Other Drugs

Opioids

What are opioids?

Opioids are a class of drug that comes from natural or synthetic ingredients found in the opium poppy plant. Opioids work to reduce and alleviate pain by activating nerve cells in the brain known as opioid receptors that stop pain signals from the brain to the body. Opioids include prescription pain medications and illegal drugs, both of which can become addictive.

Some examples of prescription opioids include morphine, codeine, oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin), fentanyl, methadone, tramadol, and buprenorphine. Oftentimes, opioids are combined with other medications, such as acetaminophen, when prescribed. Illegal opioids include heroin and any prescription opioid that is sold to people without a prescription.

Other names for opioids include:

Opiates
Painkillers
Narcotics
Oxy
Lean

Sources: Mayo Clinic, Cleveland Clinic, Vertara Health, Johns Hopkins Medicine

What do opioids look like?

Opioids come in various forms, including pills, powder, and liquid.

Morphine: Clear liquid, tablets, capsules, and suppositories. Morphine ‘immediate-release’ (as-needed basis and go into effect quickly) tablets are round and white while extended-release (taken at scheduled times and provide longer-lasting pain relief) morphine tablets are round, oval, or capsule-shaped and can be a variety of colors, like blue, green, purple, pink, brown, orange, or gray. Suppositories can be inserted rectally and are white tablets.
Codeine: Little round, white pills
Oxycodone: Different colored round pills, including white, blue, green, yellow, and orange
Hydrocodone: Round or oval white pills.
Fentanyl: Clear liquid, brightly colored pills, or powder.
Methadone: Green liquid, also can be a pill or injectable.
Tramadol: Round or oval white pill.
Buprenorphine: Orange and oval shape.
Heroin: Pure heroin is a white powder that looks similar to cocaine. Additives or impurities to heroin give it a brownish powder and a tar-like substance.

Source: National Institute on Drug Abuse

How are opioids used?

Prescription opioids often come in either pill or liquid form administered either orally/rectally or intravenously via an I.V. or shot.

Illegal opioids sold on the streets, like heroin, may come in a powder form that can be dissolved in another liquid or melted down into an injectable form via a syringe needle. Some opioids in powder form are inhaled, snorted, or smoked.

Short-term effects

Opioids can make people feel relaxed and euphoric or “high” and can numb pain. Common short-term effects of opioid use include

Drowsiness
Slowed breathing
Constipation
Unconsciousness
Nausea
Coma

More information about short term effects of opioids can be found here.

Long-term effects

Long-term effects of opioids include:

Shallow or slow breathing
Physical agitation
Poor decision making
Abandoning responsibilities
Mood swings
Irritability
Depression
Lowered motivation
Anxiety attacks

Why do people use opioids?

Many people are prescribed opioids to help with pain management, which may be from surgery, cancer-related pain, or while at the emergency department from an accident, etc. Opioids are addictive substances, meaning that if a person begins misusing opioids, they may become hooked.

Are opioids addictive?

Yes. People can become addicted to the euphoric “high” associated with opioid use. Opioids are most addictive when taken using methods different from what is prescribed such as crushing pills so that they can be snorted or injected. Furthermore, several factors can impact addiction.

Risk factors of opioid misuse include:

Family history of substance abuse
Personal history of substance abuse
Stressful circumstances
Young age
Heavy tobacco use
History of severe depression or anxiety
Prior drug or alcohol rehabilitation

Source: Mayo Clinic

Why are synthetic opioids particularly dangerous?

Synthetic opioids have become a critical issue in the opioid crisis, driving overdoses at alarming rates. Many opioids can be created synthetically, however, fentanyl is of particular concern.

Fentanyl is an extremely powerful, synthetic opioid that is estimated to be 50-100 times more potent than morphine. Other drugs can be laced with fentanyl which makes this opioid especially dangerous and has significantly contributed to the opioid crisis.
- Fentanyl test strips are small pieces of paper that can detect fentanyl in different types of drugs and drug forms. This is a useful harm reduction tool that may help prevent overdose and ensure that drugs are not laced with fentanyl. For more information and where to get fentanyl test strips in Rhode Island, check out this website.

Sources: Department of Justice/Drug Enforcement Administration, National Institute on Drug Abuse, Centers for Disease Control, Prevent Overdose RI

Are opioids legal?

Most opioids are prescribed legally and are protected by law. Once someone begins either misusing or selling prescribed opioids, that is illegal. Heroin is never prescribed by medical professionals due to its danger.

Source: National Institute on Drug Abuse

What happens when someone overdoses?

When a person overdoses using opioids, the person's lungs and heart stop working properly which can lead to the person choking to death.

Signs of opioid overdose:

Small, constricted pupils
Falling asleep or losing consciousness
Slow, weak, or no breathing
Choking or gurgling sounds
Limp body
Cold and/or clammy skin
Discolored skin (especially in lips and nails)

Sources: Centers for Disease Control

How is an opioid overdose treated?

Opioid overdose can be treated with Naloxone (Narcan). Naloxone is administered as a spray in the nose and can stop or reverse the effects of an opioid overdose.

As part of a harm reduction approach, BWell offers multiple Naloxone and fentanyl strip trainings throughout the year. Check out this webpage or email [email protected] for information on upcoming trainings.

If you do not have access to Naloxone or while administering Naloxone call for help. Brown has an amnesty clause, which states that: “No student seeking medical treatment for alcohol or other drug use will be subject to University disciplinary action for the sole violation of using alcohol or other drugs. This policy shall extend to a student seeking help for another student.” More information on medical amnesty can be found here.

If on/around campus: Brown EMS - 401-863-4111

For additional resources and where to get Naloxone in Rhode Island, check out this website.