Opioid abuse and addiction are at epidemic proportions in the US. Not only are these substances highly addictive, but it is estimated that out of the 90,000 fatal overdoses in the country each year, around 70% of those are due to opioids.

Because of the euphoric and relaxing properties of opioids (and their reputation for producing tolerance in the body), they pose a high risk for abuse. Whether they’re used recreationally as heroin or as a prescription opioid for pain relief, these drugs are addictive both physically and psychologically.

However, treatment is available for people who become addicted to opioids. Before going into the types of treatment that are available for this type of addiction, this article will provide an outline of what opioids are and what the long-term effects are.

What Are Opioids?

prescription oxycodone pills and bottle

Opioids are controlled substances that target the opioid receptors in the body’s nervous system to reduce acute and chronic pain. Derived from opium, opioids are naturally occurring compounds that are found in poppy seeds and plants. The most notorious opioid drug is heroin, but there is also an array of legal opioids available in the form of prescription painkillers.

While heroin has been around for a long time, prescription opioids have also become increasingly popular. Since the 1990s, doctors have been prescribing more of these medications owing partly to an aging population and because more people have long-term pain problems.

Due to the calming effects of opioids, they pose a high risk of abuse and addiction and are primarily intended for short-term use. When taken in excess, it can lead to feelings of euphoria similar to heroin. However, opioid overdoses can lead to effects such as difficulty breathing, vomiting, coma, or even death. According to the Centers for Disease Control (CDC), between 2009 and 2019, over 247,000 people died from prescription opioids.

Below are the most abused opioids, most of which are prescription drugs.


Heroin is an opioid synthesized from morphine, a naturally occurring compound in the poppy plants of Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be snorted or injected and usually comes in a white or brown powder or as a black sticky substance (known as black tar heroin). The effects of heroin are quick and intense as the drug rapidly binds to opioid receptors in the body, especially those that affect pain, pleasure, heart rate, sleeping, and breathing.

Common street names for heroin include:

  • Dope
  • Smack
  • H
  • Junk
  • Skag
  • Snow
  • Horse
  • China white
  • Brown
  • Beast
  • Hero


Fentanyl is a potent synthetic opioid that is available as a prescription and manufactured illegally as a recreational drug. On the street, it is often combined with heroin (or sold as a substitute for heroin), or it is mixed with stimulants like methamphetamine and cocaine.

The danger with fentanyl is that it is 50 to 100 times more potent than morphine. This has led to fatal overdoses, especially on the streets where it is unregulated. In fact, the CDC estimates that over half of opioid-related deaths are due to fentanyl.

Common street names for fentanyl include:

  • Apace
  • China Girl
  • China White
  • Dance Fever
  • Goodfellas
  • Great Bear
  • He-Man
  • Tango & Cash

Oxycodone (OxyContin/Percocet)

Oxycodone is one of the most popular (and addictive) prescription opioids on the market. According to the Drug Enforcement Agency (DEA), 58.8 million prescriptions for oxycodone were dispensed in 2013.

These drugs cause euphoria and sedation and are used to treat moderate to severe pain for cancer, operations, or accidents. Oxycodone is sold under the brand name OxyContin, and when combined with acetaminophen, it is called Percocet.

Common street names for oxycodone include:

  • Hillbilly heroin
  • Blues
  • Kickers
  • Oxy
  • OX
  • Oxycotton

Hydrocodone (Vicodin)

Hydrocodone is another powerful opioid drug that is usually combined with other painkillers such as acetaminophen or ibuprofen. Its most popular form is under the brand name Vicodin, a well-known drug that contains both hydrocodone and acetaminophen. Hydrocodone can also be obtained in its pure form.

Common street names for hydrocodone include:

  • Fluff
  • Hydros
  • V-vitamin
  • Vic
  • Vike
  • Watson-387


Codeine is a common pain reliever that can be found in prescription-strength cough syrup. Typically used to treat cold and flu symptoms, codeine is the most prescribed — and the most misused — of all opioids. When consumed in high quantities, codeine can cause sedation and an altered state of consciousness.

Common street names for codeine include:

  • Cody
  • Captain Cody
  • Schoolboy
  • Doors and fours
  • Loads
  • Pancakes and syrup

When mixed with other ingredients, this can also be known as:

  • Purple Drank
  • Lean
  • Sizzurp


Morphine is a natural opioid derivative that is found in poppy plants. This substance acts directly on the opioid system in the body and is, therefore, an effective pain reliever, especially for pain associated with cancer, surgeries, etc. More than 500,000 kg of morphine is produced each year, over 70% of which is used to make other opioids such as heroin and oxycodone.

Common street names for morphine include:

  • Miss Emma
  • Monkey
  • White stuff


Darvocet/Darvon are prescription opioids that contain propoxyphene, an opioid analgesic. However, like Vicodin, Darvocet also contains acetaminophen, an added pain-relieving ingredient. While Darvocet and Darvon were previously prescribed for mild to moderate pain relief, they have since been banned by the FDA due to their dangerous side effects. These drugs were involved in numerous intentional and accidental deaths, causing some physicians to call it “the worst drug in history.”

Common street names for Darvocet/Darvon include:

  • Footballs
  • Pinks
  • N’s


Demerol is the brand name of a prescription opioid drug that is used to treat pain associated with injuries, surgeries, and other medical procedures. Primarily administered in medical settings in pill or liquid form, Demerol helps severe to moderate pain.

Common street names for Demerol include:

  • Demmies
  • Pain Killer
  • Juice
  • Dillies
  • D
  • Dust


Dilaudid is used as a prescription opioid for acute and severe pain associated with medical procedures and cancer. Dilaudid can also be used to treat severe coughs. Generically known as hydromorphone, Dilaudid is known to be 5 to 10 times more potent than morphine.

Common street names for Dilaudid include:

  • Footballs
  • Dust
  • Smack
  • Dillies
  • Juice
  • D


Methadone is a full opioid agonist — which fully activates the body’s opioid system (like heroin) — that is used to treat moderate to severe pain. It is also used as a treatment for opioid addiction as it provides a safe way to wean someone off stronger opioids like heroin. While it is actively used as medication-assisted treatment (MAT) for opioid use disorder, methadone can also be addictive.

Common street names for methadone include:

  • Amidone
  • Dollies
  • Dolls
  • Fizzies
  • Mud
  • Red Rock
  • Tootsie Roll

Statistical Overview of Prevalence of Abuse

Below are some statistics surrounding opioid abuse in the US:

  • In 2019, nearly 50,000 people died from opioid-related overdoses in the US.
  • Between 2010 and 2018, the number of people in the US dying from opioid overdoses increased by 120%.
  • According to the Centers for Disease Control (CDC), an estimated 21% to 29% of people misuse prescription opioids.
  • It is estimated that between 8% and 12% of people who use an opioid for chronic pain end up developing an opioid use disorder.
  • According to the National Survey on Drug Use and Health, over 50% of people who abused prescription opioids in 2013 received these drugs from a friend or relative.
  • An estimated 50,000 people used heroin for the first time, according to data from the 2019 National Survey on Drug Abuse.
  • The Centers for Disease Control (CDC) estimates that the economic burden (including addiction treatment, lost productivity, healthcare) of prescription opioid misuse is around $78.5 billion per year.

Why Are Opioids Addictive?

Opioids are addictive for several reasons. Psychologically, people may begin to depend on opioids because of their intensely relaxing and sedating properties. While many start out taking opioids for pain relief, some of those who become addicted to opioids may have underlying mental health issues such as anxiety or depression. These drugs then become psychologically and emotionally addictive, and it can be difficult to feel normal without them.

Opioids are also very potent, which means their effects can be intense and quick-acting. Some prescription opioids can also become habit-forming because of their high potential for tolerance, where a person has to take higher doses to experience the same effects. This higher tolerance can lead to physical dependence and withdrawal symptoms if a person stops taking it.

The other downside to opioids is that the withdrawal period can also cause anxiety and depression, which can worsen underlying symptoms. The result is that a person can become dependent on the euphoric and relaxing effects of opioids, even if they no longer need them for pain relief.

Physical and Neurological Effects of Opioids

Opioids affect the body’s natural opioid system, which results in an array of physical and neurological effects. Some of the most common are:

  • Euphoria
  • Apathy
  • Drowsiness
  • Relaxation

Opioid Combinations

Opioids are commonly abused with other substances, especially alcohol. Below are the effects and consequences of these combinations.


Alcohol is often combined with opioids, both illicit and prescription. While alcohol can increase the euphoric effects of opioids, combining these substances is dangerous because both drugs are nervous system depressants. Therefore, alcohol and opioid combinations can lead to a heightening of hazardous effects, as well as the possibility of overdoses, coma, and seizures.

Some of the negative effects that can occur by combining alcohol and opioids include:

  • Slowed heartbeat
  • Dizziness
  • Mood changes
  • Severe drowsiness
  • Weak, shallow breathing
  • Fainting
  • Confusion
  • Agitation
  • Loose, floppy muscles
  • Loss of consciousness


Opioids and stimulants such as cocaine or methamphetamine are sometimes combined to create what is known as a “speedball.” This results in a unique and powerful high. However, speedballs are very toxic and can cause strokes, heart attacks, aneurysms, or respiratory failure. Because these drugs create opposing effects on the nervous system (stimulants speed things up while opioids slow things down), the drugs cancel each other out, causing a person to think they are less intoxicated than they are.

Anti-Anxiety Medications

Anti-anxiety medications such as Xanax, Valium, or Ativan can also be dangerous when they are combined with opioids. Known commonly as benzodiazepines, anti-anxiety drugs also produce a narcotic and sedating effect on the body, which means that mixing it with an opioid can result in fatal overdoses.

People who abuse these two drugs for recreational effects should be aware that it can put them at risk for:

  • Cardiac arrest
  • Respiratory failure
  • Coma
  • Seizure
  • Overdose
  • Death

Negative Health Consequences

When taken in excess and for long periods, opioids can cause serious health consequences. These include:

  • Difficulty breathing
  • Confusion
  • Seizures or stroke
  • Headache
  • Heart attack
  • Liver problems
  • Coma
  • Constipation


It’s also important to be aware of the signs and symptoms of an opioid overdose, such as:

  • Unconsciousness
  • Confusion
  • Constricted pupils (pinpoint pupils)
  • Nausea
  • Vomiting
  • Shallow or restricted breathing
  • Cool or clammy skin
  • Frequent vomiting
  • Extreme sleepiness or inability to wake up
  • Intermittent loss of consciousness

Signs and Symptoms of Opioid Abuse

People who are addicted to opioids may exhibit the following signs of abuse.

Physical Signs of Abuse

  • Loss of alertness
  • Constricted pupils
  • Slowed breathing
  • Drowsiness
  • Mood swings
  • Poor coordination
  • Chronic nodding off

Behavioral Signs of Abuse

Opioid addiction also produces specific behavioral signs. While some of these can be applied to most types of addiction, there are some that are particular to opioids:

  • Taking larger amounts of opioids or for a longer period than intended.
  • A persistent desire (or unsuccessful efforts) to cut down or control opioid use.
  • Spending a lot of time obtaining or using opioids or recovering from their effects.
  • Cravings, or a strong desire or urge to use opioids
  • Problems fulfilling obligations at work, school, or home.
  • Continued opioid use despite ongoing negative consequences.
  • Giving up or reducing regular activities due to opioid use.
  • Using opioids in physically hazardous situations.
  • Continued opioid use despite physical or psychological issues likely to have been caused or worsened by opioids.
  • Tolerance symptoms (i.e., need for increased amounts or diminished effect with continued use of the same amount).
  • Withdrawal symptoms or taking opioids to relieve or avoid withdrawal symptoms.

Opioid Withdrawal Symptoms

Withdrawing from opioids can produce severe and uncomfortable symptoms. These include:

  • Strong drug cravings
  • Chills
  • Difficulty sleeping
  • Agitation or irritability
  • Runny nose
  • Excessive sweating
  • Digestive problems
  • Nausea/vomiting
  • Anxiety
  • Diarrhea

Treatment for Opioid Addiction

male patient with doctor

While opioids can be difficult to withdraw from, treatment is available. These treatments are often most effective when combined with other therapies, especially when it comes to medication-assisted treatment (MAT) which allows a gradual and safe way to taper off opioids.

The treatments below are available at treatment centers, medical facilities, and independent rehab centers. You may want to speak to your doctor or enroll in an inpatient or outpatient program, depending on your needs.

Quitting Cold Turkey

While it can be tempting to terminate opioid use on your own, quitting cold turkey is not recommended. Due to the uncomfortable withdrawal symptoms that arise from stopping opioid use, it is best to do this under medically assisted detox, where you can be kept safe and comfortable.

Dual Diagnosis

Dual diagnosis programs are recommended for individuals who have co-occurring mental health conditions alongside their addiction. Rehab or treatment facilities that provide dual diagnosis are equipped to diagnose and treat concurrent issues such as anxiety and depression as well as their substance use disorder. These facilities are often staffed with psychiatrists or clinical therapists that can safely address these issues while a person withdraws from opioid substances.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is one of the most successful and highly recommended treatments for both substance abuse and mental health conditions. CBT works by helping individuals re-train their thoughts and behavior patterns around drug use. Clients undergoing this treatment learn how to identify automatic and dysfunctional thinking patterns and change them into healthier, more positive ones. Another benefit of CBT is that it also helps people learn how to cope with stress, cravings, drug triggers and deal with situations that might encourage opioid use.

Motivational Interventions

Motivational interventions include programs like contingency management, which have been proven to be beneficial for treating addiction. These programs are based on a reward system that helps clients abstain from drugs and alcohol and commit to their treatment outcomes. Clients who receive motivational interventions are often given rewards or incentives, which teaches them that sobriety is possible with self-control and the right motivations.

Support Groups

Well-known support groups such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and 12-Step programs are also notoriously beneficial when it comes to drug addiction. These groups are recognized for their ability to provide ongoing support and encouragement for individuals who are recovering from substance abuse. Support groups can also reduce the risk of relapses.

Medications and Supplements

Medication-assisted treatment (MAT) is one of the most common therapies for opioid addiction. Not only do these drugs assist with withdrawal symptoms and minimize cravings, but they can also deter use. Below are some of the most common medications that are used to treat opioid addiction:


Sold under the brand name Narcan, naltrexone blocks the effects of opioids and makes them less pleasurable. This means a person won’t experience a euphoric high from the opioid, and it poses less risk for abuse. Naltrexone is available as a pill, or it can be taken as an injection, which is sold under the name Vivitrol.


Methadone is one of the most common MAT therapies for opioid addiction. It produces similar effects as heroin; however, it doesn’t impair a person’s ability to function because it is milder. Methadone works by alleviating withdrawal symptoms and reducing cravings, which makes it an effective treatment. In fact, according to the Center for Substance Abuse Treatment (CSAT), methadone is so effective that it can prevent cravings and withdrawal symptoms for up to a day and a half.


Buprenorphine is a partial opioid agonist and is another common MAT therapy for opioid addiction. This medication produces weak opioid-like effects and is often combined with naltrexone (this combination is known as Suboxone) to help minimize the risk of abuse.


Clonidine is a medication that is used to treat high blood pressure, attention-deficit hyperactivity disorder (ADHD), as well as diarrhea. It is used for drug withdrawal because it can help ease anxiety, agitation, muscle aches, and sweating during the withdrawal period.

Other Medications

As withdrawal can cause an array of symptoms, other medications are also sometimes used. This includes anti-diarrheal medicines and anti-nauseants.

Other over-the-counter medications for opioid withdrawal include:

  • Benadryl, trazodone, or hydroxyzine (Vistaril): for improving or aiding sleep.
  • Acetaminophen, aspirin, or ibuprofen: to relieve headaches and pain.
  • Mylanta, Pepto-Bismol, or milk of magnesia: to help with gastric complaints.

Wellness and Experiential Programs

Wellness and experiential programs are known for providing great benefits for drug addiction treatment. These include activities such as yoga, art/music therapy, outdoor adventures, meditation, animal therapy, and more. These activities are great for encouraging emotional expression, calmness, as well as improving physical health and teaching valuable skills.


If you or a loved one are struggling with opioid abuse or addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Help Guide.org. (n.d.). Opioid Addiction. https://www.helpguide.org/harvard/opioid-addiction.htm.

HHS.gov. (2021). What is the US Opioid Epidemic? https://www.hhs.gov/opioids/about-the-epidemic/index.html.

National Institute on Drug Abuse. (2021). Heroin Drug Facts. https://www.drugabuse.gov/publications/drugfacts/heroin.

Psychiatry.org. (2021). Opioid Use Disorder. https://www.psychiatry.org/patients-families/addiction/opioid-use-disorder.

World Health Organization (2021). Opioid overdose. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on RehabAid.com.