Codeine is a prescription medication which relieves mild to moderate pain. It was originally discovered as a naturally occurring constituent of opium. However, today’s pharmaceutical-grade codeine is produced with methylating morphine. Codeine comes alone or combined with another painkiller such as Tylenol® (acetaminophen). It is formulated into tablets, capsules or liquid to be taken orally. Codeine and codeine-combo preparations are usually taken every 4-6 hours. Since codeine can be habit forming, care must be taken to follow the doctor’s instructions (Read here on Codeine withdrawal). Do not take a larger dose, or take it more frequently, or take it for longer than the doctor has prescribed.

Heroin is a highly addictive drug, and its use is a serious problem in the United States. Recent studies suggest a shift from injecting heroin to snorting or smoking because of the increased purity and the misconception that these behaviors will not lead to dependency.

Heroin is processed from morphine, a naturally occurring substance extracted from the seedpod of the Asian poppy plant. Heroin usually appears as a white or brown powder. Street names for heroin include “smack,” “H,” “skag,” and “junk.” Other names may refer to types of heroin produced in a specific geographical area, such as “Mexican black tar.”

Heroin Health Hazards

Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and infectious diseases such as HIV/AIDS and hepatitis.

The short-term effects of heroin abuse appear shortly after a single dose and disappear in a few hours. After a heroin injection, the user reports feeling a surge of euphoria (“rush”) accompanied by a warm flushing of the skin, a dry mouth, and heaviness in the extremities. Following this initial euphoria, the user goes “on the nod,” a state of alternating wakefulness and drowsiness. Heroin depresses the central nervous system which clouds the user’s mental functioning.

There are long-term effects of heroin that appear after repeated use. Chronic users may develop collapsed veins, infection of the heart lining and valves, abscesses (pus-filled pocket inside inflamed by infected tissue), cellulitis (a bacterial infection of the skin), and liver disease. Pulmonary complications, including various types of pneumonia, may result from the poor health condition of the abuser, as well as from heroin’s depressing effects on respiration.

Additionally, street heroin may contain additives that do not readily dissolve thereby clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs.

Reports from SAMHSA’s 1995 Drug Abuse Warning Network (DAWN), which collects data on drug-related hospital emergency room episodes and drug-related deaths from 21 metropolitan areas, rank heroin as the second-highest drug involved in drug-related deaths. From 1990 to 1995, the number of heroin-related episodes doubled. Between 1994 and 1995, there was a 19 percent increase in heroin-related emergency department episodes.

Hydrocodone is an effective antitussive (anti-cough) agent, and as an opiate, it is also an effective analgesic for mild to moderate pain control. Five mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Early comparisons concluded that hydrocodone and morphine were equipotent for pain control in humans. However, it is now considered that a dose of 15 mg (1/4 gr) of hydrocodone is equivalent to 10 mg (1/6 gr) of morphine. Hydrocodone is considered to be morphine-like in all respects.

Sales and production of this drug have increased significantly in recent years (a four-fold increase between 1990 and 2000), as have diversion and illicit use. Trade names include Anexsia®, Hycodan®, Hycomine®, Lorcet®, Lortab®, Tussionex®, Tylox®, Vicodin®, and Vicoprofen®. These are available as tablets, capsules, and/or syrups. Generally; this drug is abused orally rather than through intravenous administration. Currently, about 20 tons of hydrocodone products are used annually in the United States.

Methadone is a synthetic substance with pharmacological properties similar to morphine and heroin. Methadone is prescribed for patients with severe pain, such as those with serious injuries or those who have undergone major surgery. Methadone works in the brain to decrease the sensation of pain and to mute the emotional response to pain. It comes as tablets, dispersible tablets, liquid, and liquid concentrate. Patients take it every 3-4 hours for severe pain and every 6-8 hours for chronic pain. Since methadone can be as addictive as morphine and heroin, care must be taken to follow the doctor’s instructions. Do not take a larger dose, or take it more frequently, or take it for longer than the doctor has prescribed. Methadone is one of the most difficult drugs to detox from since its effects are long-lasting and it is readily stored in the body’s tissue.

Methadone is also used as a replacement-opiate therapy for opiate dependency. A legal dependency (methadone) is substituted for an illegal dependency (heroin). Methadone is available in government-approved drug treatment clinics and by prescription in some areas.

OxyContin® is the brand name for the time-release formula of oxycodone, a narcotic analgesic for moderate to severe pain. It is used to treat terminally ill cancer patients and chronic pain sufferers as well as relieving postpartum, postoperative and dental pain. OxyContin® comes in liquid and tablet forms are taken every 6 hours. Long-acting tablets are available to take every 12 hours. Oxycodone is an opium derivative and is the active ingredient in Percodan® and Percocet®. Oxycodone binds to the pain receptors in the brain so that the sensation of pain is reduced. Since oxycodone can be habit-forming, care must be taken to follow the doctor’s instructions when taking OxyContin®. Do not take a larger dose, or take it more frequently, or take it for longer than the doctor has prescribed. Since its FDA approval in 1995, the illegal use of OxyContin® has increased significantly, and recent OxyContin-related deaths have attracted media attention, thereby illuminating the problem.

Percocet® is the brand name for the combination of acetaminophen (Tylenol) and oxycodone. Percocet® is prescribed for moderate to moderately severe pain. Oxycodone binds to the pain receptors in the brain so that the sensation of pain is reduced. Acetaminophen halts the production of prostaglandins which otherwise cause pain. It is available in tablet, capsule, and liquid form and is taken every 6 hours by mouth. Since oxycodone can be habit-forming, care must be taken to follow the doctor’s instructions when taking Percocet®. Do not take a larger dose, or take it more frequently, or take it for longer than the doctor has prescribed.

Suboxone (Buprenorphine) is a semi-synthetic narcotic; Suboxone is a sublingual formulation that is a combination of Buprenorphine and Narcan. Suboxone cannot be injected, because the Narcan component causes instant opiate withdrawal. In this form (taken sublingually) the Buprenorphine is absorbed through the mucous membrane, while the Narcan is not.

Tramadol is used to relieve severe pain. Tramadol may be used to treat pain caused by surgery and chronic conditions such as fibromyalgia or arthritis. Tramadol is an opiate (narcotic) analgesics. Tramadol works by decreasing the body’s sense of pain.

Tramadol is habit-forming if abused. Tramadol should only be taken under a doctor’s care and orders. Call your doctor if you find that you want to take extra medication or notice any other unusual changes in your behavior or mood.

Vicodin® is the brand name for the combination of acetaminophen (Tylenol) and hydrocodone. Vicodin® is prescribed for moderate to moderately severe pain. Hydrocodone binds to the pain receptors in the brain so that the sensation of pain is reduced. Acetaminophen halts the production of prostaglandins which otherwise cause pain. Vicodin® is available in a tablet, capsule, and liquid form and is taken every 4-6 hours by mouth. Since hydrocodone can be habit-forming, care must be taken to follow the doctor’s instructions when taking Vicodin®. Do not take a larger dose, or take it more frequently, or take it for longer than the doctor has prescribed.