Opioid Induced Constipation

Opioid Induced Constipation

An opioid addiction brings a plethora of side effects, from the small, almost unnoticeable, to the most severe, nearly life-threatening. Most of these side effects end up taking place once users stop engaging in use, normally as fringe effects from the detox process.

However, there’s a particularly nagging, sometimes painful condition that comes during active opiate abuse. Opioid-induced constipation afflicts a large portion of opiate and opioid users and is most typically one of the most common side effects for individuals with opiate abuse disorder.

What Is Opioid-Induced Constipation?

Opioid-induced constipation is the condition in which long-term opioid users experience regular and frequent bouts of constipation and other adverse gastrointestinal challenges. Users may find it extremely difficult to have a bowel movement and may experience pain when attempting to use the bathroom.

Additional side-effects of opioid-induced constipation include the following:

  • Intense straining while attempting a bowel movement
  • Hard stool
  • Abdominal pain and bloating
  • The feeling of a bowel movement not being complete

These side effects can be extremely painful and have the potential to have a significant impact on a user’s quality of life. What causes opioid-induced constipation, and what’s the difference between this and the naturally-occurring form of this condition?

What Causes Opioid-Induced Constipation?

In a healthy, normally functioning individual, regularly occurring bowel movements are natural. Small movements occur that cause food to pass through the small intestines and eventually into the colon, allowing the body to pass waste.

However, when an individual suffers from opiate abuse disorder, these movements don’t occur as often or occur later than normal. This causes the body to retain this waste for long periods than it should.

Additionally, water retention causes further complications, causing a more compacted GI tract than what is normally experienced in a user who doesn’t abuse opiates. Further complicating the situation is the fact that opiate users also experience a condition that causes the sphincter to respond slower to an approaching bowel movement. This also increases the difficulty, leading to constipation and extreme challenges when using the bathroom.

Opioid-induced constipation is just one of a handful of side effects of opioid medications. These side effects range in severity and how frequently they occur, but all have the potential to pose health risks.

Side Effects of Opioid Medication

Besides opioid-induced constipation, opioid medications have the potential to cause the following side effects:

  • Stomach cramping
  • Sweating
  • Higher body temperature
  • Depressed breathing
  • Increased or decreased heart rate

Regardless of the side effects, each of these symptoms has the potential to increase in severity or cause additional challenges for users who experience them. There is a long list of medications that cause these side effects and opioid-induced constipation.

Which Drugs Cause Opioid Constipation?

Drugs that have the potential to cause opioid-induced constipation include a large variety of prescription medications and illegal narcotics. Additionally, there’s also a variety of natural and synthetic opioids on this list.

  • Oxycodone
  • Hydrocodone
  • Methadone
  • Heroin
  • Morphine

In all honesty, nearly every opiate and opioid drug have the potential to cause opioid-induced constipation. What about fentanyl? Because of the prevalence of fentanyl abuse, how does this drug factor into opioid-induced constipation?

Fentanyl Use and Opioid-Induced Constipation

Research and studies conducted have uncovered a surprising fact about fentanyl. Because of this drug’s potency, one would assume it causes the most severe cases of opioid-induced constipation.

However, fentanyl has shown that it actually causes lower occurrences of this condition when compared to other opiates and opioids of high strength like morphine and methadone. The use of transdermal fentanyl patches especially highlighted this fact, with these products causing significantly low rates of opioid-induced constipation.

It’s important to note that the longer an individual abuses fentanyl or any other opioid or opiate, the higher the risk of developing opioid-induced constipation. Additionally, opioid-induced constipation is just one of many side effects in a sea of possibilities when it comes to long-term abuse of these drugs.

Side Effects of Long-Term Opiate Use

There are multiple side effects for individuals who engage in long-term opiate and opioid abuse. Listed below are some of the most significant long-term side effects

  • Depression
  • Heart issues
  • Weakened arteries
  • Physical dependence
  • Complications from withdrawal

There may also be significant health risks associated with opioid-induced constipation.

Can Constipation from Opioids Cause Health Risks?

Normally constipation doesn’t cause adverse side effects. However, individuals who suffer from long-term opiate abuse disorder with constipation may develop additional challenges.

These individuals run the risk of developing hemorrhoids, fecal impaction (dry, hard stools collect in the rectum), and bowel incontinence (leaking of liquid stools). This is why it becomes critical to cease the use of opioids or seek some form of treatment for opioid-induced constipation.

How Can I Treat Opioid-Induced Constipation?

Individuals who suffer from opioid-induced constipation must find some form of treatment for this condition, especially to avoid additional long-term challenges. The following remedies exist and may provide some level of relief in certain situations.

Fiber and Opioids

Fiber may provide relief from opioid-induced constipation. Specifically, it must be soluble fiber so it doesn’t remain in the intestines. Individuals must also remain adequately hydrated for fiber to have a significant impact.


Laxatives taken in different forms may provide a level of relief as well. Rotating between different acting forms of laxatives and stool softeners seems to be the most effective course of action.

Opioid Rotation

Tests have shown favorable results regarding the practice of opioid rotation. This includes changing the types of opiates and opioids used for pain treatment or for individuals who suffer from opioid abuse disorder.

Rectal Intervention

These are usually used as a last measure, as they can be the most invasive forms of treatment. This includes the use of enemas, suppositories, and irrigation.

Diet and Lifestyle Treatments for Opioid Constipation

Individuals who suffer from opioid-induced constipation may experience the highest levels of relief from diet and lifestyle changes. Certain practices exist that can potentially decrease the existence of this condition.

The following list contains practices to consider for relieving the challenges associated with opioid-induced constipation:

  • Changes in diet with less protein and higher levels of fiber can manifest change in the challenges associated with this condition. However, fiber content should be soluble, or this may end up increasing the complications.
  • Remaining hydrated has been known to provide relief from different forms of constipation.
  • Increased activity and exercise have been shown to reduce the chances of opioid-induced constipation significantly.
  • If you’re on medication for pain relief, changing the specific medication may decrease the chances of opioid-induced constipation. There are also newer opioids specifically formulated for individuals who suffer from this condition.

The only life change individuals can make that can guarantee the relief or elimination of this condition is complete abstinence from opiates and opioids. Many times, this requires several steps for treatment to increase the odds of success.

Detox is normally the first appropriate step in the recovery process. Medically-assisted detox is a process that includes medical supervision to assist individuals during the withdrawal process.

After successfully completing detox, the next logical step is inpatient or outpatient treatment for opioids. The decision between inpatient or outpatient rehab depends heavily on the specific situation, including the severity and length of time of the abuse.

Inpatient and Outpatient Treatment for Opioids

Inpatient and outpatient treatment options for opioids currently remain the two most effective methods of recovery for opiate and opioid abuse disorder. Depending on your situation specifically, one of these can help you to experience long-term recovery and treat the potential underlying mental health challenges a the center of the abuse.

First, we’ll outline the potential pros and cons of outpatient treatment.

Outpatient Treatment

Outpatient treatment consists of participating in recovery services several times weekly while still living at home. Individuals may be required to travel to an inpatient treatment center to complete their outpatient requirements.

Areas of service include mental health counseling, behavioral therapy, dual-diagnosis treatment, talk therapy, and other forms of service. Clients also have access to group recovery meetings with their peers. Some of the advantages of outpatient treatment are included below.


  • Clients don’t have to live at the facility and may remain at home.
  • Clients have a chance to exercise the things they’ve learned in real-time.
  • It’s possible to participate in outpatient treatment while remaining active with primary care mental health and attend additional recovery meetings outside of treatment


  • The drive to a treatment center may be long, depending on your location
  • Chances of relapse are greater in some cases, depending on a clients’ willpower


 Opioid Induced Constipation

Inpatient Treatment

Inpatient treatment requires clients to remain in a live-in facility for a period of 30, 60, or 90 days. All of the services mentioned above are made available and additional activities to help educate clients on elements of addiction and responses to triggers and other elements.


  • Personalized treatment plans and a controlled environment increase the chances of recovery
  • Constant access to mental health professionals
  • The benefits of a personally crafted diet to promote physical and mental wellness


  • Remaining away from home for a long period

Regardless of the specific form of treatment, it’s also important that clients have an opportunity to craft an aftercare plan. Aftercare plans include the following elements:

  • A detailed plan to form strong support structures. After treatment, the support structure will include family, friends, loved ones, coworkers, and other individuals directly involved with the clients’ lives. This may also start early in treatment, as clients are encouraged to utilize the advantages of group therapy sessions with the involvement of family members.
  • Locations and resources for 12-step recovery meetings or similar groups are important. Clients should be fully aware of the locations of these meetings in relation to where they reside.
  • Attention to mental health through regular visits with primary care mental health professionals. This is important for continuing attention to the underlying causes of opioid abuse disorder.
  • Continued focus and efforts to obtain employment. However, this may already be in full swing for individuals that choose outpatient treatment.

Is Long Term Recovery from the Side Effects of Opioids Possible?

Long-term recovery from the side effects of opioid abuse is possible. With the right avenues of treatment and the proper support structures, plenty of our clients have achieved long-term success. However, it’s important to have the right team on your side to give you the best odds of achieving recovery.

At Circle of Hope Treatment, we specialize in assisting clients in achieving long-term recovery. If you or someone you love is struggling with opioid abuse disorder or challenges with any other substance, contact one of our admissions specialists to find out more about our services.

1 (818) 392-5259