This page provides an in-depth overview of illicit and prescription opiate use in the UK, covering their effects, risks, harm reduction strategies, and available treatment options, including Medication-Assisted Treatment (MAT) and Buvidal.
🔍 Drug Facts: Opiates & Opioids
Also Known As: Heroin, smack, gear, fentanyl, nitazenes, codeine, dihydrocodeine (DF118s), tramadol, oxycodone, morphine.
What They Are: Opiates and opioids are drugs that act on opioid receptors in the brain to relieve pain, produce euphoria, and, in high doses, cause sedation and respiratory depression. While some opioids are legally prescribed, others are obtained illicitly or misused.
🏭 Appearance & Supply
Opiates appear in various forms, including powders, tablets, capsules, and liquids:
- Heroin: Powder form (brown/white) or black tar, often mixed with cutting agents like caffeine or fentanyl.
- Prescription opioids: Codeine, dihydrocodeine, tramadol, morphine, oxycodone – typically in tablet or liquid form.
- Synthetic opioids: Fentanyl and nitazenes, found as powder, pressed pills, or disguised as heroin.
💊 Prescription Opioid Abuse
Misuse of prescription opioids is increasing in the UK. Some individuals obtain these medications legally for pain relief, while others acquire them through online pharmacies, doctor shopping, or illicit street sales.
- Codeine & Dihydrocodeine: Commonly misused in high doses or mixed with other drugs (e.g., alcohol, promethazine) for enhanced sedation.
- Tramadol: Abused for its stimulant and opioid effects but carries risks of seizures and serotonin syndrome.
- Oxycodone & Morphine: Highly potent, with significant overdose risks if injected or combined with other depressants.
⚠️ Risks & Harms
Opioid use, whether illicit or prescribed, carries risks including:
- Overdose: Respiratory depression, coma, and death – especially when mixed with alcohol or benzodiazepines.
- Blood-borne infections: Injecting opioids increases risks of hepatitis B/C and HIV.
- Physical dependency: Withdrawal symptoms include pain, nausea, sweating, and anxiety.
- Long-term effects: Chronic use can cause memory impairment, hormone imbalances, and dental issues.
💊 Harm Reduction Strategies
- Take-Home Naloxone: Reverses opioid overdoses.
- Needle & Syringe Exchange: Reduces transmission of infections.
- MAT (Medication-Assisted Treatment): Reduces dependency and overdose risk.
- Buvidal: Long-acting injectable buprenorphine offering a safer alternative to daily dosing.
🩹 Treatment Options: Medication-Assisted Treatment (MAT)
MAT is the recommended treatment for opioid dependence, providing stable, long-term alternatives to illicit opioid use.
📌 Induction & Stabilisation
- Buprenorphine (Subutex/Espranor): Safer in overdose risk, but requires 12+ hours of withdrawal before starting.
- Methadone: Effective for long-term stabilisation but requires careful titration to avoid overdose.
- Buvidal (Extended-Release Buprenorphine): Once-weekly or monthly injection, offering improved retention and reducing diversion risks.
📌 Buvidal: A New Treatment Option
Buvidal is a long-acting buprenorphine injection that provides stable opioid substitution treatment without daily dosing.
- Given as a **weekly or monthly injection**.
- Reduces the need for **daily medication supervision**.
- Improves **treatment retention and adherence**.
- Less risk of **diversion or accidental overdose**.
📢 Signs of Overdose & Emergency Response
Recognising an opioid overdose early can save lives. Signs include:
- Slow or stopped breathing.
- Pale, blue, or cold skin.
- Pinpoint pupils.
- Unconsciousness or non-responsiveness.
Emergency response: Call 999, administer Naloxone (if available), place the person in the recovery position, and monitor until help arrives.