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It might start as legitimate pain relief — but when someone begins misusing opioids, the warning signals often hide in plain sight.
According to Brown University’s Recovery Center, key indicators of misuse include intense cravings, growing tolerance, declining performance at school or work, social withdrawal, mood swings, and persistent use despite trouble in personal relationships
Other red flags include taking opioids more frequently or at higher doses than prescribed, hoarding pills “just in case,” or prioritizing drug use over daily responsibilities. Mood changes — such as dramatic shifts from calm to irritable — as well as risky or secretive behavior, may also signal misuse. Physical signs can include pinpoint pupils, slurred speech, shallow breathing, nausea, and lethargy. In severe cases, confusion or unconsciousness may point to an overdose.
When you begin to notice troubling changes — like someone storing pills unnecessarily or showing increasing emotional instability — it’s time to take action. The University of Michigan recommends watching for signs such as using opioids to relieve boredom or stress, repeated failed attempts to quit, or continued use despite problems in school, work, or relationships. Start by having a calm, non-judgmental conversation and encouraging them to speak with a healthcare provider. Early support can be a turning point toward recovery.
Treatment for opioid use disorder often combines medication-assisted treatment (MAT), such as buprenorphine, methadone, or naltrexone, with behavioral therapies like cognitive behavioral therapy and family counseling. These approaches not only reduce cravings but also help rewire the thinking patterns that sustain addiction.
Despite the proven effectiveness of these methods, only about one in four people with opioid use disorder in the U.S. receive medication-based treatment. Early intervention increases the chance of long-term recovery, but stigma, lack of access, and denial can all delay help.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
