About addiction · Uncategorized

The highs and lows of opioids

“Drugs are a waste of time.  They destroy your memory and your self-respect and everything that goes along with your self-esteem.”  –Kurt Cobain

woman carry rock addictionPerhaps you’re here because you’re an addict questioning the safety of your drug, or your have a daughter or neighbor with an opioid addiction and you desperately need to understand the characteristics of the substance they’re taking.  Below you’ll find a review of side effects and withdrawal symptoms.

Opioids include heroin, Methadone, Subutex, Oxycontin, Fentanyl, Morphine, and others. In clinical practice they are used to treat pain or severe cough.  They’re also the cause of much heartache and tens of thousands of deaths every year.

Short-term effects

Opiates can be injected, snorted, smoked, or taken by mouth in pill form.  Some kinds, like Oxycontin and Methadone, are prescribed and often abused.  The desired “high” kicks in within seconds to hours after administration, depending on which opiate and how it is taken.  Between the extreme high and the drug’s tight interaction with the chemicals in our body, these drugs are very addictive.

Symptoms of short-term intoxication include:

  • Poor judgment
  • Incoordination
  • Problems walking and talking
  • Sleepiness
  • Lethargy
  • Nausea
  • Slowed  heart rate and breathing
  • Tiny pupils

If too much is taken, the user overdoses and stops breathing.  An overdose usually means death, unless an “anti-opiate” medication like Narcan is given to reverse the effects.  If someone you love is prescribed or abuses opiates, please talk to your pharmacist about Narcan.  In most places, it can be purchased without a prescription.  Narcan is expensive but saves lives.

Overdose deaths from opiates have sky-rocketed in the recent years, especially since the emergency of Fentanyl-laced drugs.  Fentanyl is an opiate that’s 50 times more potent than heroin.  Some of its derivatives are more than 100 times more potent and can’t be reversed by Narcan.  Why are Fentanyl-laced opiates dangerous?  Problem is that people don’t realize they’re taking Fentanyl.  They think it’s their usual drug of choice.  The individual misjudges what and how much they’re using and accidentally overdose.  Death happens in seconds.

In May 2018 the FDA discovered a batch of Oxycontin pills that were actually Fentanyl, not Oxycontin.  The Fentanyl tablets were identical to Oxycontin.  The FDA has even found Fentanyl added to cocaine.  Cocaine is not an opioid.  People who use cocaine have no tolerance to opioids.  It’s unclear why anyone would purposefully add Fentanyl to another drug, but the result is always the same: a round of accidental overdoses and deaths.

According to the National Institute of Drug Abuse, there were 72,000 drug overdose deaths in 2017; Fentanyl and Fentanyl-derivates were involved in 30,000 of those deaths.  Note that more people have passed away from the drug overdose epidemic in the past few years than Americans who died in the Vietnam War.

Of note, most of the Fentanyl is coming from overseas.

Long-term effects.

If you’ve been taking opiates long-term, whether prescribed or off the street, you might experience the symptoms of chronic opioid use.  This can include:

  • Constipation
  • Abdominal extension, bloating
  • Nausea and Vomiting
  • Gut blockage or perforation
  • Liver damage (especially for opiates that are combined with Tylenol)
  • Brain damage (from too little oxygen to the brain)
  • Body needs more to get same effect
  • Can’t stop without withdrawing
  • Decreased or increased sensitivity to pain
  • Complications that can lead to death

There are additional concerns for those who inject, including

  • Air bubbles and other emboli in the blood
  • Lung disease or stroke from these emboli
  • Heart valve infections
  • Sepsis
  • Infection or gangrene at the injection site
  • Amputations
  • HIV
  • Viral Hepatitis and liver damage
  • Complications that can lead to death


A major issue with drugs of abuse is tolerance.  The more a person uses, the more the body wants.  Before they know it, they’re taking a whopping dose — and get sick every time they try to back off or stop.  This is called withdrawal.  Often called “detox,” withdrawal is one of many motivating factors that keep people using.

Opiate withdrawal isn’t usually life-threatening, but it’s a miserable experience.  It’s intolerable.  The addicted person will do anything to avoid withdrawal, and sometimes that “anything” involves crime and violence.  Symptoms of withdrawal include:

  • Fear of dying
  • Anxiety and restlessness
  • Tearfulness
  • Sweating and chills
  • Excessive drooling
  • Body aches and belly pain
  • Vomiting and diarrhea
  • Fast heart rate
  • Itching
  • Insomnia
  • Intense, obsessive cravings to use

Withdrawal can be treated medically in detox centers and hospitals.  Doctors try to ease suffering with medications, but not all symptoms can be avoided.  Withdrawal lasts three to five days, or longer for Methadone and Buprenorphine.  The theory: when an opiate addict doesn’t have to spend their day seeking drugs to avoid withdrawal, they’re one step closer to recovery.


Spending a week on a detox unit isn’t enough.  Here’s the challenge: a person recovering from a addiction has to (a) learn to live without drugs, (b) survive all the consequences of their addiction, (c) survive those consequences a while longer and adjust to this complicated landscape, (d) maintain 1-2 years of recovery just to let their brains heal, and (e) have something to look forward to (preferably an exciting, worthwhile future).

Treatment includes detox, then rehabilitation and lifestyle changes.  Many people benefit from attending 12-step programs.  It’s also important to deal with other obstacles, like homelessness, unemployment, isolation, chronic pain, or mental health problems (depression, anxiety, anger issues, etc).

More posts about treatment of substance abuse coming up.


This website is about our book, so we’ve got to say something useful:

In addition to its relapse prevention focus, the Weird and Wacky Workbook for Recovery helps a person survive the emotional and thought meltdowns associated with early recovery and, over time, remember how to love life again.  The exciting, worthwhile future is super cool but optional. 

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