why do opiates make you itch

why do opiates make you itch

It’s a normal day at work, a customer brought in a Chevy 1500 saying something felt off in the drive shaft. You have it up on the lift and are trying to diagnose the problem when you hear a loud crack and your coworkers shouting. The lift shifts to the left and all you remember seeing is the truck heading toward your face.

You wake up in the hospital, feeling like you’ve been hit by a bus. When you tell this to the nurse, she chuckles and says “You are close. The truck you were working on shifted and you took quite a hit to your chest.” That explains why it hurts to breathe. But you feel yourself itching, not just a little but a lot. You question the nurse why you feel so itchy, and she informs you it could be a side effect of the pain medication you are on. Thinking back, you really have never been hurt seriously enough to need heavy-duty pain medication before, so it’s no wonder you are reacting to it.

In 2022, Tennessee’s opioid dispensing rate was 61.5 per 100 residents. At ReVIDA® Recovery, we understand how daunting it can feel to become dependent on a medication a doctor prescribed. Our program is flexible, and can adapt to many work schedules so you don’t have to worry about taking time off. For those wanting to learn more about substance use and recovery, our blog serves as a free resource to provide education. Today, we are looking into why opiates make you itch, and what can be done about it.

What Are Opiates?

You may have heard of opioids, but maybe not heard of opiates. Essentially, both are the same class of substance. All opioids are derived from the opium poppy plant. Opiates are considered natural as they still contain plant properties. Common opiates include morphine, codeine, and opium. Opioids are partially or fully synthesized, meaning they contain little to no plant properties. Fentanyl is a prime example of an opioid. The term opioid can be used to describe opiates, but not the other way around.

Does Opiate Use Cause Itching?

Whether for medical or recreational use, one of the side effects of opiate use is itching. This is because opiates cause blood vessels to dilate. The skin around the face, neck, and chest may flush. Because of these changes, the body releases histamine, triggering sweating and itching. In some cases, this can be caused by an allergic reaction. However, many people experience itching and are not allergic to opiates.

Some studies have found that opiate withdrawal can trigger the histamine response. It was reported that within 24 hours of sudden morphine withdrawal, bouts of scratching were noticed in patients. The spinal c-Fos positive cells that trigger this response were also increased significantly. The study concluded that sudden morphine withdrawal causes the body to go into a stressed state, and itching was seen as histamine-induced.

Opiate-Induced Pruritus: Is it Dangerous?

Pruritus is the medical term for itching. Opiates affect the brain directly, attaching to opioid receptors. These receptors cause a disturbance in the central nervous system and how certain nerves react. Opiates cause the spinal itch nerve to activate, triggering opiate-induced pruritus. The condition is not permanent and will stop as the medication leaves the system.

Pruritus is not localized to one part of the body, although some may experience it that way. Common areas where itching occurs include the scalp and arms. However, itching can occur anywhere on the body and can range in frequency in each spot. One day your leg may feel the most itchy while another day your arm is. Overall, every person is different and will experience opiate-induced pruritus differently.

opiate use and skin itching reactions

How do I Know I Have Opiate-Induced Itching?

If you have recently been prescribed an opiate medication, you may notice you are more itchy than normal. Talk to your doctor to see what can be done or if you need to switch medications. If breathing problems ever accompany itching, seek medical attention immediately as you may be allergic to the opiate.

Those who use substances recreationally are prone to opiate-induced itching. Those who use opiates illicitly are commonly injecting them. These wounds can become infected, increasing itching. The problem is that itching wounds often opens them back up, making it more difficult for them to heal. Paired with a weakened immune system, these wounds can become toxic quickly, and cause life-threatening infections.

Some substances don’t necessarily cause itching. Cocaine, ecstasy, and other substances aren’t associated with itching, but they can be mixed with opiates. Drug dealers will cut their substances to make them last longer and to enhance the effects of the substance. Illicit substances are also not regulated, so the dealer doesn’t have to tell you what is in the substance you are purchasing. If you notice yourself itching and don’t normally buy opiates, your substance may have been cut with one.

Can I Prevent Opiate-Induced Itching?

The best way to prevent opiate-induced itching is to avoid taking them. Those who use illicit substances may find it helpful to seek treatment to discontinue their use. Opiates do cause withdrawal symptoms, and entering treatment will ensure detox is done safely and comfortably.

Those who have chronic pain and need medication to help manage it should discuss with their care team what to do if opiates are causing disrupting itching. There are many medications available to treat pain, and depending on the severity, there may be alternatives. However, there are no specific medications to treat itching specifically. Some have had success with pairing antihistamines with opiates, but it is not a guarantee.

How to Treat Itching From Opiates

As we stated above, there is no formal treatment for opiate-induced itching. Allergy medications may help for some, but not everyone will see relief. If itching from opiates is causing problems in your everyday life, talk to your doctor. Those who are using opiates illicitly are encouraged to check into a treatment facility. In treatment, you may experience itching during withdrawal, but this will subside as detox takes place.

Is Itching a Sign of an Opiate Use Disorder?

While itching is an unpleasant side effect of opiate use, it does not necessarily mean you have an opiate use disorder. Experiencing side effects from a medication is common even if you have taken the medication before. However, if you find yourself experiencing withdrawal symptoms between uses, you may be developing dependence. Some other signs of opiate use disorder include:

  • Hiding use from family and friends
  • Changing friend groups
  • Poor work or school performance
  • Increased depression and anxiety
  • Paraphernalia such as pill bottles, needles, rubber bands, and lighters

understanding itching caused by opiates

Seeking Treatment for Opiate Addiction in Knox County, TN

Managing opiate addiction can cause many unpleasant side effects, like itching all the time. However, the fear of withdrawal can make it feel impossible to stop. The good news is that opiate addiction treatment programs are readily available. It does not matter if you are using morphine, heroin, or fentanyl, addiction can occur with any opiate or opioid. Treatment will help you address the root causes of your addiction and put you on the path to recovery. Through therapy, medication-assisted treatment, and skill-building, you will be armed with the tools needed to succeed in life and recovery.

If you or someone you love is managing an opiate or opioid use disorder, it’s not too late to find healing. ReVIDA® Recovery has been helping those living with addiction for years throughout the Appalachian area. We offer medication-assisted treatment such as Suboxone because we have seen the benefit for those working to find their recovery. Our team of dedicated professionals is here to help you find what works for you, and help with life in areas such as legal, work, and housing. The goal is to provide you with support and guidance as you reclaim your life and find recovery. Call us today at 423-631-0432 to schedule an appointment.