Narcotic Use Disorder

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

What is narcotic use disorder (NUD)?

NUD is a medical condition that develops from long-term use or misuse of a narcotic. You are not able to stop taking the narcotic even though it causes physical or social problems. NUD may be use of a narcotic such as heroin or misuse of a prescription narcotic such as fentanyl. This disorder is also called narcotic abuse.

What are the signs and symptoms of NUD?

Signs and symptoms of NUD include at least 2 of the following in a 12-month period:

You take a narcotic in a way it was not intended. This is also called misuse. Examples of misuse include taking more than prescribed or taking it longer than recommended. Another example is taking it for a different reason than prescribed. Your prescription may be for pain relief, but you take it because it makes you feel good. Misuse can also mean you take the narcotic even though you do not have a prescription for it.
You have a strong urge or craving for the narcotic. This is also called addiction. You spend large amounts of time trying to get, take, or recover from the narcotic. You also spend time thinking about when you can take the narcotic again.
You become dependent on the narcotic. Dependence means your body becomes used to the narcotic. You have withdrawal symptoms when you do not take the narcotic for a short amount of time. You have to take it to stop or prevent withdrawal symptoms, such as shaky hands.
You become tolerant to the narcotic. Tolerance means you continue to need higher amounts to feel the effects you want.
You are not able to stop, or to take less. You start it again when you try to quit. You try to lower the amount or increase time without it, but you are not able.
You continue to take the narcotic even though it causes problems or is dangerous. For example, you drive even though the narcotic makes you drowsy. You try to make the effect stronger by mixing the narcotic with alcohol, medicines, or drugs. You have problems at school, work, or home. You spend less time doing important or enjoyable activities.

How is NUD diagnosed and treated?

Your healthcare provider will ask about the amount and type of narcotics you had over the last 12 months. Your blood or urine may be used to check the level of narcotic in your system. Your provider can help you make decisions about treatment. Treatment may be offered in a hospital, outpatient facility, or treatment center.

Detoxification (detox) means healthcare providers will slowly decrease the amount of the narcotic. Another narcotic medicine, such as methadone, may be given to help decrease symptoms of withdrawal.
Therapy may include work with a psychiatrist, psychologist, or therapist. Therapy can happen in group or individual sessions. Some therapy may include family members. Your healthcare provider or therapist may be able to help you find a support group in your area. A support group is a way to get help from others who have NUD.

What do I need to know about narcotic safety?

Do not suddenly stop the narcotic. A sudden stop may cause dangerous side effects. Work with your healthcare provider to decrease the amount slowly.
Do not take prescription narcotics that belong to someone else. The kind or amount may not be right for you.
Do not mix narcotics with other medicines, drugs, or alcohol. The combination can cause poisoning, or cause you to stop breathing. Alcohol, sleeping pills, and medicines such as antihistamines can make you sleepy. A combination with narcotics can lead to a coma.
Learn about the signs of poisoning. Examples include slow breathing, pale or cold skin, and small pupils. Tell others about these signs so they will get help for you if needed. Talk to your healthcare provider about naloxone. You may be able to keep naloxone at home in case of poisoning. Your family and friends can also be trained on how to give it to you if needed.
Take prescribed narcotics exactly as directed. Do not take more than the recommended amount. Do not take it more often than recommended or for a different reason. Be sure to remove an old patch before you place a new one. Make sure the patch is not exposed to sunlight. Sunlight speeds up the narcotic release from the patch.
Keep narcotics out of the reach of children. Store narcotics in a locked cabinet or in a location that children cannot get to.
Follow instructions for what to do with leftover prescription narcotics. Your healthcare provider will give you instructions for how to dispose of it safely. This helps make sure no one else gets to it.

Where can I go for support and more information?

Substance Abuse and Mental Health Services Administration (SAMHSA)
PO Box 2345
Rockville , MD 20847-2345
Web Address: http://www.samhsa.gov or https://dpt2.samhsa.gov/treatment/

National Institute on Drug Abuse
6001 Executive Boulevard, Room 5213
Bethesda , MD 20892-9561
Phone: 1- 301 - 443-1124
Web Address: www.nida.nih.gov

Call your local emergency number (911 in the US) or have someone call if:

You have chest pain or trouble breathing.
You have a seizure.
You cannot be woken.

When should I seek immediate care?

You have trouble staying awake and your breathing is slow or shallow.
You have a fast, slow, or irregular heartbeat.
You have pale or cold skin.
You feel lightheaded or faint.
Your speech is slurred, or you are confused.

When should I call my doctor?

You have nausea and are vomiting, or you cannot stop vomiting.
You have balance problems.
You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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