Narcotic Side Effects

Author: Angela Doel

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Narcotics, also known as opioids, are natural, semi-synthetic and synthetic substances that act on the central nervous system to reduce pain. These substances work by binding to opioid receptors in the brain, blocking the transmission of pain signals and producing feelings of euphoria and sedation.

In this Article:

• What are Opioids and How Do They Differ in Potency?
• What Are Narcotic Side Effects?
• What are Narcotic Withdrawal Symptoms?
• What are the Signs of Overdose Risk?
• Do Certain Narcotics Have Less Dangerous Side Effects Than Others?
• How Does Opioid Addiction Develop?
• How Can I Avoid Misusing Opioids?

What Does Controlled Substances Mean?

Narcotics/opioids are controlled substances that the government classifies from Schedule I to Schedule V based on their potential for abuse, addiction and medical use.

Most opioids, except heroin, are considered Schedule II narcotics. Examples include oxycodone and hydrocodone. They are used to relieve acute, surgical and chronic pain. When used correctly and under the supervision of a healthcare provider, these medications can be an integral part of a pain management plan.

Fentanyl is another example of a Schedule II narcotic. It is 50-100 times stronger than morphine and is often used to treat severe pain and in surgical anesthesia. While pharmaceutically produced fentanyl is legal, in recent years, the production of illicit fentanyl has surged. Illicit fentanyl is more dangerous than other illegal narcotics because producers frequently mix it with other substances such as heroin, cocaine, xylazine and MDMA. Even more concerning is that producers will commonly press the illegal substance into fake pills designed to look like legitimate prescription medications such as oxycodone, xanax or adderall.

What Are Narcotic Side Effects?

Common side effects of narcotics include:

Constricted pupils are a common side effect of narcotic abuse.

• Drowsiness, inability to concentrate or confusion
• Apathy
• Nausea, vomiting and constipation
• Euphoria
• Flushing of the face and neck
• Pupil constriction
• Respiratory depression

Misusing narcotics increases the risk of experiencing unpleasant and potentially dangerous or life-threatening side effects.⁴ As the dose increases, the potential of experiencing harmful effects also increases. Some of these preparations are so potent that a single dose can be life-threatening.

What are Narcotic Withdrawal Symptoms?

Chronic use can lead to physical dependence on narcotics. This means that your body has become accustomed to the drug and needs it to function normally.  When dependent, withdrawal takes place when you stop taking it. The type and intensity of the physical symptoms you experience during withdrawal depend on the drug used, the daily dose, the interval between doses, the duration of use and your physical and behavioral medical history. These symptoms usually appear within hours of the last dose.

People who become dependent on opioid medication and stop using it can experience unpleasant withdrawal symptoms. These symptoms include:⁴

• Muscle and bone pain
• Diarrhea and vomiting
• Sleep problems
• Cold flashes with goosebumps
• Sweating
• Uncontrollable leg movements
• Severe cravings
• Runny nose, watery eyes
• Yawning
• Anxiety and agitation

These symptoms can be extremely uncomfortable and are the reason many people find it difficult to stop using opioids.⁴ 

To help manage withdrawal symptoms and support recovery, the FDA has approved several medications to make the detox process easier and safer. These medications include buprenophine, naltrexone and methadone.

The FDA has also approved the sale of a device, NSS-2 Bridge, that can help ease withdrawal symptoms.⁴ The NSS-2 Bridge is a small electrical device placed behind the person’s ear that can be used for up to five days during the acute withdrawal phase.³

Long Term Effects of Narcotics Abuse

Long term use and abuse of narcotics can have a number of consequences for the health and well-being of users.

What are the Signs of Overdose Risk?

Narcotics contribute to the majority of overdose deaths in America. According to the Centers for Disease Control, provisional data for 2025 indicated that narcotics were involved in nearly 66.2% of all overdose deaths.  While the number of overdose deaths has declined since 2023, every day, over 140 people will lose their lives to a drug overdose in America.

The three main symptoms that identify a narcotic overdose, known as the “opioid triad,” are:⁶

• Unconsciousness
• Respiratory depression
• Pinpoint dilated pupils

Additional signs and symptoms of an opioid overdose include:⁷

• Unresponsiveness
• Inability to speak
• Limp body
• Pale or clammy face
• Blue lips, fingernails and skin
• Bluish purple skin tone (for lighter-skinned people) or grayish or ashen skin tone (for darker-skinned people)
• Slow and shallow or irregular/discontinued breathing
• Slow, erratic or nonexistent pulse
• Choking sounds or a snore-like gurgling noise
• Vomiting

Do Certain Narcotics Have Less Dangerous Side Effects Than Others?

While narcotics carry different levels of potency, they all carry the risk of harmful side effects. Even so-called “weak” opioids can have the same harmful effects as morphine.⁸

Examples of “weak” narcotics include codeine or tramadol, which are used to treat mild to moderate pain and cough. Although they are considered weaker than other opioids such as hydrocodone or morphine, they can potentially cause respiratory depression, even at low doses.

When it comes to the risk of narcotic addiction, there is no evidence that, at equivalent strength, weak narcotics carry a lower risk of addiction than other opioids, such as low-dose morphine.⁸

How Does Opioid Addiction Develop?

Opioids work by binding to receptors in the brain and body that are involved in feelings of pain and pleasure. When binding to these receptors, they block pain signals and release dopamine, a neurotransmitter that produces a pleasurable feeling. This dopamine release can strongly reinforce the act of taking the drug, making you want to repeat the experience.⁴

Long-term use of prescription narcotics, even as prescribed by a doctor, can cause some people to develop a tolerance to the drug, which means they need higher or more frequent doses of the drug to get the desired effects.⁴ Going without the drug causes several physiological effects, from mild to potentially life-threatening.

If you are dependent on opioids, you will require medical support to help you safely stop taking the drug.⁴ Research shows that the most effective treatment for opioid use disorder involves the use of medication-assisted treatment with behavioral therapy.¹⁰

How Can I Avoid Misusing Opioids?

If you are prescribed an opioid drug, you should use it only as long as you need it and only when you are feeling pain. Dependence can develop in a matter of weeks with regular use.

People misuse opioids by:⁴

• Taking medicine in a way or dose other than your doctor prescribed
• Using another person’s prescription medicine
• Taking medicine for the “high” or pleasurable effects it causes

There are several steps you can take to help prevent opioid misuse and dependency:⁴

• Never take more than the prescribed dose and always follow the prescribed directions exactly. If you miss a dose, do not take a double dose to catch up.
• Do not combine opioids with alcohol.
• Do not combine opioids with other medications or drugs without your doctor’s approval.
• Stop taking opioid medications as soon as your doctor agrees they are no longer needed.
• Always follow the prescribed directions.
• When taking liquid doses, use an accurate measuring device and measure out only the prescribed amount.
• Use the medication only in the form in which it was prescribed.
• Never use another person’s prescription or share your prescription with others.
• Do not drive a car or operate heavy machinery while using the medication.

Treatment specialists can help you address the effects of narcotics misuse. Inpatient detoxification services can help you safely navigate withdrawal symptoms and get you on the path toward long-term recovery .

Call (phone) to speak with a treatment specialist about options available to you.

References

1. Department of Justice Drug Enforcement Administration (2020). Narcotics.
2. S. National Library of Medicine. (2021, July 2). Pain medications – narcotics.
3. National Institute on Drug Abuse. (2021). Fentanyl DrugFacts.
4. National Institute on Drug Abuse. (2021). Prescription opioids drugfacts.
5. National Institute on Drug Abuse. (2011, March 11). Opioid overdose crisis.
6. Centers for Disease Control and Prevention. (2016). Poison Center & Public Health Collaborations Community of Practice Newsletter.
7. National Harm Reduction Coalition. (2020, September 1). Training Guide: Opioid overdose basics. Recognizing opioid overdose.
8. National Library of Medicine. (2016, February 25). “Weak” opioid analgesics. Codeine, dihydrocodeine and tramadol: no less risky than morphine. Prescrire International, (168), 45-50.
9. Barnett M. (2001). Alternative opioids to morphine in palliative care: a review of current practice and evidence. Postgraduate Medical Journal, (77), 371-378.
10. Centers for Disease Control and Prevention. (2020, August 12). RX Awareness.

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