Opioids are depressant drugs that slow down the central nervous system and the messages which pass between the brain and the body. They are highly effective medications for the management of moderate to severe pain.

Opioids may be naturally occurring derivatives of the opium poppy, such as heroin, codeine, and morphine or synthetic compounds which act in the same way such as methadone, buprenorphine, oxycodone, or fentanyl.

Heroin is the opioid most commonly associated with non-medical use, however, in recent times there has been an increase in non-medical use of prescription opioids such as oxycodone, fentanyl, methadone and buprenorphine.

Prescription Opioids Drug

Prescription opioids include oxycodone, morphine, codeine, fentanyl, pethidine, methadone, and buprenorphine. They are prescription medications used to treat moderate to severe acute and chronic pain and to treat opioid dependence

Other names of Opioids Drug

Smack, Scag, dope, H, junk, hammer, slow, gear, harry, horse, black tar, china white, Chinese H, white dynamite, dragon, elephant or poison.  Hillbilly heroin, Oxy, OC, O, Done, Bupe.

Prescription opioids are usually known by their chemical (generic) name or their brand names. Different brand names may just be exactly the same drug made by different companies so it is important to look at the generic name.

What they look like

Heroin in its purest form is a fine white powder but it may also occur as a grey, brown or black powder, off-white granules or as small pieces of light brown ‘rock’.

In a treatment program methadone is usually given out in syrup form and is drunk with cordial or fruit juice. Buprenorphine, under the brand name Subutex® comes in tablet form and is dissolved under the tongue.

Codeine, morphine, pethidine, and oxycodone are usually prescribed in tablet form

Fentanyl is usually prescribed as a skin patch.

Low to moderate doses

Opioids Drug Effects may include

  • Feelings of intense pleasure
  • Strong feelings of well being
  • Pain relief
  • Drowsiness
  • Reduced coordination
  • Nausea and vomiting
  • Reduced appetite

Higher Doses

Opioids Drug Effects may include:

  • Difficulty concentrating and remembering things
  • Difficulty urinating, constipation,
  • Nausea, loss of appetite
  • Sweating and itching
  • Slow breathing and heart rate
  • Irregular heartbeat
  • Unconsciousness
  • Death

Long term Effects of Opioids Drug

These may include:

  • Dry mouth, tooth decay
  • Constipation
  • Cognitive impairment
  • Reduced sexual desire and sexual performance
  • Irregular menstrual periods and difficulty having children in women
  • Intense sadness
  • Relationship difficulties
  • Financial and work problems, legal problems
  • Overdose and death from respiratory failure
  • Dependence (needing more to get the same effect, withdrawal symptoms)

Side Effects of Prescription Opioids

Similar to other opioids, the most common side effects are:

  • Constipation
  • Headache
  • Increased sweating
  • Drowsiness, tiredness
  • Loss of appetite, nausea, vomiting
  • Abdominal pain
  • Skin rashes, itching, or hives
  • Dry mouth and tooth decay
  • Menstrual problems
  • Lowered sex drive
  • Weight gain (especially for women)

Codeine may be sold in combination with paracetamol or ibuprofen. Taking more than the recommended dose of these medications can cause serious health problems.

Codeine and Paracetamol

Long term use and use of more than the recommended dose can lead to serious liver damage from the paracetamol.  This can lead to death from liver failure.

Codeine and Ibuprofen

Long term use and use of more than the recommended dose can lead to serious bleeding in the stomach and intestines caused by the ibuprofen.  This can be fatal.  Ibuprofen also increases your risk of fatal heart attack or stroke even if you do not have heart disease or other risk factors.

Preventing and reducing harm

Opioids and other drugs

When you mix opioids with other drugs the effects can be unpredictable and sometimes dangerous.

  • If you mix opioids with other depressant drugs such as alcohol or benzodiazepines your heart rate and breathing can drop to dangerous levels. This increases the risk of overdose and death.
  • Taking opioids with stimulant drugs such as amphetamines places enormous strain on your heart and kidneys and can increase the risk of overdose.


Injecting opioids may cause:

  • vein and skin damage, abscesses and ulcers
  • deep vein thrombosis and clots causing loss of limbs, damage to organs, stroke and possibly death.
  • becoming dependent
  • infections such as tetanus, tuberculosis, Hepatitis B and C and HIV/AIDS

Sharing equipment such as needles and syringes greatly increases the risk of contracting blood borne viruses such as Hepatitis B, Hepatitis C and HIV.

It is safest not to inject drugs.  However, if you choose to inject you should always use new clean equipment.  The National Alcohol and other Drug Hotline 1800 250 015 can provide information on where to obtain clean needles and syringes in your state or territory.

Legal Issues of Opioids Drug

It is illegal to possess, use, supply, manufacture or sell Heroin in Australia or to help someone else to do these things.   Supply includes giving heroin to a friend.  It is also illegal to possess, use, or supply prescription opioids which were not prescribed for you and have been diverted from legal medical use.  Penalties can differ in different states and territories but include heavy fines and imprisonment.

It is illegal to drive while under the influence of Heroin or other opioids. Penalties may include heavy fines, imprisonment and loss of your driving license

It is important to be aware, however, that police will not be involved in ambulance callouts for Heroin overdoses unless ambulance officers feel threatened or it is associated with other criminal activities.











Adapted from Drug Facts, Alcohol and Drug Foundation

© Alcohol and Drug Foundation 2019, used with permission.