Watching a loved one struggle with addiction can be scary, especially when they begin exhibiting concerning behaviors, such as falling asleep at inappropriate times, being difficult to wake up, or falling unconscious. One behavior that people often observe in those struggling with opioid addiction is called “nodding off.”

Nodding off can easily be mistaken for falling asleep and jerking awake, so it is sometimes dismissed as exhaustion or boredom. However, nodding off or “being on the nod” is more than fatigue–it is a side effect of taking too many opioids, and it can have serious or life-threatening implications.

If you or someone you love are struggling with opioid abuse or addiction, please call our team at ARISE Treatment Center today to discuss your various treatment options.

What Does Nodding Off on Drugs Mean?

The term “nodding off” may be used interchangeably with “nodding out” and it refers to the act of unintentionally drifting back and forth between consciousness and semi-consciousness after getting high on an opioid, such as heroin or fentanyl. Someone who is nodding out may appear to be falling asleep, as their head may fall forward or to one side with their eyes closed. They may quickly jerk awake, lifting their head up and opening their eyes, then seem like they are falling asleep again. External stimuli can make a person suddenly jolt awake, but they may go back to a state of semi-consciousness or unconsciousness shortly after.

While nodding out may look like falling asleep, it is drug-induced. People who are “on the nod” may mumble words that don’t make sense, remain silent, or make low groaning, moaning, or choking noises.

Why Do People Nod Off on Drugs?

Nodding out occurs as a result of taking too many depressant drugs (usually opioids) at one time. Opioids and other central nervous system depressants slow down heart rate, respiration, and brain activity, often causing drowsiness and fatigue. When a person takes too much, they may have difficulty staying awake, and their brain may begin shutting down. This results in nodding off.

People can “be on the nod” without losing consciousness completely. However, when nodding off is combined with other symptoms like bluish colored skin or lack of breathing, it can be a sign of an overdose.

What Types of Drugs Cause People to Nod Off?

Any drug that depresses the central nervous system can cause people to nod off, including opioids, benzodiazepines, sedatives, and tranquilizers. However, opioids are notorious for causing nodding. Opioids are a class of drugs that are derived from opium, a natural pain reliever, and are prescribed to treat pain. Opioids are highly addictive though, and people who abuse them may nod off frequently.

Examples of opioids that may cause nodding out include:

• Fentanyl
• Heroin
• Oxycodone (OxyContin, Percocet)
• Hydrocodone (Norco, Vicodin)
• Hydromorphone (Dilaudid)
• Morphine
• Codeine

Understanding the Dangers of Nodding Off on Heroin and Other Opioids

Many opioid users claim to love the way nodding out feels, however, this state of mind is dangerous. Taking an excess amount of opioids, to the point where you can’t stay awake, is dangerous. High doses of opioids will slow down your heart rate and respiration significantly, resulting in dangerously low blood-oxygen levels. If you experience low blood-oxygen levels repeatedly and for extended periods of time, the brain and other organs become deprived of the oxygen they need to function. This can lead to a variety of cardiovascular complications, infections, and breathing problems.

Further, nodding off can increase the risk of injury. For example, drifting in and out of consciousness while driving or operating heavy machinery can result in a serious accident. Driving in this state of mind can be even more dangerous than drunk driving because your eyes will close and your body may go limp, causing you to lose control of the vehicle completely.

As you continue using opioids, your tolerance will increase, causing you to continue increasing your regular dose to achieve the same effects. Eventually, the line between nodding out and overdosing becomes skewed, and you could easily overdose while trying to “go on the nod.”

Spotting the Signs of an Overdose

Nodding out can be a sign of overdose, especially when it exists alongside other overdose symptoms.

Common symptoms of an opioid overdose include:

• Shallow or labored breathing
• Weak heartbeat
• Pale skin
• Bluish tinted lips and fingernails
• Low blood pressure
• Limp body
• Vomiting
• Making gurgling or gasping noises (known as the death rattle)
• Coma
• Death

If someone is nodding off but they are still responsive when you speak to them, they may not be experiencing a life-threatening overdose. However, you should keep an eye on them, for if they stop responding emergency medical services must be contacted immediately.

If you suspect you or someone you love are experiencing an overdose, call 911 and administer naloxone, if available.

Is Nodding Out a Sign of Addiction?

Nodding out is a side effect of taking too many opioids and being high, but it doesn’t always mean a person is addicted. But if someone you love is nodding out regularly and exhibiting one or more of the following signs of addiction, they may be struggling with opioid abuse and dependence.

Signs of opioid addiction include:

• Physical signs of opioid intoxication such as flushed skin, pinpoint pupils, and itching
• Experiencing withdrawal when opioids are not in the system
• Having strong cravings for opioids
• Lying to friends and family about opioid use
• Neglecting responsibilities
• Losing interest in activities that were once enjoyed
• Changes in behavior, mood, sleeping patterns, eating patterns, and social circles
• Spending excess time and money on opioids/opioid abuse

Get Help for Opioid Abuse and Addiction Today

Arise Treatment Center offers residential and outpatient opioid rehab services in Vista, California. Our multidisciplinary team of addiction and mental health professionals is dedicated to helping you uncover the root cause of your addiction so you can live a healthier, happier life.

No matter your situation or how far you feel as though you’ve fallen, we can help you get back up. Learn more about our opioid addiction treatment services or find help for yourself or a loved one by contacting us today.