Opioids are substances which bind to opioid receptors. This includes both naturally occurring opiates such as morphine and synthetic opioids such as buprenorphine and methadone.

Features of opioid misuse

• rhinorrhoea
• needle track marks
• pinpoint pupils
• drowsiness
• watering eyes
• yawning

Complications of opioid misuse

• viral infection secondary to sharing needles: HIV, hepatitis B & C
• bacterial infection secondary to injection: infective endocarditis, septic arthritis, septicaemia, necrotising fasciitis
• venous thromboembolism
• overdose may lead to respiratory depression and death
• psychological problems: craving
• social problems: crime, prostitution, homelessness

Emergency management of opioid overdose

• IV or IM naloxone: has a rapid onset and relatively short duration of action

Harm reduction interventions may include

• needle exchange
• offering testing for HIV, hepatitis B & C