Opioids—including prescription medications like oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and codeine, as well as illegal drugs like heroin and synthetic opioids like fentanyl—are highly addictive. In 2021, nearly five times as many people died from prescription opioid overdoses compared to 1999, and these numbers continue to rise.
Many people don’t realize they’ve developed opioid use disorder until they try to stop and experience severe cravings or withdrawal symptoms. Others may be taking opioids exactly as prescribed by their doctor yet still develop physical dependence. This assessment provides an objective way to evaluate whether your opioid use has crossed into problematic territory.
Opioids work by attaching to receptors on nerve cells in your brain, spinal cord, and body to block pain signals. They also trigger the release of dopamine, a chemical that creates feelings of pleasure and euphoria. This combination of pain relief and intense good feelings is what makes opioids so effective medically—but also what makes them so addictive.
Your brain can interpret these euphoric feelings as something extremely important that needs to be repeated. Over time, your brain adapts to the presence of opioids, requiring more of the drug to achieve the same effects (tolerance) and needing the drug to function normally (dependence). When opioid use becomes compulsive and continues despite harmful consequences, it’s called opioid use disorder (OUD)—the clinical term for opioid addiction.
This screening tool evaluates your opioid use based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)—the standard used by healthcare professionals to diagnose opioid use disorder. The assessment examines:
Whether you're taking opioids as prescribed or have begun using them differently—taking higher doses, using more frequently, obtaining them from non-medical sources, or combining them with other substances.
Whether you experience intense desires or urges for opioids that are so strong you can't think of anything else, whether you've tried unsuccessfully to cut back or quit, or whether you spend significant time obtaining, using, or recovering from opioid use.
Whether opioid use has caused you to neglect major responsibilities at work, school, or home; damaged relationships; resulted in risky behavior; led to financial or legal problems; or caused physical or mental health issues.
Whether you need increasingly larger doses to feel the same effects, or whether you experience withdrawal symptoms—such as body aches, sweating, nausea, anxiety, or intense cravings—when you miss a dose or try to stop.
Understanding the warning signs can help you identify whether addiction has developed:
Drowsiness and confusion, constricted “pinpoint” pupils, slowed breathing, constipation, nausea, significant weight changes, poor coordination, and symptoms that feel like a bad flu when you haven’t taken opioids recently.
Taking medications in ways not prescribed (crushing pills, snorting, injecting), “doctor shopping” for multiple prescriptions, requesting early refills, obtaining opioids from friends or illegal sources, isolating from loved ones, neglecting hygiene and responsibilities, and engaging in risky behavior to obtain drugs.
Overwhelming cravings that dominate your thoughts, mood swings, increased anxiety or depression, irritability when unable to use, continued use despite knowing it’s causing harm, and denial about the severity of the problem.
Experiencing flu-like symptoms, body aches, sweating, chills, dilated pupils, rapid heartbeat, nausea, vomiting, diarrhea, insomnia, anxiety, and intense drug cravings when you stop or reduce opioid use.
Based on your responses, you’ll receive feedback about your level of concern:
You’re showing early warning signs of opioid use disorder. Now is the time to address the issue before it progresses. Discuss your opioid use with your healthcare provider and explore pain management alternatives.
You’re exhibiting clear signs of opioid use disorder that require professional intervention. Treatment at this stage can prevent progression to severe addiction and reduce the risk of overdose.
You’re experiencing significant opioid addiction. Immediate professional help is critical. Without treatment, you face serious health risks including overdose and death.
Opioid use disorder is a treatable medical condition. Effective treatment typically includes:
Medical Detoxification: Supervised withdrawal management where healthcare providers use medications to ease withdrawal symptoms and make the process safer and more comfortable. Never attempt to quit opioids “cold turkey” on your own.
Medication-Assisted Treatment (MAT): FDA-approved medications like methadone, buprenorphine (Suboxone), and naltrexone (Vivitrol) work by reducing cravings, blocking opioid effects, or easing withdrawal. These medications, combined with counseling, are the gold standard for opioid addiction treatment.
Behavioral Therapy: Individual and group counseling helps address underlying issues, develop coping strategies, identify triggers, and build relapse prevention skills.
Inpatient or Outpatient Rehabilitation: Comprehensive programs providing structured treatment in either residential (24/7 care) or outpatient settings (attend treatment while living at home).
Continuing Care: Long-term support through counseling, support groups like Narcotics Anonymous or SMART Recovery, and regular medical monitoring to prevent relapse and maintain recovery.
Opioid overdose can be fatal. Warning signs include severe drowsiness or inability to wake up, slowed or stopped breathing, blue lips or fingernails, cold and clammy skin, and choking sounds. If you suspect an overdose, call 911 immediately and administer naloxone (Narcan) if available. Naloxone can reverse opioid overdoses and save lives.
If your assessment indicates concern:
Call the SAMHSA National Helpline at 1-800-662-4357 (free, confidential, 24/7) for treatment referrals
Discuss your opioid use honestly with a healthcare provider
Research evidence-based treatment programs in your area
Keep this life-saving overdose reversal medication accessible
This assessment is a screening tool, not a medical diagnosis. Only qualified healthcare professionals can diagnose opioid use disorder. If you’re experiencing a medical emergency, call 911.
Recovery from opioid addiction is possible. Taking this assessment is a brave first step toward understanding your situation and getting the help you need to reclaim your life.
All calls are 100% free and confidential
