Opioids
What Is It?
Opioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioids are made from the plant directly, and others are made by scientists in labs using the same chemical structure. Opioids are often used as medicines because they contain chemicals that relax the body and can relieve pain. Prescription opioids are used mostly to treat moderate to severe pain, though some opioids can be used to treat coughing and diarrhea. Opioids can also make people feel very relaxed and "high" - which is why they are sometimes used for non-medical reasons. This can be dangerous because opioids can be highly addictive, and overdoses and death are common. Heroin is one of the world's most dangerous opioids, and is never used as a medicine in the United States.
Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.
Alternative Names
hydrocodone (Vicodin®) oxycodone (OxyContin®, Percocet®), oxymorphone (Opana®)
morphine (Kadian®, Avinza®), codeine, fentanyl,
Oxycodone: O.C., Oxycet, Oxycotton, Oxy, Hillbilly Heroin, Percs
Hydocodone: Vike, Watson-387
Morphine: M, Miss Emma, Monkey, White Stuff
Codiene: Captain Cody, Cody, Lean, Schoolboy, Sizzurp, Purple Drank With glutethimide: Doors & Fours, Loads, Pancakes and Syrup
Fentanyl: Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash, TNT
Hydromorphone: D, Dillies, Footballs, Juice, Smack
Demerol: Demmies
Oxymorphone: Biscuits, Blue Heaven, Blues, Mrs. O, O Bomb, Octagons, Stop Sign
Legality
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Common Forms
Tablet, capsule, liquid, lozenge, sublingual tablet, film, buccal tablet, suppository, dispersible tablet.
Common Ways Taken
Injected, swallowed, smoked, snorted, rectal.
Short Term Effects
Pain relief, drowsiness, nausea, constipation, euphoria, slowed breathing, death.
People who use heroin report feeling a "rush" (a surge of pleasure, or euphoria). However, there are other common effects, including:
- dry mouth
- warm flushing of the skin
- heavy feeling in the arms and legs
- nausea and vomiting
- severe itching
- clouded mental functioning
- going "on the nod," a back-and-forth state of being conscious and semiconscious
Long Term Effects
Increased risk of overdose or addiction if misused.
People who use heroin over the long term may develop:
- insomnia
- collapsed veins for people who inject the drug
- damaged tissue inside the nose for people who sniff or snort it
- infection of the heart lining and valves
- abscesses (swollen tissue filled with pus)
- constipation and stomach cramping
- liver and kidney disease
- lung complications, including pneumonia
- mental disorders such as depression and antisocial personality disorder
- sexual dysfunction for men
- irregular menstrual cycles for women
Other Health-related Issues
Pregnancy: Miscarriage, low birth weight, neonatal abstinence syndrome.
Older adults: higher risk of accidental misuse because many older adults have multiple prescriptions, increasing the risk of drug-drug interactions, and breakdown of drugs slows with age; also, many older adults are treated with prescription medications for pain.
Risk of HIV, hepatitis, and other infectious diseases from shared needles.
Heroin often contains additives, such as sugar, starch, or powdered milk, that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage. Also, sharing drug injection equipment and having impaired judgment from drug use can increase the risk of contracting infectious diseases such as HIV and hepatitis (see "Injection Drug Use, HIV, and Hepatitis").
When Combined with Alcohol
Dangerous slowing of heart rate and breathing leading to coma or death.
Withdrawal Symptoms
Restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), leg movements.
Additional Information
Naloxone is a medicine that can treat an opioid overdose when given right away. It works by rapidly binding to opioid receptors and blocking the effects of heroin and other opioid drugs. Sometimes more than one dose may be needed to help a person start breathing again, which is why it’s important to get the person to an emergency department or a doctor to receive additional support if needed. Read more in the Substance Abuse and Mental Health Services Administration’s Opioid Overdose Prevention Toolkit.
Naloxone is available as an injectable (needle) solution and nasal sprays (NARCAN® Nasal Spray and KLOXXADO®). Friends, family, and others in the community can use the nasal spray versions of naloxone to save someone who is overdosing.
The rising number of opioid overdose deaths has led to an increase in public health efforts to make naloxone available to at-risk persons and their families, as well as first responders and others in the community. Some states have passed laws that allow pharmacists to dispense naloxone without a prescription from a person’s personal doctor.
Medications for opioid use disorders – including heroin use disorder – are safe, effective, and save lives. These medicines interact with the same opioid receptors in the brain on which heroin acts, but they do not produce the same effects.
- Methadone, an opioid receptor full agonist, attaches to and activates opioid receptors to ease withdrawal symptoms and cravings.
- Buprenorphine, an opioid receptor partial agonist, attaches to and partially activates opioid receptors to ease withdrawal symptoms and cravings.
- Naltrexone, an opioid receptor antagonist, prevents heroin from attaching to opioid receptors, thus blocking its effects.
Sources: NIH, SAMSA, National Institute on Drug Abuse, Wikipedia. (Collected 2023)