Opioid education guide
The clinical reference opioid: a full mu-opioid agonist with powerful analgesic effects and serious respiratory, gastrointestinal, and dependence risks.
01 · Classification
A naturally occurring phenanthrene alkaloid and Schedule II narcotic analgesic. Its metabolites include M3G, which can contribute to neurotoxicity, and M6G, a potent opioid metabolite that can accumulate with renal impairment.
02 · Acute effects
Therapeutic / low
Analgesia, calm, mild sedation, constricted pupils, dry mouth, lower blood pressure, and constipation.
High / misuse
Euphoria, heavy somnolence, mental clouding, itching, nausea, slurred speech, and pinpoint pupils.
Severe toxicity
Coma, severe respiratory depression, agonal breathing, cyanosis, cold clammy skin, or death.
Medical emergency
Pinpoint pupils, profound unresponsiveness, slow or absent breathing, gurgling, blue or gray skin, or limp extremities require immediate help.
Dangerous combinations
Benzodiazepines, alcohol, gabapentinoids, sedating antihistamines, barbiturates, and other central depressants amplify respiratory depression.
Never mix opioids with other sedatives or use an unverified pill. Tell emergency responders what may have been taken.
03 · Long-term consequences
Abrupt cessation can cause severe aches, vomiting, diarrhea, sweating, piloerection, muscle jerks, and insomnia.
M3G accumulation can worsen pain and cause allodynia, myoclonus, agitation, or seizures, especially with kidney disease.
Persistent gastrointestinal slowing can cause impaction, ulceration, and bowel perforation.
Long-term exposure may cause hypogonadism, amenorrhea, sexual dysfunction, fatigue, and osteopenia.
Verified resources
1-800-662-4357 · Free, confidential, 24/7 treatment referral and information.
For slow or absent breathing, loss of consciousness, or suspected overdose, call 911 immediately and use naloxone if available.