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Alcohol and Substance Abuse - Opiates

Mark Dombeck, Ph.D.

Member Drugs: (Brand Names) [Street Names]

  • Heroin [Horse, Junk, Smack, Snow, "H", Brown, Black]
  • Morphine
  • Codeine (OxyContin, Tylenol with Codeine)
  • Methadone, LAAM

What The Drugs Looks Like:

  • Heroin comes in the form of a white or brown crystalline substance that can be powdered.
  • Commercial opioid medications come in pill and liquid forms.

Most Typical Routes Of Administration:

  • Nose (snorting powered form)
  • Lungs (inhaling pipe smoke)
  • Mouth (swallowing pills)
  • IV (injection into a vein)

What These Drugs Do (Symptoms Typical Of Intoxication):

  • Short term effects:
    • The intense "rush" which most abusers prefer is obtained from intravenous injection
    • Feeling of well being, euphoria, relaxation, drowsiness and mental confusion
    • Higher doses and overdose can cause: sleep; very low blood pressure, slowed heart rate and respiration; low body temperature; muscle constriction; cold clammy skin; cyanosis (not enough oxygen in the bloodstream); coma and death.
    • Physical as well as emotional responses to pain are numbed
    • Apathy and an inability to concentrate,
    • Nausea, vomiting, sweating, chills
    • Slowed pulse, rate of breathing and lowered blood pressure
  • Long term effects:
    • Chronic constipation
    • Impaired vision
    • Mood swings and instability
    • As tolerance develops, the user can no longer get the pleasurable effects, but must continue taking the drug to prevent withdrawal.

Pattern of Withdrawal Symptoms:

Symptoms last 10-14 days or even longer

  • Chills and hot flashes
  • Sweating
  • Cramps
  • Nausea
  • Tremors
  • Loss of appetite
  • Insomnia
  • Dilated pupils
  • Watery eyes
  • Runny nose
  • Yawning fits
  • Diarrhea
  • Panic attacks
  • Bone aches
  • Muscle aches
  • Lethargy

Most Significant Problems:

  • High possibility of a potentially fatal overdose
  • Addictive with strong, painful withdrawal symptoms
  • May possibly contribute to depression or anxiety

How Tested For:

  • Blood Test (remains positive for approx. 2 days after last dose)


Reader Comments

- swim - Jul 17th 2013

i started injecting heroin about 4 months ago.  befor that, i smoked crack on a regular basis.  i left the town i was living in and moved up here.  i stayed sober untill i met some people who used and that got me going agian......just with a diffrent drug.  im not pbysically addicted to it yet, but i sure as hell am mentally.  when i dobt have it i cant sleep and become severally depressed, like right now.  i tried to stop, but after about 2 days of ni sleep that ended that.  im spending all my money, and alot of other peoples, on ghis drug, and if i dont stop im never going to ne able to accomplish my dreams.  im only 20 years old and i dont want to live my life as an addict.  i want to leave this place and become independent.  i need help but im not sure how to get it. i cant tell my family i know theyd never understand and i cant put them through that..... i love them to much.  im not sure what to do at this point, but i know i could stop if not for the mindnumbing depression.  

Good to be able to share - Steve Rostoks - Nov 8th 2012

Hi my name is Steve and I'm really fu**ed up. i'm sure there are alot of people out there thet feel the same way and thats cool but this is all new to me so let me talk. i have never talked to people like this before but here goes. Every day when I wake up all I want to do is die. The pain and heartache of my day to day life is shit. I hate my job but just keep going back coz it pays well. My mother died six years ago from a brain tumer, which I could have maybe dealed with alot better if my brother wasn\\


I am 30 and got addicted to pain killers after a surgery and the recreational use of opiates rarely at 24 to now having to switch to snorting heroin. I moved to a different state where I could get suboxone w out being on a year and a half waiting list. I was on two 8mg suboxone strips a day ran out of money over xmas to see the doc. At that time i went off a 1/4 strip on one a day and it was almost as bad as just quitting the opiates. I think it is just a mental crutch. I've seen people say it took two weeks of withdrawls from suboxone. Myself it was 3 days on but i took a little hydrocodone in there two to easy jumping out of my skin. The least amount of time n the quicker u cut back on suboxone the better off you are cuz that has withdrawl too. I started treatment in July and have been off everything for a couple weeks now.

Son needs help.. - Donna - Jun 25th 2011

Hi - I have a son, 29, who has been using/abusing opiates for several years.  He went from buying dried poppies (?) and boiling the flower part to make a tea that he drank, to popping opiates in pill form and now for about a year has been injecting it..  I have seen him do this & it makes me sick.  He gets it in pill form?  or ?  and then mixes it on a spoon with water then uses a needle to draw it up & then injects this into his arms..  He has expressed to me several times that he wishes he never started - even 'quit' with the use of another drug that helps you not crave it - but has always gone back to using it again.  For awhile, I thought he was using heroin but he says it is opiates.  I don't know anymore.  I do know that he goes through money (my mother's) daily for his 'fix'.. if he withdraws, he is antsy, feels like flu symptoms & has a runny nose.  He says withdrawal is horrible and has often used a bottle of cough syrup before with dextromethoraphan (?) in it to help him sleep through the worst of it. . I have tried getting him to rehab but hard to find one that will take him - no insurance and they seem to have had several government 'cuts' so a long list of people waiting.  It's hard to see .. I am afraid he is killing himself & I can't do much to stop it.  Any help or what to do to try & help him get off this stuff?   I have no idea what else to do..   Thank you.

going through hell! - - Jun 12th 2010

  I've been addicted to opiates for about 10yrs but really PHYSICALLY and MENTALLY screwed for about 6.  Almost 2yrs ago, I started Suboxone. (Another opiate/opiate-blocker)  It's a very helpful med, but now that I'm not "numb" (mentally) anymore I've had more anxiety, depression, jealousy, and insecurities than I could ever imagine!  My therapist says it's  normal, but that I also have ADD!  SO, now I'm also on Adderall.  It does help me focus and gives me motivation to get outta bed in the morning, but it tends to backfire...a LOT. 

  I have an amazing boyfriend, he's been so patient with me but I cannot get over this horrible jealousy and I'm VERY insecure.  Even when he goes to work, I can't spend the evening alone, comfortable and sound.  I sit here, all pessimistic, telling myself not to get too comfortable cause it's just gonna blow up in my face like SOOO many other things have in my life.  It's tearing us apart and I know he's at the end of HIS rope. 

  I used to be so good at relatonships.  Never had insecurities like this, especially after how long we've been together!  I don't know what's wrong with me and I can't control it.  Is it part of recovery?  Is it the Adderrall?  PLEASE HELP ME!!

there is help!! - Barbara Mills - Apr 2nd 2010

My son recently went to rehab,at Livengren,in Hulmeville.Pa.He stayed for 3 wks with counseling ,meds and meetings ,he overcame the addiction to opiates.He did everything he could get his hands on.And suprisingly tried and became VERY addicted to heroin.What a shock to his whole family,and I think even himself.

There is a med called naltrexone,please,if you havent tried it,ask for it.Methadone just keeps you addicted to something else.Naltrexone is an opiate,and alcohol blocker.It works,and my very good friend is on this for alcoholism.Please get help!!It works!!!And with counseling you find out the underlying cause,not just cover it up.

Perks - Susan - Jan 4th 2010

Hi My name is Susan and ive been trying to kick my drug habet for 10 or more years. Ive been in and out of detox and rehab and had one year clean. My freind at work gave me a perk to wake me up and now im up to over 10 a day. i lost my job , apt money everything to this habbet. Im now on welfare and living in a room with no food. My family feeds me now and then . Its so humiliating to ask for help. Its been 4 days now and its so hard not to just give in. It took everything i had to have a shower today.

My dr. gave me clonidine to help with the with drawl. It helps me sleep and stops the pain in my muscles but makes me very dizzy. Im going to hang on . Ive done the withdrawl before and got through it. God only knows why i picked up again . Im praying i get through this . Good luck to you all too. Susan

I've just told my sister her son was taking pills and it blew completely up in MY face - - Dec 30th 2008

I had noticed some bodylanguage that I've notice before on my daughter while active addition.  I love my nephew and just couldn't believe my eyes when I thought aI was picking up on some manurisms when using opiates.  Later confirmed some trafficing on text messages and struggled to tell the family a few weeks until I was the way, they shoot the messanger......with bazookas are brought out.  Horrible things were said about how f....uped addicts are and she hates them all.  I'm still sitting there waiting to be supporter for her and she continues just lamblasting me.  What now? 


Not Sure - - Dec 28th 2008

My boyfriend has been on and off oxy and perks for a few years now.  He's gone through some withdrawls but nothing major.   He recently got a nice job and has been working hard 6 days a week.  He has not been using any opiates since he got this job.   One of the main ways I can tell that he was using were his eyes.  The pupils were constrcted to the size of a pin point.  Over the holidays he has had four days off from work.  And his pupils are small again.  He swears to me that he is not using and would never want to go back down that road.  It ruined his life in so many ways.  He gets mad  at me because I think that he did use them.   His behavior hasn't changed and does't seem to be high.  He does drink a few and only seems to be tipsy from the few that he does drink.   Could something else be casuing his eyes to look this way???  Or is he lying to me about the use ???

Help! Addicted to Oxy! - Stephanie - Dec 7th 2008

Is there anyone out there who has overcome an addiction to OxyContin.  I've read tons of horror stories but have yet to find something truly inspiring, like "A Million Little Pieces" but only true (an excellent story, by the way...Highly recommended!).  I need a little bit of hope and something to look towards besides how I am going to find the money for my next pill.  I have spent at least $80 to $120 on average a day for the last 5 years.  You may be thinking "bullshit" but it is true.  I graduated from college in 2002 and had big dreams and goals to accomplish.  Never in a million years would I have dreamed that this is where Oxy would take me.  If you haven't tried it, DON'T...If you have...STOP, and if your habit is like mine..Please Help Me! I don't know what to do!  It is ruining my life, my body, and my soul! 

there is no hope - - Aug 25th 2008

i have tried so many times to quit doing hydrocodone.  There is help you just have to trust in god taper off the withdrawals just feel like really bad flu.  the truth is ihave tried to go to doctors to get help or to go to hospital type rehabs.  unless you have thousands in disposable income no one is willing to help you.  i have been to psychiatrists and they will help you if you get off the stuff first.  many of us are in this position because of disease or illness and then we are treated like pieces of trash beacause we ask for help.  i started because i severe depression.  no one takes insurance. the doctors who put you on this stuff see you as a liability.  i am going to loose my husband and my child all because i want help worse than anything.  right now it only seems like killing  myself is the only way to get help

I HAVE SEVERE OSTOIS ARTHRITIS & SEVER REHUMATORID ARTHRITIS & TAKEN ALL KINDS OF PAIN MEDS & the only one that helps the pain alot is methadone ,iv been taking methadone 4 about 15-16 yrs .& was allways doing & never got in trouble until i had 2 stop taking methadone.. i would like 2 come in & talk 2some one about my problem. im on parole & my parole officer said it is ok with him 2 start taking methadone again ,thank you for your time.. need 2 talk 2someonebout this

I too need help - G Man - Aug 13th 2007

I have been taking lortab / hydrocodone now going on 7 months. I have became immune to the effects and need more and more to do the job it ( they) once did. I'm taking 10 to 20(5/500's) per day.A real sign of addiction. My problem is compounded by I'm a survivor of Leukemia (chemotherapy aftermath). My back (spine) kills me where they performed a bone marrow sample. My heart now hurts as does my kidney's. I have a pinched nerve in the back of my neck at the base of my skull causing severe headaches.

I hurt all over and cannot function without the opiate to make the pain go away. The Oncologist saved my life (true enough) thus far, but I now question did he truly do me any favors ? Living with tremendous pain versus take lortabs till death ( by way of liver failure) is no grand horizon. I commend anyone brave enough to face cancer of any kind and change the fate it would otherwise opt for you whatever the outcome;at least it went your way and not the cancer's.

One thing I now detest is that the Doctor had no problem writting the script that got me started but has done much to ditch me and the liability I pose him. I had one nurse practioner tell me these are worse than cocaine to battle from an addiction stand point. From my life expeirence he was right !

I'm not a weak individual but see no way out of this one. The withdraws are almost worse than I can handle or all I went through battling the Leukemia. Does  anyone have any suggestions they may offer to get rid of both the addiction and the exscruating daily pain ? Please Post ASAP!

I need help. - A/ Female (28) - Feb 11th 2007
Well.... I have been taking lortabs for about a year now. I take them oral ( neber snort). I am ready to take that step and get off of them ,but I am very afraid of the withdrawals. I know that sounds funny, but I have a fear of vomiting, and I hear that is one of the major withdrawal symptoms. I am hear trying to get some advice on what may be the best route for me to take to get off this devil pill. I take ten to twenty a day, that depends on how many I start the day with. Does anyone I mean anyone have a word of help?

response/questions - Maria - Dec 7th 2006
How long have been cleaned? Was pills all you did? I hear stories of how people overcome it, but in reality is seems so far away. I see too many people saying I want to get out and I dont want to do this anymore but is like they have no choice or do they?

You will overcome - Paul - Oct 23rd 2006
I have been dependent on hydro, oxycontin, roxicodone for 16 yrs due to spinal condition, 5 herniations, diabetic neuropathic pain et al. I am now off meds for 23 days all narcs...23 days post..still having minor w/d particularly in emotional realm. Detox in hospitals if you r dependent, and not an ADDICT, there is a fine nuance of definition. I have been funcitonal as a prof therapist w brain injured folks the last 20 yrs, even while dependent. Clonidine patches/ catapress tts patches MAX DAILY dose 2.4 mg. In the hospital detox wards they will use 0.1 mg pills and titrate. Your outpatient physician can prescribe this. Diazapam (valium), is also used in detox wards to help you come off the opiates. other than that if you have pain use heat, lidocaine patches applied to spasms....and stay away from ULTRAM, methadone, benzo (the new sub for methadone)..they r all opiates..and bad ones at do you want adequacy and functionality in life. Your choice and with God's help you will overcome. I believe the spiritual man or woman can overcome! God's strength to you, and clarity of mind. You can reply to my email if you have questions on pain conditions and detox, or ? Paul

independence - Bob - Jul 15th 2006
its all a mental game. i did and loved it and lost everything i worked for. i am 20 years old now and i have to start all over. i was never given anything in life i had to work for it. i started working when i was 11 years old when school was out. i was a labor for my step father, who owns a roofing company. i probably was 4ft. 10in. tall and weigh about 120 pounds. i carried shingles for him. and these shingles weighed about 120 pounds so it sucked. i saved my money for a long time and bought my own truck. Drugs were the last thing on my mind. then i injured my knee bad and was stuborn and didnt go to the doctor. later on i joined my grandfather house construction crew and began to be around people who snorted pain pills. i didnt want them until one day my knee was bothering me. i swallowed half of a 7.5 mg hydrocodone. and the adrenaline rush it gave me was great. naturally my adrenaline would go easy and this was cool because i didnt have to do anything but take that pill to feel that way. that led to more and more until i snorted one. and i loved it. things just went to the worse after that because i did it more. and then i got to the point that i used my intelligence to find out how it worked and found ways to snort it and make work faster and hit harder at once. i had 2 cars, a house, and didnt owe anything on them they were mine. now i have hit me on my 20 birthday, which last wednesday, that i was addicted. i could get them whenever i wanted. and last month i spent about $700 on pills, thats just what i remember. i know that i was snorting at least 10 hydrocodone 10's everyday. and here street price is $6-7 per pill. i looked at the people that i did this with and they were 40 years old and had nothing but a habit. so i went home to my parents who orally took them and said help. i havent slept that much in a while but im making. and honestly i dont think people have to have rehab to come through all you need is the will and determination to do it. and the best thing you can do is not be around it and make it unavailable to get. and if you cant get it you dont have and you come out a new person. my sinuses have been running for a week, i havent slept very good, havent eat much but i honestly feel so much better even with the withdraw symptoms. and they are easing up and i look better physically and feel better about myself mentally. and i know you may think your young its easy, no its not its hard for anybody. but the best high you can get is the that your body produces naturally. the thing that i found to be the the most helpful is having something to occupy your mind. you cant sit around and think about it do something. and for the people who havent been through this dont try and give advise because you dont know what its like. i learned my lesson the hard way and now its to move on. and for the people that have gotten away from it help young teens get away from it. they are easy to spot because that was you once and dont you wish that someone who experieced it help you. live above the influence. you are an individual and you make your own choices and later on youll realize that and youll be me typing your story hoping that a teenager reads before he goes to far. your body can only stand so much.