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 from automobile crashes; nationally, there is an overdose death every 5 minutes.

But there is hope, too: The crisis has inspired national action, from grassroots groups to states and the federal government. In Virginia, we’re taking steps toward recovery. Since 2016, when the state health commissioner declared the Virginia opioid crisis to be 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 medications prescribed to reduce acute pain and the pain that often 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. Learn more about opioids, including common drugs like heroin and fentanyl.

When used correctly under a health care provider’s direction, prescription opioids can help relieve pain. But their effectiveness may decrease with prolonged use, leading some people to use more than prescribed. Opioids are strong, and misusing them may lead to dependence and addiction. If taken incorrectly, 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 drug 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 drug.

Side Effects of Opioids

Side effects of opioid use may vary, but these are some of the most common:

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

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


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 may experience withdrawal symptoms. When  administered and monitored in a treatment setting, medications such as methadone, buprenorphine, Suboxone, or naltrexone can help alleviate cravings and the symptoms of withdrawal. Withdrawal can be physically painful but is usually not life-threatening.

Early symptoms of opioid withdrawal include:

  • Agitation
  • Anxiety
  • Increased tearing (secretion or shedding of tears)
  • Insomnia
  • Muscle aches
  • Runny nose
  • Sweating
  • Yawning

Later symptoms of withdrawal include:

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


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

  • Virginia’s 40 locally operated Community Services Boards (CSBs) offer treatment programs throughout the state to people with or without insurance. Find the CSB that serves your community.
  • Treatment and 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