid overdose, accidents under the influence, and other risks associated with long-term addiction.
These are some signs that your loved one is under the influence of opioids:
- Drowsiness or “nodding out,” where the person is incapable of holding a conversation or maintaining focus
- Complaints of being tired when asked about this behavior
- Pinpoint pupils
- Loss of interest in normal activities, social withdrawal
- Mood swings
- Suspicious or avoidant behaviors
- Weight loss
- Financial problems
- Isolation from friends of family
- Flu like symptoms or frequent illness
Signs of Overdose
These are signs of an opioid overdose:
- Sedation or non responsiveness despite yelling their name or shaking them
- Slowed or stopped breathing
- Slowed or stopped heartbeat
- Bluish tinge to the skin and nails
- Vomiting and/or gurgling sounds
If you believe that your loved one is experiencing an opioid overdose, call 911 immediately and administer Narcan if available.
Naloxone & Narcan
Naloxone, sold under the brand name Narcan, is a medication that, when used correctly on someone who is experiencing an opioid overdose, can save lives.
It works by binding to the opioid receptors that have become overloaded by opioids and “kicking them off,” so they are no longer active.. This makes it an effective way to treat an opioid overdose 
Available in the form of a nasal spray, naloxone is easy for a friend or family member to administer to someone in crisis. Administering the drug takes just a few steps:
- Call 911 first!
- Open the package and remove the spray bottle
- Tilt the person’s head back and spray half the naloxone into one nostril and the other half into the other nostril.
- Start rescue breathing if needed.
- If there is no change within the first three to five minutes, administer another dose.
- If two doses cause no change, there may be another issue that requires treatment.
Friends and family members of people living with addiction are encouraged to always have at least two doses of naloxone on hand at all times. Naloxone is available over the counter at most drug stores without a prescription 
How to Talk to Your Loved One About Addiction
Talking to someone you love about their addiction can be tricky. It’s important to be kind and supportive but also to make it clear that things have to change going forward.
Here are a few tips:
- Choose your words carefully, and be kind.
- Avoid blaming them for their addiction. Say, “It’s time we get help,” rather than, “Since you have no willpower, you have to go to treatment.”
- Make your boundaries and expectations clear. Say something like, “Recovery is a necessity, and treatment is the only way to get there.”
- Listen to their concerns, fears, and responses even if they are blaming and hurtful.
The primary goal of talking to someone about their addiction is not to blame them for the results of their substance misuse. Make it clear that you love them and support them in getting the help they need to recover but that you will not support their continued misuse of substances. This can mean no longer providing financial support, covering for them at work or with other family members, bailing them out of jail, or giving them a place to live. It’s not an easy conversation, but it’s an essential first step to understanding that change is needed.
How to Take Care of Yourself While Your Loved One Is Struggling
Though it can be overwhelming and even exhausting to continually keep up with the emotional fallout and difficulties that arise due to a loved one’s opioid misuse, it is important to prioritize self-care.
This means making sure that you are eating healthfully, getting good sleep, exercising regularly, and most importantly, staying in contact with people who can help you to keep everything in perspective and get help for yourself and your loved one. Many support groups exist for family members of those with OUD.
Understand Best Treatment Options for OUD
The best treatment options for someone living with an OUD will almost always include a combination of the following:
- Medication, like Suboxone, to support ongoing recovery
- One-on-one therapy that helps them to address issues that may have led to opioid misuse in the first place
- Medical treatment for chronic pain if pain itself is one of the drivers for the opioid misuse
- Family therapy
- Group therapy that provides new social support away from people who are still using drugs
Support Groups for Family & Friends
- Al-Anon: This 12-step-based group is a good place to find other people who have family members living with substance use disorders or who are in recovery. Alateen is an offshoot organization designed to support teenagers.
- Nar-Anon: This 12-step-based group is less available than Al-Anon, but its focus is on the use of other substances in loved ones struggling with opioid use disorder. It may be more helpful in terms of providing actionable resources specific to opioid addiction.
- SMART Recovery Family & Friends: This is a secular support group that focuses on science to support its members as they cope with a loved one’s SUD.
Opioid Addiction FAQs
How does OUD affect families?
OUD can destroy families, damage relationships, finances, and overall quality of life. However, comprehensive treatment can help to mend relationships and build families back stronger. There is always hope for families in recovery.
How do you cope when a loved one has an addiction?
If your loved one is dealing with addiction, you need support as much as they do. Do not shy away from asking for help from a therapist, primary care physician, or support group. You can’t effectively help your loved one if you don’t take care of yourself.
What is the best treatment for OUD?
The best treatment for OUD will address the physical as well as the psychological nature of addiction and any underlying mental health or medical disorders. Medication for Addiction Treatment (MAT) is the recommended approach for opioid use disorders. Suboxone is the preferred medication due to its effectiveness and abuse-deterrent qualities.
By: Elena Hill, MD, MPH
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- Words Matter – Terms to Use and Avoid When Talking About Addiction. National Institute on Drug Abuse. https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/words-matter-terms-to-use-avoid-when-talking-about-addiction. November 2021. Accessed April 2022.
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