Opioids affect the central nervous system and the gastrointestinal tract. Some of them have both beneficial and negative effects. Opioids are either natural opiates (made from the resin of opium poppies), semi-synthetic (created from natural opiates), fully synthetic or naturally occurring in the body (such as endorphins). Many opioids are commonly called narcotics.

 

Opioids first produce a feeling of euphoria, a high, that is often followed by drowsiness; nasea and vomiting; and constricted pupils, watery eyes and itching. The symptoms of an opioid overdose include slow, shallow breathing; clammy skin; convulsions; and coma.

 

Tolerance to opioids develops rapidly and dependence is likely. The use of contaminated syringes may result in diseases such as AIDS and hepatitis. Addiction in pregnant women can lead to premature, stillborn or addicted infants who experience severe withdrawal symptoms.

 

Common opioids are:

 

Heroin

 

Slang terms: smack, horse, mud, brown sugar, junk, black tar, Big H

 

Heroin is a semi-synthetic opioid, derived from morphine, that is illegal in the United States and highly addictive. It is used as both a painkiller and a recreational drug for its euphoric, “body-high” effects and has an extremely high potential for abuse. It is one of the most addictive drugs, and is both physically and psychologically addictive. It can be injected, inhaled or snorted, and is the fastest-acting opioid. Large doses of heroin can cause fatal respiratory depression.

 

It is typically sold as a white or brownish powder or as a black sticky substance (“black tar heroin”). Although purer heroin is becoming more common, most street heroin is “cut” with other drugs, inert substances or poisons. Because heroin abusers do not know the actual strength of the drug or its true contents, they are at risk of overdose or death. Heroin laced with fentanyl and other poisons has been known to cause death within hours. Like cocaine , heroin also poses special problems because of the transmission of HIV and other diseases that can occur from sharing needles or other injection equipment.

 

Chronic users may develop collapsed veins, infection of the heart, abscesses, cellulites, and liver disease. Pneumonia and other complications may result from the poor health condition of the abuser, as well as from heroin's depressing effects on respiration. Withdrawal has severe symptoms that usually subside after a week. Some symtoms are drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes, kicking movements, and more.

 

Information on heroin from Partnership to End Addiction - Search

 

Information on heroin from the U.S. Drug Enforcement Administration

 

Opium

Opium comes as dark brown tarlike chunks or a powder that is smoked, eaten or injected. It is made from opium poppies. It can cause euphoria, a sense of well-being and a calm drowsiness. It depresses the resipiratory system, which is potentially deadly with large doses. Other effects can include nausea, confusion and constipation. Long-term use can lead to drug tolerance. Opium use can also lead to physical dependence and addiction. Withdrawal symptoms can occur.

 

Smoking, drinking tea or using a syrup are the common forms of ingesting opium.

 

Information on opium from Partnership for a Drug-Free America - Search

 

Prescription pain relievers

 

Prescription pain relievers can be abused illegally for their opioid effects by those without prescriptions or a medical need. Abuse can bring tolerance, addiction and dependence. Additionally, because many of the opioids are mixed with acetaminophen, there is an added risk of liver toxicity. They are fast becoming the drug of choice in the United States and can be dangerous when taken improperly. The U.S. Drug Enforcement Agency has information about prescription drug abuse here.

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Some commonly abused or illegally resold pain relievers include:

• Hydrocodone (Vicodin). Hydrocodone is a semi-synthetic opioid. It is prescribed by doctors as a pain reliever and cough suppressant under several brand names and a generic form. Vicodin is one of the most common brand name. Hydrocodone tablets come in varying strengths, always mixed with acetaminophen (the active ingredient in Tylenol). Pure hydrocodone is not available in the United States. Long-term abuse can lead to liver problems and even liver failure because of the acetaminophen. Drinking alcohol while taking hydrocodone can be very dangerous. Hydrocodone is available as a cough syrup under a few brand names, including Tussionex. Common side effects of taking hydrocodone include dizziness, lightheadedness, nausea, sweating, drowsiness, constipation, vomiting and euphoria. Symptoms of hydrocodone overdose include respiratory depression, extreme sleepiness, clammy or cold skin, narrowed or widened pupils, a slowed heartbeat, coma, seizures, cardiac arrest, and death.

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• Oxycodone (OxyContin, Percocet, Percodan). Oxycodone is a semi-synthetic opioid. It is the main ingredient in several prescription painkillers, including OxyContin and Percocet. It is noted for its strong potential for addiction and dependence. Some brands, such as OxyContin, are fully oxycodone, which makes the drug much stronger. Other variations are mixed with acetaminophen (Percocet) or aspirin (Percodan). The straight oxycodone tablets are dangerous because of the addictive and harmful qualities of the drug, and mixed versions such as Percocet can be dangerous if abused or overused for similar reasons to Vicodin (damage to liver because of the acetaminophen). Oxycodone has similar side effects and overdose effects to Vicodin, although circulatory collapse and respiratory arrest can be overdose effects. It also has severe withdrawal symptoms, especially for those who are abusing it rather than using it as prescribed.

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• Morphine: Morphine, a natural opiate, is available as tablets or syrup, or as an injection. It may be injected, swallowed or even smoked. It is commonly prescribed to manage pain, for example after surgery, for severe chronic pain or for palliative care. Morphine acts directly on the central nervous system to relieve pain. It has a high potential for addiction; tolerance and dependence develop quickly. It has side effects similar to other opoids, and taking a large single dose could cause severe respiratory depression, coma or death. Heroin is derived from morphine.

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• Codeine: Codeine is a natural opiate, though it can also be synthesized from morphine. It is less potent than morphine, and like all opioids has the potential for physical and psychological addiction, though milder than morphine or heroin. It is prescribed to treat cough, diarrhea and pain. It is available as a single-ingredient drug or mixed with others like acetaminophen or ibuprofen (Tylenol 3 and Tylenol 4 are acetaminophen-codeine combination pills). In some countries, cough syrups and tablets containing codeine are available without a prescription. Codeine can be fatal to a breast-fed infant if the mother is taking it.

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• Methadone: Methadone is used for the treatment of pain and also for detoxification treatment of opioid addiction. However, it in itself has become abused and can be as harmful as any other opioid. Other drugs used for treating addiction and dependence that also can be abused are naltrexone and buprenorphine.

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• Other: Any prescription painkiller with an opioid base (derived from opium, morphine, codeine, etc.) has the potential to be abused and cause dependence.

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Online resources:

• Information on prescription pain relievers from Partnership to End Addiction - Search

• Information on OxyContin from the U.S. Drug Enforcement Administration