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
Other Opioids
- Opiate/opioid painkillers are medicines with effects similar to opium. They act by stimulating opioid receptors in the brain and nervous system.
- There are a large number of opiate/opioid medicines including codeine, morphine, dihydrocodeine, methadone, buprenorphine and diamorphine (also known as heroin).
- Opium comes from the flower of the opium poppy and has been used for many hundreds of years to treat pain, sleeplessness and diarrhoea. Increasingly the terms opiate and opioid are used interchangeably when referring to these drugs.
- Opiate is sometimes used to refer only to those drugs derived directly or indirectly from natural opium. However, they all act on the opioid receptor in the body.
AKA (common names)
Low - moderate doses
- relief of pain
- reduced coughing
High doses
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:
- constipation
- itching
- nausea and retching
- lethargy
- dizziness or fainting
- in overdose, suppression of normal breathing, and risk of respiratory arrest (when you stop breathing altogether).
- certain opiate painkillers have additional specific non-opioid effects, which may be described by the prescriber, and will be described in the patient information leaflet.
Overuse of codeine when it is taken already combined with one of the simple analgesic drugs, can lead to paracetamol, aspirin or ibuprofen poisoning and even death. Whilst paracetamol, ibuprofen and aspirin may seem harmless in normal doses, they can cause really serious problems in high doses - with risks of kidney failure, liver failure, and of severe damage to, or bleeding from, the stomach, which can be fatal.
Signs of overdose
- 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:
- awake, but unable to talk
- body is very limp
- face is very pale or clammy
- fingernails and lips turn blue or purplish black
- For lighter skinned people, the skin tone turns bluish purple, for darker skinned people, it turns grayish or ashen
- breathing is very slow and shallow, erratic, or has stopped
- pulse (heartbeat) is slow, erratic, or not there at all
- choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”)
- vomiting
- loss of consciousness
- unresponsive to outside stimulus
Route of administration & onset
- 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.
Duration of effect & 'come down' (half-life)
Mechanism of action (on the brain)
- 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.
Tolerance (dependence) & withdrawal
- 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
Short-term harms & risks
Long-term harms & risks
- long-term changes in opioid receptors and peptides
- adaptations in reward, learning and stress responses
- paracetamol, aspirin or ibuprofen poisoning and even death
