Substance	Heroin
Street names	Horse, junk, H.brown, scat M, microdots, poppy, tar, black, smack
Effects	Analgesia, drowsiness (nod out), relaxation, constricted pupils, constipation, nausea, slurred speech, impaired judgement, decreased sexual and aggressive drives, hypertension, euphoria/ detachment
Length of Effects	Onset: 20-30 minutesDuration: 4-8 hours

     Opiates such as Oxycodone are CNS (Central Nervous System) depressants and are detoxified in the liver and excreted in urine and stool. Most of the metabolites, with the exception of methadone, are excreted in 24-48 hours.

     Narcotics are the most effective medicine for relief of intense pain, cough suppression (antitussives), and treatment of intestinal disorders such as colic and diarrhea. As drugs of abuse, they are sniffed, smoked or self-administered by subcutaneous ('skin-popping') or IV ('mainlining') injection. Heroin is rapidly converted to morphine in the body. Hydromorphone is shorter acting and more sedating than morphine and 2 to 10 times as potent. Percodan is aspirin plus oxycodone. Percocet is acetaminophen plus oxycodone. The primary effects of oxycodones are analgesia, drowsiness, changes in mood, and at high doses clouding of mental functioning. IV use usually causes a 'kick' or 'rush' of feelings in the lower abdomen, along with warm skin flushing, an intoxicated feeling, euphoria, and decreased respiratory rate, peristalsis, and pupil size. Narcotics lead to a rapid tolerance and physical dependence after short-term use. Cross-tolerance is common among the opiates.

The signs of opiate intoxication may be seen within 2-5 minutes of IV use, beginning with euphoria and progressing to lethargy, somnolence, apathy, and dysphoria. Unintentional overdose frequently occurs with recreational use of narcotics because of the unpredictability in potency and purity. Some narcotic overdoses may be suicide attempts. Signs of overdose are presented in Table 2.

Withdrawal from opiates occurs with decreased amounts or cessation of the drug after prolonged moderate to heavy use. Manifestations of withdrawal include craving, nausea or vomiting, muscle aches, tearing or rhinorrhea, pupillary dilation, piloerection (goosebumps), perspiration, diarrhea, yawning, fever, nightmares, or insomnia. Generally within twelve hours of the last dose there is physical discomfort followed by a restless sleep, flulike symptoms and craving. The onset of withdrawal begins at the time of the next usual dose and ranges from 4-6 hours for heroin to 1 day for methadone. The kicking movements sometimes observed during the withdrawal are responsible for the phrase "kicking the habit." The individual may be suicidal during withdrawal. The severity of withdrawal is related to the degree of dependence, but it usually runs its course in 96 hours. Symptoms may recur for 6-10 months.