In Signs of Opiate Addiction, we discussed the terms opiates and opioids. Both are powerful drugs that are highly effective for the relief of pain. And, as all too many of us know, they are dangerously addictive. What’s the difference between the two? You often hear the words used interchangeably.

Let’s look at their origins.

Natural vs. Synthetic vs. Semi-Synthetic Opioids

Natural opiates most often originate from the opium poppy. Two common examples (at opposite ends of the spectrum) are morphine and heroin. Physicians and surgeons administer morphine as a pain reliever and anesthetic. Heroin, on the other hand, is manufactured solely to get high. 

All naturally sourced opiates all live under the larger category of opioids, defined as any drug that acts on the opioid receptors in the brain and body to create the effects of relief and euphoria.

Synthetic opioids are man-made drugs which act on the same receptors. For instance, methadone (prescribed to treat opioid dependence) is a synthetic opioid, as are Fentanyl and Percocet.

Semi-synthetic opioids are hybrids. Among these are several pharmaceuticals, such as Oxycontin, the  brand name for a particular type of oxycodone.

Use of Opiates and Opioids

No matter their type or intended use, all opiates and opioids carry a high risk of addiction. Even people introduced to the drugs as part of legitimate therapy for chronic pain are at risk without careful monitoring and administration. In fact, many addicts started out “legit” and turned to street opioids after becoming tolerant, then dependent. Recently, a Center for Disease Control study revealed that six percent of patients prescribed just a single day’s supply of a narcotic painkiller are still opioid users a year later. This percentage doubled in just eight days of prescribed use.

Who would get take a trip on an airline with planes that crash 12% of the time?

Tolerance, Dependence, and Addiction

Clinically speaking, the dangers of using opiates and opioids involve tolerance and dependence, twin bedfellows of addiction.

Three Types of Tolerance

There are three types of tolerance: learned, chronic, and acute.

  • Learned tolerance comes from frequent use. A person has learned to compensate for the effects of the drug by performing tasks repeatedly under the influence, so he may not appear high to others.
  • Chronic tolerance happens when a drug becomes less potent over a period of weeks or months. Its effects steadily decrease over time, leading to increased dosage or more potent methods of consumption such as snorting or injecting.
  • Acute tolerance refers to the effect of doses within shorter intervals. For instance, a “hit” taken 40 minutes after the last doesn’t give the same kick.

It is easy to see how tolerance to opiates and opioids goes hand-in-hand with dependence.

Dependence

Dependence is the condition in which the brain and body adapts to ongoing drug use. As a result, when a user stops taking the drug, unpleasant physical withdrawal symptoms follow. Dependence to opioids is sometimes treated professionally with detox and controlled “tapering”  which may include the use methadone or suboxone, opioids themselves which reduce physical withdrawal symptoms with less  of the “high”. These “substitute” drugs carry addictive risks themselves, which explains why this type of treatment should involve regular medical supervision.

Addiction

The National Institute on Drug Abuse (NIDA) defines addiction is a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences”.  In other words, addiction is uncontrollable. A person may or may not realize his next hit will be hurtful to himself or others, but he cannot help himself. Paradoxically, he is often neither morally inferior nor weak; he simply has a disease which completely robs him of the power of choice.

Furthermore, his compulsion to use can return unexpectedly after a period of abstinence. His recovery from addiction will require more than detox—it requires ongoing solutions for physical, psychological, and spiritual aspects of living.

Prescription and Street Names for Opiates and Opioids

Staying abreast of the pharmaceutical, marketing, and street names for all the combinations of opiates and opioids is impossible. The illegal drug industry concocts new and deadly combinations of illicit opiates and other street drugs all the time.

Naturally occurring opiates, derived from the opium poppy include

  • Morphine
  • Heroin
  • Codeine
  • Opium

Some synthetic and semi-synthetic opioids are:

  • Oxycodone
  • Methadone
  • Hydrocodone
  • Demerol
  • Fentanyl
  • Carfentanyl
  • Buprenorphine
  • Tramadol

Some brand names for pharmaceutical opioids, synthetic and semi-synthetic:

  • Abstral
  • Actiq
  • Arymo ER
  • Astramorph
  • Buprenex
  • Butrans
  • ConZip
  • Demerol
  • Depodur
  • Dilaudid
  • Dilaudid-HP
  • Dolophine
  • Dsuvia
  • Duragesic
  • Duramorph
  • Exalgo
  • Fentora
  • Hysingla ER
  • Infumorph
  • Ionsys
  • Kadian
  • Lazanda
  • Levo Dromoran
  • Methadose
  • MorphaBond
  • MS Contin
  • Nalbuphine
  • Nubain
  • Nucynta
  • Nucynta ER
  • Onsolis
  • Opana
  • Oxaydo
  • OxyContin
  • Roxicodone
  • RoxyBond
  • Stadol
  • Sublimaze
  • Suboxone
  • Subsys
  • Sufenta
  • Talwin
  • Targiniq ER
  • Troxyca ER
  • Ultiva
  • Ultram
  • Ultram ER
  • Vantrela ER
  • Xtampza ER
  • Zalviso
  • Zohydro ER

Now for some street names. This is was derived from the DEA document “Drug Slang and Code Words”, published May 2017. The list is growing all the time.

Fentanyl

  • Apache
  • Birria (mixed with heroin)
  • Butter
  • China (Girl, Town, White)
  • Chinese
  • Chinese Food
  • Crazy
  • Crazy One
  • Dance Fever
  • Dragon
  • Dragon’s Breath
  • Facebook (mixed with heroin in pill form)
  • Fent
  • Fenty
  • Fire
  • FriendGirl
  • Goodfella
  • Great Bear
  • He-Man
  • Jackpot
  • King Ivory
  • Lollipop
  • Murder 8
  • Poison
  • Shoes
  • Tango & Cash
  • Toe Tag Dope
  • White Girl

Heroin

  • A-Bomb (mixed with marijuana)
  • Achivia
  • Adormidera
  • Antifreeze
  • Aunt Hazel
  • Avocado
  • Azucar
  • Bad Seed
  • Ballot
  • Basketball
  • Basura
  • Beast
  • Beyonce
  • Big (Bag, H, Harry)
  • Bird
  • Birdie Powder
  • Black
  • Black Bitch, Goat, Olives, Paint, Pearl, Sheep, Tar
  • Blanco
  • Blue
  • Blow Dope
  • Blue Hero
  • Bombita (mixed with cocaine)
  • Bombs Away
  • Bonita
  • Boy
  • Bozo
  • Brea Negra
  • Brick Gum
  • Brown (Crystal, Rhine, Sugar)
  • Bubble Gum
  • Burrito
  • Caballo
  • Caballo Negro
  • Caca
  • Café
  • Capital H
  • Carga
  • Caro
  • Cement
  • Chapopote
  • Charlie
  • Charlie Horse
  • Cheese
  • Chicle
  • Chiclosa
  • China
  • Chinese (Food, Red)
  • Chip
  • Chiva
  • Chiva Blanca
  • Chivones
  • Chocolate
  • Chocolate Balls
  • Choko
  • Chorizo
  • Chutazo
  • Coco
  • Coffee
  • Comida
  • Crown Crap
  • Curley Hair
  • Dark
  • Dark Girl
  • Dead on Arrival (DOA)
  • Diesel
  • Dirt
  • Dog Food
  • Doggie
  • Doojee
  • Dope
  • Dorado
  • Down
  • Downtown
  • Dreck
  • Dynamite
  • Dyno
  • El Diablo
  • Engines
  • Fairy Dust
  • Flea Powder
  • Foolish Powder
  • Galloping Horse
  • Gamot
  • Gato
  • George Smack
  • Girl
  • Golden Girl
  • Good & Plenty
  • Good H
  • Goma
  • Gorda
  • Gras
  • Grasin
  • Gravy
  • Gum
  • H
  • H-Caps
  • Hairy
  • Hard Candy
  • Harry
  • Hats
  • Hazel
  • Heaven Dust
  • Heavy
  • Helen
  • Helicopter
  • Hell Dust
  • Henry
  • Hercules
  • Hero
  • Him
  • Hombre
  • Horse
  • Hot Dope
  • Hummers
  • Jojee
  • Joy Flakes
  • Joy Powder
  • Junk
  • Kabayo
  • Karachi
  • Karate
  • King’s Tickets
  • Lemonade
  • Lentaaver
  • Manteca
  • Marias
  • Mayo
  • Mazpan
  • Meal
  • Menthol
  • Mexican Brown, Horse, Mud, Treat
  • Modelo Negra
  • Mojo
  • Mole
  • Mongega
  • Morena
  • Morenita
  • Mortal Combat
  • Motors
  • Mud
  • Mujer
  • Muzzle
  • Nanoo
  • Negra
  • Negra Tomasa
  • Negrita
  • Nice and Easy
  • Night
  • Noise
  • Obama
  • Old Steve
  • Pants
  • Patty
  • Peg
  • P-Funk
  • Piezas
  • Plata
  • Poison
  • Polvo
  • Poppy
  • Powder
  • Prostituta Negra
  • Puppy
  • Pure
  • Rambo
  • Red Chicken
  • Red Eagle
  • Reindeer Dust
  • Roofing Tar
  • Sack
  • Salt
  • Sand
  • Scag
  • Scat
  • Schmeck
  • Sheep
  • Shirts
  • Shoes
  • Skag
  • Slime
  • Smack
  • Smeck
  • Snickers
  • Speedball (mixed with cocaine)
  • Spider Blue
  • Sticky Kind
  • Stufa
  • Sugar
  • Sweet Jesus
  • Tan
  • Tar
  • Tecata
  • Tires
  • Tootsie Roll
  • Tragic Magic
  • Trees
  • Turtle
  • Vidrio
  • Whiskey
  • White Boy, Girl, Junk, Lady, Nurse, Shirt, Stuff
  • Wings
  • Witch, Witch Hazel
  • Zapapote

Hydrocodone

  • 357s
  • Bananas
  • Dro
  • Fluff
  • Hydro
  • Norco
  • Tabs
  • Vics
  • Vikes
  • Watsons

Opium

  • Auntie
  • Aunt Emma
  • Big O
  • Black
  • Chandoo
  • China
  • Chinese Molasses
  • Chinese Tobacco
  • Chocolate
  • Cruz
  • Dopium
  • Dover’s Powder
  • Dream Gum, Stick
  • Dreams
  • Easing Powder
  • God’s Medicine
  • Goma
  • Gondola
  • Goric
  • Great TobaccoGum
  • Hocus
  • Hops
  • Incense
  • Joy Plant
  • Midnight Oil
  • Opio
  • Pen Yan
  • Pin Gon, Pin Yen
  • Pox
  • Skee
  • Toxy
  • Toys
  • When-Shee
  • Zero

Oxycodone

  • 30s
  • 40s
  • Beans
  • Blues
  • Buttons
  • Greens
  • OC
  • Oxy
  • Whites

Percocet

  • 512s
  • Bananas
  • Blue
  • Blueberries
  • Buttons
  • Ercs
  • Greenies
  • Hillbilly Heroin
  • Kickers
  • M-30s
  • Percs
  • Rims
  • Tires
  • Wheels

Common Signs of Addiction to Opiates and Opioids

How can you tell if you or someone you know has crossed the threshold to addiction?

The simplest and most reliable symptom is loss of control. An addict is not just someone who will not stop; indeed, he has a complete inability to stop. His cravings are uncontrollable, so they may manifest in behavioral, lifestyle, and withdrawal signs:

Some Behavioral and Lifestyle Signs

  • Doctor shopping (such as seeking multiple prescriptions from different doctors)
  • Dramatic mood swings
  • Social withdrawal/isolation
  • Sudden financial problems
  • Family members’ medications going missing
  • Money and valuable property going missing
  • Poor hygiene

Withdrawal Signs 

  • Headaches
  • Nausea and vomiting
  • Diarrhea
  • Sweating
  • Fatigue
  • Anxiety
  • Inability to sleep

A Word About Detox and Recovery

Persons addicted to opioids often need medical detox, because physical withdrawal symptoms can be severe, even fatal. Medically supervised tapering and drug substitution therapies may be necessary. In addition, there are probably other health issues which have been aggravated or brought about by drug abuse. A word of warning: after tending to these, a person may feel he his addiction is cured. It isn’t, nor will it ever be. The good news is that this is not cause for despair. Happy and healthy sobriety is attainable, which is the great promise of the support, fellowship, and guidance of Discovery Place. If you or a man you know is fresh from detox and feeling restless, irritable, and discontent, he probably still needs help. Contact us.

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