What is a sign of physical dependence on opioids?

The occurrence of abstinence syndrome is a primary sign of physical dependence on opioids. When a person who has been using opioids regularly suddenly reduces their dose or stops taking the drug, their body responds negatively due to the absence of the substance it has come to rely on. This withdrawal manifests as a collection of physical and psychological symptoms, collectively referred to as abstinence syndrome. These symptoms can include nausea, sweating, agitation, muscle aches, and insomnia, among others.

In contrast, an increase in energy levels, decreased tolerance to opioids, or an improved mood are not indicators of physical dependence. Increased energy levels can occur for a variety of reasons unrelated to opioid dependence, and they do not indicate reliance on the drug. Decreased tolerance would suggest that the body is less adapted to the drug's effects, which is the opposite of what one would expect with physical dependence, as tolerance typically increases—the body requires higher doses to achieve the same effect over time. Improved mood might occur during treatment but does not reflect physical dependence and might be attributed to other factors, such as effective pain management or the euphoric effects of opioids.