Opioids (OxyContin, Vicodin, heroin, fentanyl, morphine)

What they are:

Opioids are a class of drugs either derived from, or chemically similar to, compounds found in opium poppies. Opioids include legal prescription painkillers like oxycodone (OxyContin®), hydrocodone (Vicodin®), morphine, codeine, fentanyl, and others. Heroin, which is illegal, is also an opioid.1

Some slang terms for prescription opioids are OCs, Oxy, perks, and vics. Slang terms for heroin include smack, junk, black tar, and horse.2

How they're taken:

Prescription opioids can be used appropriately, as prescribed by a doctor, in a couple ways. They can be taken orally in their original pill form, or they can be administered by an oral film patch, which dissolves in the mouth. Opioids can also be administered intravenously, in cases of pain management.

Prescription opioids can be misused a number of ways, too. They can be taken orally in pill form, but in higher dosages than prescribed, or without a prescription at all. They can also be crushed up and inhaled or injected.

Heroin can be inhaled, injected, or smoked.

How they work:

Opioids bond to opioid receptors in the human body and brain, blocking pain. In addition to providing pain relief, opioids produce feelings of euphoria and relaxation—especially when misused (taking the wrong dosage, using without a prescription).

Side effects of opioids can include nausea, confusion, and depression.3 Opioids also quickly build both tolerance and physical dependence, which can lead users to take larger and larger doses in order to feel the same relief. This can lead to addiction and overdose. Get more detailed information on opioids.

Signs someone could be misusing:

General changes in mood and behavior can be an indicator of substance use. A person who is actively misusing opioids may seem drowsy and disoriented. "Heroin nods" are a common side effect; when this happens, a user seems to fall asleep, while sitting or even standing, with their head hung down.4 Movements may be slowed and speech may be slurred.

Drug paraphernalia can often be found around the user's bedroom or living space. The presence of things like vials, needles, rubber tubing, and spoons that are bent or burned on the bottom, could indicate heroin misuse.

When someone takes opioids in high doses, their heart rate and breathing may become depressed. They may eventually stop breathing altogether, which can of course lead to death. Symptoms of overdose may include pinpoint pupils, unconsciousness and/or respiratory depression.5 Naloxone is a medication that can immediately reverse an opioid overdose. Learn more about naloxone.

Learn More


1. NIDA. Drugs of Abuse: Opioids. May 2016.
2. NIDA for Teens. Drug Facts. October 2016.
3. CDC. Prescription Opioids. March 2016.
4. Abadinsky, Howard. Drug Use and Abuse: A Comprehensive Introduction.  Cengage Learning, 2007.
5. Information sheet on opioid overdose. World Health Organization, November 2014.