Opioids
Includes heroin, smack, and misuse of pharmaceutical opioids. Overdose risk is real and withdrawal needs medical support.
Opioids act on receptors that control pain and reward. They include illicit forms such as heroin and pharmaceutical forms such as tramadol, codeine and morphine when misused.
Tolerance builds quickly, and stopping produces a physically demanding withdrawal. Dependence can develop even when the substance was first taken for genuine pain.
When it is an emergency
- Very slow or stopped breathing
- Blue lips or fingertips
- Unresponsive or unable to wake
- Pinpoint pupils with deep drowsiness
Signs worth noticing
- Pinpoint pupils, drowsiness alternating with alertness
- Body aches, runny nose and restlessness between doses
- Escalating amounts to achieve the same effect
- Missing medicines at home, or repeated prescription requests
Real risks
- Overdose and respiratory depression
- Infection from injecting, including HIV and hepatitis
- Severe withdrawal without medical support
- Loss of employment, legal problems and financial harm
When to seek help
- Any regular opioid use outside medical direction
- Withdrawal symptoms between doses
- A previous overdose or near-miss
What treatment involves
- Medical assessment as a first step, before any withdrawal attempt
- Opioid substitution or withdrawal management prescribed by qualified clinicians
- Structured rehabilitation and relapse-prevention therapy
- Long-term follow-up, since relapse risk stays elevated for a long period
If you are the family
- Do not attempt an unsupervised detox at home
- Learn the signs of overdose and act immediately if they appear
- Secure prescription medicines in the house
- Expect a long process and plan for aftercare from the start
What recovery looks like
- Regular follow-up with a clinician or counsellor
- Relapse-prevention planning that names specific triggers
- Peer or community support where it is available and comfortable
- Family involvement, when the person consents to it
- Attention to sleep, nutrition, work and daily routine
Questions to ask any centre
- What kind of assessment will be done before any treatment starts?
- Who provides medical care here, and what are their qualifications?
- Is withdrawal expected in this case, and how will it be managed?
- What therapies are offered, and how often?
- What does the fee include, and what is charged separately?
- What happens after discharge, and for how long?
Common questions
This guide is general education, not medical advice, and it cannot tell you what is happening in a specific person. Only a qualified clinician can assess that.