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What Are the Long-Term Effects of Opioids?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 13, 2023 • 11 cited sources

The long-term effects of opioids include substantial effects on the gastrointestinal, immune, endocrine, respiratory, neural and cardiovascular systems.[1]

Opioids can help ease pain caused by a broken bone, torn muscle or invasive surgery. But these prescription painkillers work best when used for a short period. Take them for weeks, months or even years, and you could develop some of these serious physical and mental health issues. 

Opioid use disorder, characterized by compulsive drug use, is among the most serious consequences of long-term opioid use. But other issues, including drug tolerance, physical dependence and an increased risk of cancer, could also start with long-term use. 

Opioids & Your Mind & Body

Opioids are powerful substances that attach directly to receptors scattered throughout your brain. While you may notice the drug’s impact on the way you think and feel, the substances can change almost every major system within the human body.

The following three issues are common in people who use opioids long term.

Tolerance

Brain cells with opioid receptors gradually become less responsive.[2] A dose that once delivered intense intoxication now seems to do much less. 

Drug tolerance like this is incredibly dangerous, as it could lead you to take more and more of the same drug. In time, you could take enough to trigger an overdose, which could be fatal. 

Tolerance can also lead you to move from a painkiller like Vicodin to a stronger drug like heroin. Buying drugs from dealers can expose you to contaminants, and in some cases, it can lead to overdose. Drugs spiked with substances like fentanyl are incredibly strong and can cause death in minutes. 

Physical Dependence 

With repeated use, your brain and body become accustomed to the constant presence of opioids. In time, you won’t feel healthy without them. 

Physical dependence like this can lead to significant withdrawal symptoms when you stop taking drugs.[3] Those symptoms can include the following:

  • Nausea
  • Vomiting
  • Aching muscles 
  • Watering eyes
  • Diarrhea

Researchers say physical dependence can occur within about five days of taking some types of opioids.[4] The stronger your dose, the quicker dependence symptoms can appear. 

Opioid Use Disorder

Addiction, also known as opioid use disorder (OUD), involves compulsive use of drugs. Researchers say up to one person in four with long-term opioid use develops OUD symptoms.[5]

OUD causes significant physical and mental suffering. As drugs move to the center of your life, you have little time to maintain relationships, build a career or nurture your talent. Instead, you’re focused on obtaining drugs, using them or recovering from a binge. If left untreated, OUDs are life-threatening. 

What Are the Long-Term Effects of Opioid Use?

Quitting opioids isn’t easy, but continued use leads to significant health issues. Overdose is the most serious consequence. 

As opioid tolerance deepens, you take more and more of your opioid drug. Soon, you take so much that your body’s central nervous system is overwhelmed. Your breathing rate slows and stops, as does your heart. Without immediate medical attention, an overdose can be fatal. 

Many drugs can cause overdose, but opioids are closely associated with this issue. In 2020, almost 75% of drug overdose deaths involved opioids.[6] 

Long-term opioid use is also closely associated with the following health issues:[1]

  • Bowel dysfunction
  • Broken bones
  • Heart damage
  • Infections
  • Sleep disorders

Researchers say people who use opioids over the long term are at higher risk of dying from any cause than people who use over-the-counter painkillers.[7] The longer you keep opioids in your system, the more damage they can do. 

Signs & Symptoms of Opioid Use Disorder

People with OUD lose control over how often they use opioids and how much they take. This is a serious condition, but it’s treatable. 

Doctors look for the following signs when diagnosing OUD:[8]

  • Using more opioids than your doctor recommends
  • Failed attempts to quit or cut back on opioid use
  • Spending a lot of time getting, using or recovering from opioid use
  • Drug cravings
  • Use that impedes your ability to fulfill obligations
  • Continued use despite social problems 
  • Giving up social, occupational or recreational activities to use drugs 
  • Using drugs in dangerous situations 
  • Continued use despite the knowledge that it’s hurting you 
  • Opioid tolerance

The more symptoms you have experienced in the past year, the more significant your OUD. 

In treatment programs, doctors use medications like Suboxone to ease your brain cells into sobriety.[9] Your medications won’t make you high, but they will help to ease uncomfortable withdrawal symptoms and drug cravings.

Therapy helps you understand why you started misusing drugs and how the use habits are harming your life. Therapy can help you build sobriety skills, so you’re less likely to return to harmful drug use.[10] 
Medication for Addiction Treatment (MAT) programs combine therapy and prescription medication, offering a comprehensive approach to OUD.[11] Enrolling in programs like this can help you build a sober life and avoid the severe consequences associated with long-term opioid misuse.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Less Well-Known Consequences of Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review. Drug Design, Development and Therapyhttps://www.dovepress.com/less-well-known-consequences-of-the-long-term-use-of-opioid-analgesics-peer-reviewed-fulltext-article-DDDT. January 2022. Accessed March 2023.
  2. The Neurobiology of Opioid Dependence: Implications for Treatment. Addiction Science and Clinical Practicehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/. July 2002. Accessed March 2023.
  3. FDA Identifies Harm Reported from Sudden Discontinuation of Opioid Pain Medicines and Requires Label Changes to Guide Prescribers on Gradual, Individualized Tapering. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes. April 2019. Accessed March 2023.
  4. Opioid Dependence Can Happen After Just 5 Days. Truth Initiative. https://truthinitiative.org/research-resources/substance-use/opioid-dependence-can-happen-after-just-5-days. October 2018. Accessed March 2023.
  5. Patients' Frequently Asked Questions. Centers for Disease Control and Prevention. https://www.cdc.gov/opioids/patients/faq.html. November 2022. Accessed March 2023.
  6. Opioid Use Disorder. American Psychiatric Association. https://www.psychiatry.org/patients-families/opioid-use-disorder. December 2022. Accessed March 2023.
  7. Long-Term Harms of Opioids. Royal College of Anaesthetists. https://fpm.ac.uk/opioids-aware-clinical-use-opioids/long-term-harms-opioids. Accessed March 2023.
  8. HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. U.S. Department of Health and Human Services. https://www.cms.gov/About-CMS/Story-Page/CDCs-Tapering-Guidance.pdf. October 2019. Accessed March 2023.
  9. The Effectiveness of Medication-Based Treatment for Opioid Use Disorder. Medications for Opioid Use Disorder Save Liveshttps://www.ncbi.nlm.nih.gov/books/NBK541393/. March 2019. Accessed March 2023.
  10. Relapse Prevention and the Five Rules of Recovery. Yale Journal of Biology and Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/. September 2015. Accessed March 2023.
  11. Effects of Medication Assisted Treatment (MAT) for Opioid Use Disorder on Functional Outcomes: A Systematic Review. Rand Health Quarterly. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302321/. June 2020. Accessed March 2023.

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