Long-Term Health Effects of Opioid Use & Addiction

Opioids include both prescription painkillers and the illicit drug heroin. 1 Fentanyl, a powerful prescription drug used for severe chronic pain that is now commonly produced and used illegally, is another opioid.2 Widespread opioid abuse has driven the opioid epidemic, which has caused more than a quarter-million drug overdoses in the U.S. in the past 20 years.3 However, while overdoses understandably attract a lot of media attention, there are many other negative health effects of long-term opioid use or abuse. We’ll discuss some of them in this article.

How Do Opioids Work?

Opioids work by activating opioid receptors throughout the body.1 When opioids bind to and activate certain types of opioid receptors, they:1

  • Reduce pain and discomfort by modifying the perception of pain signals that reach the brain
  • Cause an accompanying release of dopamine, an important neurotransmitter associated with reinforcing certain types of behavior. These pleasurable or rewarding feelings can strengthen the desire to use opioids repeatedly.

People may engage in illicit or high-dose opioid misuse to elicit feelings of euphoria, otherwise known as a high. Opioids’ pain blocking and reinforcing, pleasurable effects make these drugs very addictive.1

What Are the Long-Term Effects of Opioid Use?

Certain adverse health effects may be associated with chronic opioid use or abuse. Studies on long-term opioid treatment have indicated several associated risks, including the potential for harm in various organ systems throughout the body.4

GI System

Long-term opioid use can lead to GI problems like recurrent or chronic constipation, a widely recognized, very common, and unwanted side effect of opioids.4

Studies have shown that up to 45% of people taking opioids therapeutically report experiencing constipation, with some having constipation so severe that they need to reduce their dosage or stop using opioids. In serious cases, bowel obstruction can result, a potentially fatal complication that may require hospitalization.4

Other opioid-related GI complaints include nausea, vomiting, stomach cramps, and bloating. Opioid users who have GI symptoms tend to have many more ER visits, hospital admissions, and longer hospital stays than those without GI symptoms.4

The GI symptoms associated with opioid use also seem to have a mental health impact on users. Chronic constipation has been shown to increase an opioid user’s risk of psychological distress and depression.4

Opioid Abuse and the Respiratory System

Opioids can cause several respiratory problems, including slowed or irregular breathing; in overdose, they can lead to dangerously slowed breathing or complete respiratory arrest. The lack of adequate oxygen to the brain resulting from an opioid overdose can lead to coma, brain damage, or death.1,4

Cardiovascular System

Your cardiovascular system could also be negatively affected by long-term opioid use. One study published in the American Heart Association journal Circulation found that opioid use is a risk factor for heart rhythm abnormalities such as atrial fibrillation, a condition that can lead to serious adverse cardiac events, such as stroke, heart failure, and death.5,6

Research has also shown a potential connection between prescription opioid use and an increased risk of coronary heart disease and cardiovascular disease in women.7

Among injection opioid users, bloodborne bacterial infections that result from unsanitary intravenous needle use can lead to endocarditis, an infection of the inner lining of the heart that can be fatal when left untreated.8,9

Reproductive Health

Long-term opioid use may negatively impact the reproductive systems of both men and women. Some studies show that for women, opioid use may be associated with decreased fertility as well as an increased risk of pregnancy loss and other pregnancy complications such as placental abruption, and preterm birth.11

For men, long-term opioid use may affect testosterone production and decrease the quality and quantity of the sperm.12

Babies born to mothers who use opioids during pregnancy may suffer from neonatal abstinence syndrome (opioid withdrawal after birth). They are also at risk of having longer post-birth hospital stays, being re-hospitalized within the first month of life, being born with birth defects, and having developmental delays.13

Falls and Fractures

Opioid use may contribute to the risk of fracture in the elderly. A study comparing older adults with arthritis who managed pain with opioids to those who managed pain with NSAIDs (e.g., ibuprofen) found that those who used opioids—especially short-acting opioids such as codeine and hydrocodone—had an increased risk of fractures as compared to the NSAID-using group. Higher opioid doses are associated with higher fracture risk.14

The negative impact that opioids can have on sensory-motor and cognitive function in the elderly can make falls more likely in these individuals.14,15 With the increased likelihood of fracture, a fall can be very dangerous in an older adult taking opioids, particularly if they are taking them in high doses.15

Opioid Abuse and HIV or Other Infectious Diseases

Certain types of opioid use can raise the risk of infectious diseases such as the human immunodeficiency virus (HIV) and viral hepatitis. Injection opioid users are considered high-risk for these diseases because these infections are easily spread by the sharing of contaminated needles and other tools used for injection.8

Some non-injection opioid users may still be at risk of transmitting infectious diseases through unsafe sex practices.16

Getting Help for Opioid Addiction

Old and new habitsProblematic use of any type of opioid, legal or illegal, is linked to a high risk for opioid addiction. While opioid addiction is a chronic disorder, it is a treatable one.17 With proper treatment, people recover from addiction and start living happier, healthier, and drug-free lives.

Opioid addiction treatment can take many forms but often begins with some form of detox.18 Because withdrawal from opioids can intensely unpleasant, many people detox from opioids with medical support in a professional treatment program.19

It is important to continue in your recovery efforts after detox, even if you’re feeling better physically and motivated to stay sober. Detox alone is rarely able to fully address a range of contributing issues (behavioral, social, and psychological) often associated with addiction.18 You’ll need to learn new methods of coping without opioids, begin acquiring healthy habits, and develop the life skills you’ll need to get and stay in recovery.

AdCare programs in Rhode Island and Massachusetts offer both inpatient and outpatient programs for those struggling with opioid addiction. Don’t put off your health, happiness, and wellness any longer—reach out for help today and start the path to recovery.