Get the facts about opioids and learn how to recognize the signs of abuse.
When we talk about opioids, we mean heroin and prescription painkillers, like OxyContin, Percocet, or Vicodin. Opioids are used to reduce pain. They are also very addictive.
Here’s a list of common opioid drugs, also called narcotics:
- Fentanyl (Actiq, Duragesic, Fentora)
- Hydrocodone (Lorcet, Lortab, Norco, Vicodin)
- Hydromorphone (Dilaudid, Exalgo)
- Meperidine (Demerol)
- Methadone (Dolophine, Methadose)
- Morphine (Avinza, Kadian, MS Contin, Ora-Morph SR)
- Oxycodone (OxyContin, Oxyfast, Percocet, Roxicodone)
- Oxycodone and naloxone (Targiniq ER)
Heroin is a type of opioid — it comes from morphine. It’s usually white or brown powder (it can also be dark tar) that people inject (“shoot up”), snort, or smoke.
Street names for heroin include:
Some names refer to where the heroin was made, like “Mexican Black Tar.” Others are more like brand names, such as “Brainstorm.”
Opioids are powerful and addictive. After you start using opioids, your brain may want more and more of them — even if you think it’s a bad idea. The longer you use opioids, the less they seem to work. Your body may want more of the drug to get the same level of pain relief. For some people, this becomes an addiction.
Someone addicted to opioids looks a lot like everyone else. A person with an addiction might be an honor-roll soccer player who started out with a prescription for opioids after knee surgery. Or it might be an office manager with chronic low back pain. Opioid addiction can happen to anyone, including the people you love the most. Don’t overlook the signs of abuse. If you think someone might be misusing opioids, talk to them right away.
It’s easy to overdose on opioids. One dose could kill you, even if it’s the exact same dose you took yesterday. Opioids slow your breathing. If you take too much, your breathing will stop and you can die. If you think someone is overdosing, you can give them Narcan, a drug that helps the person wake up.
Your body gets attached to opioids when you use them regularly or for a long time. This is called physical dependence. Your body doesn’t feel good without the drug. If you try to stop, you’ll go through intense withdrawal. Many people who are dependent on opioids will become addicted.
People switch to heroin because it’s cheaper. Heroin often costs less and is easier to get than prescription opioids. Just like prescription opioids, heroin is very addictive and people usually need medical treatment to recover. Heroin has bigger risks too. Sometimes, it’s mixed with other drugs (laced), which can make it more dangerous than other opioids.
There are many signs of opioid misuse, but most people using won’t have all of them. You may only notice a few.
Looking at someone who’s misusing opioids, you may notice:
- Small or “pinpoint” pupils
- Track marks on arms (scars or bruises from using needles)
- Itches and scratches on the skin
- An overall unhealthy look
You also might notice health problems linked to opioid misuse. For example:
- Weight loss
- Vomiting (throwing up)
- Constipation (having trouble pooping)
- In women, not getting a period
You may also see changes in their behavior. For example, a person misusing opioids may:
- “Nod off” to sleep
- 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
Looking around their home, you may notice:
- Missing money, credit cards, or valuables
- Pawn slips
- Purchases returned for refunds
- Extra plastic Ziploc bags
- Bottles of vinegar and bleach and cotton balls
- Aluminum foil or chewing gum wrappers with burn marks
- Spoons with burn marks (if you share a home, you may also notice that spoons go missing)
What do these household items have to do with opioid abuse? Having them can be a sign that a person is getting high. They might use vinegar or bleach to clean needles. They might use aluminum foil, gum wrappers, or spoons to smoke heroin. Finding lots of extra plastic bags can be a sign that someone is buying or selling drugs.
Many people who are addicted to opioids steal money or valuable items (to sell or pawn) so they can buy more drugs. If someone you love is taking money from you or you notice things missing from your home, don’t ignore it. It might be a sign of opioid misuse.
When people who are dependent on opioids stop taking them suddenly, they may have different symptoms as their body reacts. This is called withdrawal. Symptoms of opioid withdrawal include:
- Diarrhea (watery poop)
- 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 is a synthetic (man-made) opioid that is 50x stronger than heroin and 100x stronger than morphine. There are two types of fentanyl:
- Pharmaceutical fentanyl is prescribed by a doctor, mostly to manage pain in advanced cancer patients.
- Non-pharmaceutical fentanyl, which is made illegally, is often mixed with heroin and/or cocaine in order to increase the drug’s effect. Often the user is not aware that fentanyl was mixed in, which can lead to overdose.
The presence of fentanyl increases the risk of overdose. Users can use fentanyl test strips to determine if their batch of heroin includes fentanyl.
Law enforcement personnel who conduct investigations related to fentanyl should use caution when investigation and handling evidence. Activities may include executing search warrants and collecting, transporting, and storing evidence. Evidence collection activities in the field have the potential to aerosolize powders. Also, law enforcement personnel who handle evidence in the chain of custody have the potential to come into contact with fentanyl unless controls are in place to prevent exposures.
More information can be found in this video: