Learn about opioids and understand the signs of opioid misuse.

• What are opioids?
• What are the risks of opioid misuse?
• What are the signs of opioid misuse?

What are opioids?

Opioids are a type of drug used to reduce pain and are highly addictive. This includes heroin and prescription medications (Oxycodone, Morphine, Percocet, Fentanyl).

Heroin is a type of opioid made from morphine and is usually white/brown powder but can also look like tar. Heroin can be injected (“shoot up”), snorted, or smoked. Heroin can also be known as smack, H, junk, or named after where it was made (“Mexican Black Tar”), and some have their own brand name (“Brainstorm”).

What are the risks of opioid misuse?

Opioids are addictive. Opioid use may begin to increase after starting use because your brain may start to want more than you originally started taking, even if you know you shouldn’t be taking more. Your tolerance may be lowered the longer you are on the opioid, meaning your body may want more of the drug even if your pain level has not increased. This can cause you to start taking more of the opioid to manage your pain, in addition to a physical dependence on opioids. This means that your body is so used to the drug that when you stop taking them your body will go through intense withdrawal and get sick. The need to increase doses to get the same effect combined with the physical dependence is the reason why opioids are so addictive.

People addicted to opioids come from all walks of life.  Opioids do not discriminate.  Addiction can happen to anyone; it does not discriminate on any level. It can be a coworker, teammate, patient, friend, or family member. If you think someone you know is misusing opioids, reach out to them right away, use any of the resources on this site for help and guidance if you are unsure of what to do. (Resources)

What causes a person to switch from pills to heroin and fentanyl? The biggest reason for a person to switch is the cost– prescription opioids are difficult to find and are often expensive. Heroin often costs less, and fentanyl is cheaper still. Heroin and fentanyl are often seen as a way to avoid going into prescription opioid withdrawal, especially when a person does not have a prescription or has little money to buy prescription opioids on the street.  Heroin and fentanyl are a less safe opioid supply, greatly increasing the risk of overdose.

Overdosing on opioids is easy. Opioids slow your breathing and can cause your breath to stop. All it can takes is one dose for this to happen and it can be the same exact dose you have taken before.

If you think someone is overdosing, you can administer naloxone, also known as Narcan, and call 911.

A person’s appearance may change when they are misusing opioids:

• Small or “pinpoint” pupils
• Scars or bruises from using needles (also known as “Track Marks”)
• Itches and scratches on the skin

There are multiple health problems that may be noticed when a person is misusing opioids:

• Weight loss
• Vomiting (throwing up)
• Constipation (having trouble pooping)
• In women, not getting a period
• Depression

Behavior may change in a person misusing opioids:

• “Nodding off” (falling asleep)
• Start using laxatives
• Lose friends they’ve had for a long time
• Have problems in school or at work
• Lose interest in activities
• Spend more time away from home
• Make frequent, secret phone calls
• Get in trouble with the police

Things in their homes may have changed as well:

• Missing money, credit cards, or valuables (stolen or sold for money)
• Pawn slips (pawned items for money)
• Purchases returned for cash refunds
• Extra plastic Ziploc bags (buying or selling substances)
• Bottles of vinegar and bleach and cotton balls (vinegar or bleach to clean needles; cotton balls are used when injecting drugs)
• Aluminum foil or chewing gum wrappers with burn marks (used to smoke opioids)
• Spoons with burn marks or missing spoons (also used to prepare for injecting)

Withdrawal symptoms, withdrawal happens when a person dependent on opioids suddenly stops taking them.  Symptoms of opioid withdrawal include:

• Diarrhea (watery poop)
• Sweating
• Dilated (very big) pupils
• Irritability (moodiness)
• Anxiety (feeling worried or nervous)
• Trouble sleeping
• Talking about craving medicines or drugs
• Complaining about pain — especially stomach cramps, muscle aches, and bone pain

Fentanyl:

Fentanyl is a type of opioid that is man-made or synthetic. Fentanyl is 50x stronger than heroin and 100x stronger than morphine and there are two types:

• Pharmaceutical fentanyl is made in a lab and prescribed by a doctor
• Non-pharmaceutical fentanyl is made illegally and often mixed with other drugs, like heroin and/or cocaine, to increase the drug’s effect.

The user may be unaware that there is fentanyl in the drug they are using and therefore unaware of their increased risk of overdosing. There are fentanyl test strips that can be used to determine if there is a presence of fentanyl in the drug that is about to be used.

OPIOID NARCOTICS:

*Contains acetaminophen. Too much acetaminophen can poison the liver and lead to liver failure and/or death.