Opiates can be divided into two groups: the naturally occurring opiates like heroin and morphine which are derived from the opium poppy and the synthetic opiates like methadone and dipipanone.
Opiates can be smoked, sniffed, inhaled or injected depending on the drug and preparation.
Drug effect
Opiates are used for their analgesic (painkilling) properties. They also reduce breathing rate and heart rate, hunger and anxiety. These effects combined with an increase in blood flow to the skin gives the warm, contented and sometimes euphoric feeling that is often reported. First time users may vomit but this stops with repeated use.
At low doses, opiates do not interfere with physical coordination or mental alertness. After high doses, opiates produce a stupor (gauching).
Dependency
Tolerance to opiates develops very quickly and after a few weeks of regular use, doses must be increased to produce the same effect.
Dependence takes longer to develop, but after taking opiates regularly for some months there are physical withdrawal symptoms. The speed with which dependence develops and the severity of withdrawal symptoms experienced depends upon the quantity and type of drug taken, the method of administration and to some extent the expectations of the user.
Withdrawal usually begins eight to 48 hours after the last dose of drug, peaks after three to five days and then fades after five to 14 days.
Withdrawal from opiates can be unpleasant and uncomfortable. Symptoms are similar to a bad bout of flu and include: sweating, stomach cramps, muscular pain, running nose and diarrhoea. Most symptoms fade fairly quickly but sleeplessness and feelings of weakness may continue for some months.
Long-term use
The physical effects of long-term opiate use are not often serious in themselves. Common side-effects include constipation, irregular periods (menstrual cycle) and weight loss. However the use of unsterile equipment and the injecting of adulterated heroin, crushed tablets or the contents of capsules, can lead to more serious problems, including abscesses, vein collapse, loss of limbs, hepatitis B and C and HIV infection.
Overdose risk
Deaths from opiate overdoses are relatively rare although the intravenous use of Diconal is particularly dangerous. The risk increases after a period of abstinence or when opiates are mixed with other drugs such as cocaine, barbiturates or alcohol.
Risks in pregnancy
Many women do not have periods (menstrual cycle) when they are using opiates regularly but as soon as they cut down or stop their periods return. Many female drug users become pregnant at this time.
There is no evidence that opiates cause birth defects although they may possibly increase the risk of miscarriage and still births. However, opiate use should not be stopped suddenly because this also increases the risk of miscarriage or premature labour. Gradual withdrawal over 12 weeks may be advised.
Babies born to mothers who continue to "use" throughout the pregnancy show withdrawal symptoms within three days of birth (possibly longer if the mother has been using methadone). Symptoms include excessive restlessness, shrill crying, sleeplessness, constant sucking, diarrhoea, yawning and sneezing. In severe cases babies may suffer convulsions which can be fatal.
Legal status
Opiates are prescription-only medicines and most are controlled drugs (Class A or B, Schedule 2) which means that it is an offence to possess or sell the drug without a prescription or authority. See individual drugs for further details.
Painkiller and depressant ("downer") and anti-emetic (anti-sickness)
Description
Pink scored tablet (Dipipanone 10mg and Cyclizine 30mg)
Therapeutic use
Moderate to severe pain
Street use
By mouth or injecting crushed tablets
Dependency
Yes
Withdrawal
Effects of Diconal last for four to six hours. Withdrawal is similar to other opiates with flu-like symptoms lasting for five to 10 days.
Long-term use
Constipation
Breathing difficulties
Irregular periods (menstrual cycle)
If injected
- causes sudden drop in blood pressure which can be
fatal
- circulatory problems and tissue damage caused by
alkaline base of tablet
- septic abscesses from alkaline base of tablet
- infection risk.
Overdose risk
If Diconal is injected there is a serious risk of overdose because of loss of blood pressure. Many of the overdose deaths among opiate injectors involve this drug.
White tablets (30mg)
Elixir (10mg/5ml)
Ampoules (50mg/ml)
Therapeutic use
Moderate to severe pain
Street use
Mainly by mouth as drug does not dissolve in water. This makes it difficult to inject.
Dependency
Yes
Withdrawal
Probably similar to other opiates. Flu-like symptoms for five days.
Long-term use
Constipation
Breathing difficulties
Irregular periods (menstrual cycle)
Overdose risk
Probably fairly low, although risks increase if drug is mixed with other drugs.
Legal status
Dihydrocodeine is a Class B controlled drug (Schedule 2). This means it is an offence to possess the drug without a prescription or to supply it to others.
Medical practitioners are not required to notify the authorities about anyone they suspect to be dependent on this drug.
Maximum penalty For possession: Five years and/or unlimited fine
For dealing:14 years and/or unlimited fine
If prepared for injection the increased maximum penalties apply:
White/brown powder normally containing five to 30 percent pure heroin. Often cut with adulterants or other drugs. Diamorphine BP - clear solution in ampoules. Also available 10mg tablet and 5, 10, 30, 100, 500mg freeze dried powder in ampoules.
Therapeutic use
Severe pain
Street use
Smoked, sniffed, "Chasing the Dragon" (inhaling fumes of heated heroin), injected. Heroin produces little effect if taken by mouth.
Dependency
Yes
Withdrawal
Effects of heroin last for two to three hours and withdrawal symptoms appear eight to 24 hours after last dose. Symptoms resemble severe flu together with diarrhoea. They peak around the third day and fade after five to ten days. Sleeplessness may continue for some months.
Long-term use
Constipation
Breathing difficulties
Irregular periods (menstrual cycle)
If injected
-infection risk
-circulatory problems.
Overdose risk
Deaths from the use of heroin alone are relatively infrequent. However the overdose risk increases after a period of abstinence or if heroin is mixed with drugs like cocaine, barbiturates or alcohol.
Legal status
Diamorphine is a prescription-only medicine and is a Class A controlled drug (Schedule 2). This means it is an offence to possess the drug without a prescription or to supply it to others.
Maximum penalty For possession: Seven years and/or unlimited fine
For dealing: Life and/or unlimited fine
By mouth or injecting crushed tablets, linctus or ampoule
Dependency
Yes
Withdrawal
The effects of methadone last up to 24 hours which is longer than heroin. Withdrawal symptoms are slower to develop but last longer. Flu-like symptoms appear up to two days after last dose, peak after five to six days and fade after 14 days. Sleeplessness may last for longer. It has been suggested that withdrawal is more difficult than from heroin.
Long-term use
Constipation
Breathing difficulties
Irregular periods (menstrual cycle)
If injected
-infection risk
-circulatory problems.
Depresses effects of other opiates.
Overdose risk
Deaths from the use of methadone alone are relatively infrequent. However the overdose risk increases after a period of abstinence or if methadone is mixed with other drugs such as barbiturates or alcohol.
Legal status
Methadone is a prescription-only medicine and is a Class A controlled drug (Schedule 2). This means it is an offence to possess the drug without a prescription and to supply it to others.
Maximum penalty
For possession: Seven years and/or unlimited fine
For dealing:
Life and/or unlimited fine
For more detail information on Methadone please click here.
White tablet (0.2mg) marked with symbol. White tablet (0.4mg) marked with symbol (dissolved under tongue). 1ml & 2ml ampoules (0.3mg/ml).
Therapeutic use
Moderate to severe pain
Street use
Dissolved in the mouth, crushed and sniffed or injected.
Dependency
Yes
Withdrawal
Effects of Temgesic last for about six hours. Withdrawal symptoms begin within a day of the last dose. Withdrawal symptoms include tightness of chest, headaches, dry retching and flu-like symptoms.
Long-term use
Constipation
Breathing difficulties
Irregular periods (menstrual cycle)
If injected
-infection risk
-circulatory problems.
Overdose risk
Overdose risk is probably low
Legal status
Temgesic is a prescription-only medicine and was recently made a controlled drug, Class C (Schedule 3).
Maximum penalty
For possession: Two years
For dealing: Five years
SPECIAL NOTE
Temazepam (one of the benzodiazepines) is also sometimes called Tems and thus can be confused with Temgesic.
For more detailed inforamtion on Burenorphine (Subutex) please click here.
Injection 10mg/ ml. Available on the black market in 2ml (20mg) multi close vial.
Therapeutic use
Moderate to severe pain
Street use
Injected
Dependency
Yes
Withdrawal
Similar to other opiates.
Abdominal cramps, anxiety, nausea and vomiting, crying, restlessness, irritability and "flu like" symptoms.
Long-term use
Considered to have low abuse potential, but physical, psychological dependence and tolerance may develop following long-term or misuse or abuse.
Overdose risk
Deaths from overdose are relatively rare, but complications associated with injecting, like hepatitis C or septicaemia, are more likely. Overdose may produce pinpoint pupils, sedation, dizziness and breathing difficulties. Its effects are increased if mixed with other central nervous system depressants such as tranquillisers, sedatives, hypnotics or alcohol.
Legal status
Nubain is not controlled under the Misuse of Drugs Act (1971). It is a prescription-only medicine.
SPECIAL NOTE
Nubain is abused particularly by people involved in competitive sports especially body builders to overcome musculo-skeletal pain despite the risk of injury, to keep calm before competition, and to take part in sport or training after injury.
Nubain addicts shoot up between six to eight times a day whereas heroin users would tend to shoot up only once. This carries considerable risk of infection, hepatitis C, HIV and other infections if sharing equipment.
