Opiate & Opioid Facts

In this article, we take a closer look at opiates and opioids, what they are, how they are used, the side effects of opiate/opioid use and more.

What are opiates and opioids?

Opiates are natural chemical compounds that are extracted or refined from plant matter, such as poppy sap and fibers. Examples of opiates include heroin, morphine, and codeine.

The terms ‘opiates’ and ‘opioids’ are often used interchangeably. However, the two are different.

Unlike opiates, opioids are chemical compounds that are not generally derived from plant matter and are commonly manufactured in a ‘lab’ or ‘synthesized’. Examples of opioids include methadone and fentanyl.

What are the street names for opiates and opioids?

Some of the most common street names for opiates and opioids include:

• Heroin – Smack, Thunder, Big H, Black Tar, Horse, Hell Dust
• Fentanyl – Goodfellas, Great Bear, Poison, Tango & Cash, China Town
• Methadone – Chocolate Chip Cookies, Maria, Salvia, Street Methadone
• Opium – Big O, Aunti Emma, Midnight Oil, Zero, Dopium, Black Pill
• Codeine – Captain Cody, Cody, Little C, Schoolboy

What do opiates look like?

Opiate painkillers are available in a wide range of forms, and a variety of colors. They are commonly supplied in tablet, capsule or syrup form.

How are opiates/opioids used?

Opiates and opioids are used in a variety of ways, depending on their format.

Often, they are ingested in tablet, capsule, or syrup form, but can also be inhaled using a nebuliser, or absorbed via a patch on the skin.

They may also be injected or smoked.

How do people behave when they take opiates and opioids?

How someone feels and behaves after taking opiates/opioids can vary.

However, people who misuse these substances may experience mood and sleep changes and can be prone to poor decision making.

What are the side effects of opiates and opioids?

The physical side effects of opiates and opioids depend on several factors, including the type of drug used, how the drug is ingested, frequency of use, and the metabolism and weight of the person.

Some common side effects include:

• Dilated pupils
• Raised body temperature
• Nausea
• Hallucinations
• Reduced blood pressure and slower heart rate
• Urinary retention
• Constricted pupils
• Respiratory depression (slow/ineffective breathing)
• Drowsiness

When injected, adverse effects include vein damage, infections, and blood clots.

A person who injects opiates or opioids is also at an increased risk of overdosing or contracting life-altering infections such as HIV, hepatitis B and hepatitis C. This risk is even greater among users who share needles.

What happens when you use opiates/opioids with other drugs?

Below is an overview of the side effects of using opiates/opioids with other drugs.

Alcohol and sedatives

Consuming synthetic opioids alongside alcohol or other sedatives, such as benzodiazepines, can have serious consequences, increasing the risk of overdose, which can lead to a coma or respiratory/heart failure.

Fentanyl

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin, and 100 times stronger than morphine. It is a major contributor to fatal and non-fatal overdoses among recreational drug users.

What is the legal status of opiates/opioids in the US?

Different opiates and opioids are classified differently under federal law, depending on their potency, potential for abuse and dependency, and whether they are legal when prescribed by a physician.

Most opiates/opioids are classed as schedule II, III, IV or V narcotics under the Controlled Substances Act.

Some examples of opiate/opioid classification are below:

• Heroin is a Schedule I drug under the Controlled Substances Act, due to its high potential for abuse
• Fentanyl, opium, and methadone are Schedule II narcotics under the Controlled Substances Act. Methadone can be used under supervision by a physician, to aid recovery from heroin addiction
• Codeine is a Schedule III narcotic, as it is regarded as having low to moderate potential for causing harm and dependency

You can learn more about the legal status of different drugs by visiting www.dea.gov.

Are opiates and opioids used in medicine?

Some opiates and opioids may be prescribed in healthcare settings to treat a range of conditions, including as pain relief for patients experiencing chronic pain or receiving end of life care.

Methadone is used to treat heroin dependency and can help reduce withdrawal symptoms.

Can you become addicted to opiates and opioids?

Opiates and opioids trigger the release of endorphins, the feel-good neurotransmitters in the brain.

Endorphins lessen a person’s perception of pain and boost feelings of pleasure, creating a temporary but powerful sense of wellbeing.

This means that a person using opiates, even when prescribed, can be vulnerable to developing a dependency or addiction.

Addiction is typically defined as a compulsive craving, which leads to repeated use of a drug – often with harmful consequences.

How long does it take for opiates/opioids to show up in a drug test?

Even after the ‘high’ has worn off, and long after the drug was first consumed, opiate/opioid use can be detected by a drug test, depending on the type of test you take.

The drug testing detection windows for opiates/opioids are as follows:

• Oral fluid (saliva) – up to 48 hours
• Urine – up to 4 days
• Hair – up to 12 months (depending on the length of hair available)
• Nails – up to 12 months (up to 6 months for fingernails and up to 12 months for toenails)

Oral fluid and urine drug testing are known as ‘narrow-window’ forms of testing and can be used to detect drug use from 30 minutes after consumption, up to a few days.

This can vary depending on the type of substance and how much was used.

The rate at which hair and nails grow means that both hair drug testing and nail drug testing can provide a ‘wide-window’ of detection for drugs and their metabolites (up to 12 months).