When it comes to pain relief, opioids are among the most effective drugs. However, while their pain-relieving effects are undeniable, it’s no secret that opioids expose users to numerous dangers. One of these is opioid toxicity, a dangerous condition that can affect even those who take their medication precisely as prescribed.
If you aren’t sure what opioid toxicity is or how it differs from an opioid overdose, keep reading.
This article will discuss the key things you should know about opioid toxicity, including its causes, symptoms, and prevention.
What Are Opioids?
Opioids are potent drugs prescribed to control moderate-to-severe pain, typically when non-opioid painkillers are ineffective or cannot be used.
Depending on their origin, opioids can be:
- Natural, i.e., extracted directly from the opium poppy plant
- Semi-synthetic, or produced in laboratories by synthesizing natural opioids
- Synthetic, meaning they are fully human-made and devoid of natural opioids
All opioids, regardless of their type, alleviate pain by interacting with opioid receptors, thereby interrupting the transmission of pain signals between the body and the brain. Besides pain relief, they can also induce feelings of euphoria and deep relaxation by stimulating dopamine release, which increases the risk of opioid abuse. Nearly 4% of Americans abuse opioids every year.
Opioids have a high potential not only for abuse but also for opioid dependence and addiction. Since these risks increase with extended use, opioid painkillers are not recommended for chronic pain management in most cases.
Closely following your doctor’s instructions can reduce the risk of opioid dependence, but it doesn’t eliminate it. Continuous exposure to these powerful drugs alters brain chemistry, which means anyone taking them can become dependent.
Some commonly prescribed opioids include:
- Fentanyl (Actiq®, Abstral®)
- Hydrocodone (Norco®, Vicodin®)
- Morphine (MS-Contin®, Kadian®)
- Oxycodone (OxyContin®, Percocet®)
- Hydromorphone (Exalgo®, Dilaudid®)
What Is Opioid Toxicity?
Opioid toxicity is a serious adverse reaction resulting from a build-up of opioid drugs in the bloodstream. It usually develops over time with repeated exposure to opioids and produces unwanted and harmful effects. Even those who take opioids precisely as instructed can fall prey to opioid toxicity.
For example, if you have liver or kidney problems, your body may struggle to effectively eliminate the drug, causing it to accumulate in your bloodstream. As a result, you may experience severe opioid side effects, such as difficulty breathing, despite carefully following your doctor’s instructions and taking the drug at recommended doses.
Opioid toxicity may produce body-wide adverse effects that can be both physical and psychological. The effects caused by opioid toxicity are typically dose-dependent but may vary between people due to differences in tolerance and other individual factors. The same dose can be therapeutic for one patient yet toxic for another.
Symptoms of Opioid Toxicity
The symptoms of opioid toxicity tend to be very similar to those of an opioid overdose, as these conditions are closely related.
The most common symptoms of opioid toxicity include:
- Seizures
- Confusion
- Drowsiness
- Slurred speech
- Abdominal pain
- Slowed heart rate
- Constricted pupils
- Nausea and vomiting
- Respiratory depression
- Decreased blood pressure
- Discolored skin, lips, and fingernails
In severe cases, opioid toxicity can lead to coma, organ injury, and other potentially life-threatening conditions. For this reason, you should not take it lightly; if you notice anyone displaying the signs of opioid poisoning, seek medical help immediately.
What Are the Main Causes of Opioid Toxicity?
The leading cause of opioid toxicity is an over-accumulation of opioids in the bloodstream.
Here are some factors that can make it more challenging for your body to break down opioids, putting you at an increased risk of opioid toxicity:
- Prolonged opioid use. Taking opioids regularly over an extended time can make you more susceptible to opioid toxicity, especially if you take them in high doses.
- Medical conditions. Certain health problems, such as liver damage, can affect how quickly your body clears out opioids.
- Age. Since metabolism tends to slow down with age, older people may be more likely to experience opioid toxicity.
Generally speaking, the quicker your body gets rid of the medication, the less likely you are to suffer from opioid toxicity. The drug formulation can also play a role here, as extended-release opioids are long-acting and often have a very long half-life. Therefore, they can stay in your bloodstream for days—and sometimes even weeks.
For example, the half-life of methadone ranges between 8 and 59 hours, which means it can stay in your system for up to 295 hours (or more than 12 days). As such, it is more likely to steadily build up in your bloodstream and lead to opioid toxicity than short-acting opioids that are eliminated within a day or two.
Opioid Toxicity vs. Opioid Overdose: What Are the Differences?
The terms “opioid toxicity” and “opioid overdose” are often used interchangeably, and while they are closely related, these conditions differ in terms of their onset. While an opioid overdose happens shortly after consuming an excessive amount of opioids, opioid toxicity develops gradually with prolonged use of the drug—even if you take it at recommended doses.
Prescription opioids can slowly build up in your system and eventually lead to harmful physical and psychological effects, even when taken as instructed. This is known as opioid toxicity.
Meanwhile, an opioid overdose typically happens much quicker. You might notice the first symptoms of an opioid overdose within minutes after your body is exposed to the drug.
Ultimately, though, both opioid toxicity and opioid overdose indicate opioid poisoning. While many opioid overdose cases involve other substances besides opioids, drug toxicity typically refers to the buildup of a particular type of drug (i.e., opioid toxicity describes the harmful accumulation of opioids specifically).
Both opioid toxicity and opioid overdose should be treated immediately to reduce the risk of long-term effects and death. Sadly, more than 78,000 Americans lost the battle against opioids and opioid addiction in 2022 alone.
Opioid Withdrawal Symptoms & Timeline
Opioid withdrawal symptoms are a set of physical and psychological symptoms that follow after the discontinuation of opioid medication. These symptoms are a sign of physical dependence on opioids. People who are dependent on opioid medications often continue to take them just to avoid going through the pain and discomfort of opioid withdrawal.
If you experience unwanted effects after taking opioids for some time, this may be a sign of opioid toxicity. Nonetheless, you should never quit opioids abruptly or without consulting your doctor.
Since repeated exposure to opioids changes brain chemistry and causes dependence, your body may no longer be able to function normally without taking them. Worse yet, abrupt drug discontinuation may induce severe opioid withdrawal symptoms, which can lead to potentially life-threatening complications and put you at an increased risk of relapse, overdose, and death.
Opioid withdrawal symptoms usually start within 12 hours after the last dose of immediate-release opioids. If you’ve been taking extended-release opioids, it may take 24 hours for the first withdrawal symptoms to show up.
The severity and duration of these symptoms depend on individual factors, such as the extent of your drug use and your metabolism. Though opioid withdrawal symptoms typically resolve within a couple of weeks, some people continue to suffer from them for months and even years.
The most common opioid withdrawal symptoms include:
- Anxiety
- Nausea
- Diarrhea
- Vomiting
- Depression
- Body aches
- Dilated pupils
- Opioid cravings
- Trouble sleeping
- Changes in blood pressure
- Flu-like symptoms (fever, watery eyes, etc.)
How to Prevent Opioid Toxicity
The most effective way to prevent opioid toxicity is to avoid opioid pain medications. If you are suffering from pain, discuss possible non-opioid treatment options with your doctor before initiating opioid therapy.
Here’s what you can do to reduce the risk of opioid toxicity and overdose if you have to take opioids:
- Take opioids responsibly. Carefully following your doctor’s instructions is critical to decreasing the risk of opioid toxicity. Also, remember to monitor your opioid intake to ensure you do not take an extra dose by accident, as this could lead to an overdose. If you miss a dose, skip it and take the next scheduled dose as usual.
- Do not share opioid medications. Never take opioids that have been prescribed for anyone else other than you. Likewise, do not share your medications with others and store them in a safe place that children or pets cannot access.
- Work closely with your doctor. Inform your doctor about any medications, supplements, etc., you’re taking to ensure they won’t interact with opioids. If you experience any opioid side effects or have any concerns regarding opioid use, discuss them with your doctor.
What to Do If You Experience Opioid Toxicity
If you experience opioid toxicity, seek medical help immediately. Even if you aren’t entirely sure whether you’re suffering from opioid poisoning,
There is a fine line between opioid toxicity and opioid overdose. Having an opioid buildup in your bloodstream can cause you to overdose, dangerously suppress your breathing, and lead to other life-threatening adverse events. Getting prompt medical attention is the only way to minimize these risks.
If you’ve been taking opioids long enough for them to accumulate in your system, chances are you may be struggling with opioid dependence. This condition is characterized by opioid tolerance and withdrawal symptoms.
If this sounds familiar, know it’s not your fault—it can happen to anyone who takes opioids for an extended time. No matter how long you’ve been taking opioids, seeking treatment for opioid toxicity and dependence can help you regain control over your life.
ANR Treatment for Opioid Dependence
Accelerated Neuro-Regulation (ANR) is an innovative opioid dependence treatment that has helped close to 25,000 people worldwide quit opioids in the past.
The ANR treatment stands out from traditional treatments because it tackles opioid dependence at its core rather than simply treating its symptoms.
By re-regulating the endorphin-receptor system, ANR restores your brain to its pre-addiction state. This way, it addresses the root cause of opioid dependence, eliminating the risk of ongoing withdrawal symptoms and relapse. As a result, ANR has a very high success rate.
While effectiveness is one of the greatest advantages of ANR treatment, it isn’t the only one. ANR treatment is also scientifically proven to be safe. Since we tailor it to each patient individually, it can be safely performed even on those with complex medical issues.
ANR is carried out in an ICU setting of accredited hospitals by highly experienced and compassionate critical care physicians, anesthesiologists, and other board-certified healthcare professionals. The procedure, which is performed under sedation, takes around 4–6 hours, whereas the average hospital stay for our patients lasts just 36 hours.
To learn more about ANR and start your recovery journey, contact us and book a free, 100% confidential consultation.
Key Takeaways
Opioid toxicity is one of the many risks anyone taking opioids faces, which is why it is best to avoid opioid medications altogether.
If you have no other option, always take your medication as prescribed and inform your doctor about any unwanted effects you’re experiencing to reduce the risk of opioid toxicity, overdose, and dependence.
Now, let’s go over the key points we covered today:
- Opioids are potent drugs with a high potential for abuse, dependence, and addiction, prescribed to ease moderate-to-severe pain that cannot be managed with weaker painkillers.
- Opioid toxicity is an adverse reaction caused by an over-accumulation of opioids in the bloodstream that can lead to organ damage, coma, and more if left untreated.
- The main difference between opioid toxicity and opioid overdose is that opioid toxicity usually develops over time. In contrast, an opioid overdose happens quickly after ingesting a large amount of opioids at once.
Additional Information
PTSD and Opioid Addiction: Risks, Prevention & Treatment
Opium Overdose: Risks, Side Effects & Prevention
Home Remedies for Opiate Withdrawal to Help Manage Your Symptoms