• long-term changes in opioid receptors and peptides
• adaptations in reward, learning and stress responses
• paracetamol, aspirin or ibuprofen poisoning and even death

• Tolerance occurs due to short-term and long-term receptor changes, and adaptations in intracellular signalling mechanisms.
• Withdrawal can be severe and is characterised by:
  • watering eyes
  • runny nose
  • yawning
  • sweating
  • restlessness
  • chills
  • cramps
  • muscle aches

• Activates receptors called mu and delta opioid receptors. These receptors are abundant in brain areas involved in responses to psychoactive substances, such as in the mesolimbic dopamine pathway.

• The most common are tablets, capsules and syrups/linctus taken orally.
• Solutions for injection.
• Less common forms include lozenges, nasal sprays, suppositories and skin patches.

• There is a greater risk of overdose and death if you are mixing opiate painkillers with other drugs that suppress breathing such as alcohol, benzodiazepines (like diazepam or Valium), and/or other opiate drugs.
• There's a particular risk of death due to inhaling vomit – because opiate painkillers can sedate you, can add to the risk of vomiting, and can stop you from coughing properly. The vomit blocks the airways or later leads to pneumonia.

Signs of overdose include:

The risks associated with taking an opiate painkiller, especially in high doses, purchased from a source outside the legitimate supply chain (for example, a website – particularly if hosted overseas) may include:

• relief of pain
• reduced coughing

Hillbilly Heroin, Oxycontin, Oxycodone, MS Contin, Oxies, Oxys, Panadiene, Panadiene Forte,  Codiene, Mersyndol, Captain Cody, Cody, Schoolboy, Doors & Fours, Pancakes & Syrup, Loads, M, Miss Emma, Monkey, White Stuff, Demmies, Pain killer, Apache, China girl, Dance fever, Goodfella, Murder 8, Tango and Cash, China white, Jackpot, TNT, Oxy 80, Oxycat