Currently about 91 Americans die everyday due to opioid addiction. Opioids are a category of drugs that include hydrocodone, oxycodone, heroin, methadone, and fentanyl. They depress the central nervous system reducing pain sensation, providing a sedative effect, and producing euphoria. These drugs are extremely addictive over time, and it is important to recognize this in the dental office where they are a tool for treatment. It is important to be aware of symptoms of addiction in patients. Systemic signs of opioid abuse include constricted pupils, depressed respiration, anorexia, and constipation. These are symptoms that can be readily visible to anyone in regular contact with an addict. In the dental office there are also symptoms in the mouth that can be diagnosed such as xerostomia, bruxism, and extremely poor oral hygiene. Early diagnosis can increase success in overcoming addiction. Withdrawal from opioids can be difficult, and proper treatment can sometimes require drug therapy.