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Signs of Active Opioid Intoxication Constricted, pinpoint pupils that do not respond normally to light Profound drowsiness, nodding off mid-sentence, or inability to stay awake Slurred speech, slowed movements, and impaired coordination Flushed or itchy skin from histamine release triggered by opioid use Nausea, vomiting, and severe constipation Slowed, shallow, or irregular breathing Signs of Developing Opioid Dependence Increasing the dose to achieve the same effect that a lower dose previously produced (tolerance) Appearing physically unwell, agitated, or sick between doses, specifically during periods of withdrawal Unexplained weight loss or visible signs of nutritional neglect Track marks, bruising, or skin infections at injection sites in people using intravenously Poor personal hygiene and declining attention to physical appearance Frequent runny nose or nasal damage in people snorting crushed pills or powder Fentanyl addiction carries unique physical risks because of its extreme potency