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Learn more about opioids. You’ll be better prepared to catch the signs of abuse — and prevent addiction and overdose in your community.

What Are Opiates?

Prescription Drugs (Rx) and Heroin Prescription Drugs:

Some prescription drugs are called opioids, or narcotics, which can enhance, slow down, or alter brain activity. When prescribed, they are used for treating pain. They come as multi-colored tablets and capsules; some can be in liquid form. They are swallowed and may be injected when abused. Common drugs are Adderall, Dexedrine, Ritalin, Mebaral, Quaaludes, Xanax and Valium, Nembutal, Codeine, OxyContin, Percocet, and Vicodin. Heroin: A highly addictive drug derived from morphine. It affects the brain’s pleasure systems and interferes with the brain’s ability to perceive pain. It can be injected or smoked in a cigarette or pipe. Pure heroin is a white powder with a bitter taste. Most illicit heroin is sold as a white or brownish powder and is usually “cut” with other drugs or with substances such as sugar, starch, powdered milk, or other poisons or unknown substances. Another form of heroin known as “black tar” may be sticky, like roofing tar, or hard, like coal. Its color may vary from dark brown to black.

Signs and Symptoms Withdraw Side Effects
Depression of nervous system Restlessness Muscle and Bone Pain Collapsed veins
Slurred speech Drug craving Infection of the heart lining and veins
Constricted pupils Insomnia Cellulitis
Droopy eyelids Diarrhea and Vomiting Liver disease
Vomiting Cold flashes with goose bumps Drug additives that clog veins
Constipation Kicking movements Death of cells in vital organs
Impaired night vision Increased risk of overdose
Impaired memory Potential for heart attack
Judgment and Coordination Potential for lethal seizures
Irritability Physical dependence
Stressed respiratory system Rebound effect
Paranoid and suicidal thoughts


What are the risks of opioid misuse?

Opioids are powerful and addictive. Your brain wants more opioids over time, even if you think it’s a bad idea. The longer you use opioids, the less they seem to work. It’s easy to feel like you should take more: Your body wants 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.

4 out of 5 cases of heroin addiction start with prescription medicines.


What are the signs of opioid misuse?

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
  • Depression

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, and/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)
  • 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