If you think someone is overdosing, call 911 immediately. Learn more about the signs of overdose.

Opioid Crisis 101

In Virginia and across the U.S., we are facing an opioid crisis. More Virginians die every year from overdoses than in automobile accidents; nationally, there is an overdose death every 20 minutes.

But there is hope, too: The crisis has inspired national action, from the grassroots to the government and places in between. In Virginia, we’re taking steps toward recovery. Since 2016, when the state health commissioner declared the Virginia opioid crisis a public health emergency, state agencies and community-based organizations have responded, offering lifesaving resources to all Virginians.

The journey away from opioid misuse starts one step at a time. Together, we can curb the crisis.

What Are Opioids?

Opioids are among medications that providers prescribe to reduce acute, severe pain and the pain that follows surgery. The illegal drug heroin is also an opioid. Because opioids can lead to temporary changes in mood, including feelings of euphoria, they can be misused. You can learn more about opioids, including information on common drugs like heroin and fentanyl, here.

With prolonged use, opioids’ pain-relieving effects may decrease and pain can become worse, leading some people to use more than prescribed.

When used correctly under a healthcare provider’s direction, prescription pain medicines can help. However, opioids are strong, and misusing them may lead to dependence and addiction. Even a single dose may be enough to cause serious health problems, or even death by overdose.

Opioid Use and Dependence

In addition to other side effects, opioids can cause dependence, meaning the body gets used to the medicine and slows its own production of endorphins — hormones produced by the body that provide a sense of well-being. The body starts to need the medication.

Side Effects of Opioids

Side effects may vary, but common side effects people have when using opioids are:

  • Constipation
  • Nausea and vomiting
  • Dry mouth
  • Sleepiness and dizziness
  • Confusion
  • Depression
  • Low levels of testosterone that can result in lower sex drive, energy, and strength
  • Itching and sweating


Signs That a Person Is Using Opioids

  • Spending time alone and avoiding family and friends
  • Losing interest in activities
  • Being overly tired or sad
  • Eating more or less than usual
  • Talking quickly and incoherently
  • Missing appointments
  • Missing work or school
  • Sleeping at odd hours
  • Having visible needle marks on the body (a sign of injection of opioids)
  • Having dilated pupils (the black centers of the eyes are very large)


Signs of an Overdose

Call 911 for immediate help if someone:

  • Is extremely pale or feels clammy to the touch
  • Goes limp
  • Has purple or blue fingernails or lips
  • Starts vomiting or making gurgling noises
  • Cannot be awakened or is unable to speak
  • Stops breathing or has a very slow heartbeat


Signs of Opioid Withdrawal

Someone in treatment or who stops taking opioids might experience withdrawal symptoms. Medications administered and monitored in a treatment setting, such as methadone, buprenorphine, Suboxone, or naltrexone, can help alleviate the symptoms of withdrawal and cravings. Withdrawal can be physically painful but is usually not life-threatening.

Early opioid withdrawal symptoms include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased lacrimation (eyes tearing up)
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Late withdrawal symptoms include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting


Overdose, and death by overdose, can occur when someone takes more than the prescribed amount of medication or uses illegal opioids like heroin. Treatment can help people who are at risk of overdose or who are dependent on drugs recover and regain control of their lives.

  • Virginia’s 40 locally operated Community Services Boards (CSBs) offer programs throughout the state to people with or without insurance. Find one near you here.
  • Inpatient treatment or community support programs that include medication-assisted treatment have been found to have impressive rates of success.
  • 12-step community support groups such as Narcotics Anonymous have helped many people.

How You Can Help

Find support in treatment and recovery.

Learn More

How Virginia Is Addressing the Opioid Crisis

Learn more about how Virginia is taking steps toward recovery.

Virginia’s Crisis Response