Opioids overdose is the physical reaction to an amount of opioids in someone’s system that is too much for the body to handle. When opioids overdose occurs, the brain’s respiratory system slows down until it stops. The brain is deprived of oxygen and can suffer damage, and overdose can easily be fatal.

Opioids overdose can happen the very first time someone uses opioids drugs. An overdose happens quickly. According to the National Alliance of Advocates for Buprenorphine Treatment, “With opioids, there is a small window between euphoria and death.” People experience the high that comes from taking opioids, and if they have put too much in their bodies, they overdose. Without prompt medical treatment of the overdose, chances of dying are high (Opioids Epidemic: What You Need to Know).

The risk of overdose applies to everyone using any type of opioids, so it’s important to know the symptoms of opioids overdose as well as the available treatment. That said, the overdose risk isn’t the same in every group. Let’s take a quick look at who is susceptible to opioids overdose before diving into the symptoms and treatment.

Who is at Risk for Opioids Overdose?

As mentioned, anyone can experience an opioids overdose, whether he is taking them as prescribed for pain or as an illegal street drug for recreational purposes. While people who use opioids illegally are more likely to overdose, prescription opioid painkiller overdoses are on the rise. Between 1999 and 2008, overdose deaths from prescription painkillers tripled (Foreman, 2014). Some prescription painkiller overdoses occur among the people who were prescribed the opioid medication, while other painkiller overdoses are from diverted drugs, medications prescribed for one person but taken by someone else (Foreman, 2014).

Some people are more at risk for opioids overdose than others. Risk is higher among people who:

• Have an opioids dependence
• Have been prescribed a high dose of opioids painkillers
• Also take sedatives
• Have depression
• Live in a household where someone has prescription painkillers
• Have HIV or liver disease
• Inject opioids
• Take a dose that is higher than expected
• Use heroin that is contaminated

Signs, Symptoms of Opioids Overdose

Knowing opioids overdose symptoms and signs is crucial given that, after taking opioids, things can rapidly degrade to overdose and death. It’s fairly easy to spot someone who has overdosed. Experts advise looking for what is called the opioid overdose triad:

• Pinpoint pupils
• Unconsciousness
• Respiratory depression (extremely slow breathing)

The presence of these three symptoms of opioids overdose means medical attention is needed immediately.

Opioids Overdose Treatment Needed Quickly

Opioids overdose treatment is available, but it needs to happen quickly to avoid extensive brain damage or death. Treatment must be given by a qualified medical professional, for it involves the administration of an opioids antagonist, a medication that blocks opioid receptors, preventing other opioids from attaching and continuing to act in the brain and body, and reversing the suppression of breathing.

The primary antagonist used to treat opioids overdose is naloxone. It stops overdose and resumes normal breathing. It’s administered intravenously (IV), intramuscularly (into a muscle), subcutaneously (under the skin), or intranasally (through the nose).

Opioids overdose is not just treatable, it’s preventable. Take great care with prescription medication, working with your doctor to keep dosages as low as possible, and avoid the use of illicit drugs like heroin. While it’s true that opioids overdose can happen to anyone taking opioids, it isn’t inevitable.

article references

Opioids can have serious side effects and it’s important that you’re aware of them before you starting taking them.

People take opioids (opioid prescription painkillers or illegal street drugs such as heroin) because of the effects opioids have on the body and brain. Some are positive and helpful; if prescription painkillers didn’t have a good medical purpose, doctors wouldn’t prescribe the approximately 200 million opioids per year that they currently do (Foreman, 2014).

Opioids, however, can be extremely dangerous, even deadly (Opioids Deaths: Yes, Opioids Can Kill You). Opioids side effects, which intensify with the amount of drugs taken and length of use, can harm both the body and the brain. Knowing the effects of opioid drugs can help people be cautious and vigilant about prescription opioid use and avoid illicit forms of these drugs altogether.

Before we examine opioids side effects, it’s important to note that these side effects are essentially the same for all opioids, whether they be prescription Vicodin or street heroin. Street drugs, however, do carry extra risks of collapsed veins from needle use, HIV, hepatitis, and infection of the lining of the heart.

Primary Short-Term Effects of Opioids

Most begin taking opioids because of the short-term effects. Typically, people seek help for various types of pain, both acute and chronic, and doctors prescribe an opioid painkiller. These intentional, helpful opioids effects include

• Analgesia, or numbing of pain
• Euphoria, a temporary but heightened feeling of joy

All opioids do these helpful things for people. Opioids, though, offer short-term pain relief and euphoria and thus are extremely habit-forming. People need more and more and easily develop a tolerance for and dependence on opioids and this can (but doesn’t always) lead to addiction. Extreme use, whether or not it’s born out of addiction, leads to extreme side effects.

Opioids Effects on the Brain

Opioids effects on the brain begin almost immediately. Once the opioid mechanism of action, in which the opioids attach to the opioid receptors in the brain and body, kicks in, opioids take over. They replace the brain’s own opioids—endorphins, endomorphins, dynorphins, and enkephalins—and cause the brain to stop producing them. Further, they turn the brain’s electric activity against it and rewire a new feedback loop to create an increasing need for opioids.

Once they have established control in the brain, opioids cause more problematic side effects. In a nutshell, opioids cause brain damage. Specifically, long-term opioids effects on the brain include

• Sedation, both sleepiness and overall slowed brain activity
• Oxygen deprivation because of repressed respiratory functioning (this lack of oxygen is a major source of brain damage)
• Reduced complex decision-making ability
• Trouble making healthy, positive choices and decisions
• Decreased cognitive functioning in general

This decreased brain functioning can lead to death. Opioids depress the respiratory center of the brain. This is not only the cause of the reduced oxygen levels that can cause brain damage, but it is also the primary cause of opioids overdose deaths. The brain just stops telling the body to breathe.

Clearly, the lungs and respiratory system are negatively affected by opioids. Other body systems are impacted, too.

Opioids Effects on the Body

Opioid drugs have sweeping effects on the body and can cause permanent damage to someone’s health. Opiates effects on the body are long-term and include damage to the

• Respiratory system (slowed breathing)
• Digestive system (nausea, vomiting, constipation)
• Excretory system (constipation, difficulty urination due to constricted bladder muscles)
• Immune system (suppression of functioning leads to increased infections/illnesses)
• Endocrine system (menstrual irregularities, decreased testosterone levels, impotence, etc.)
• Nervous system (increased sensitivity to pain)

Opioids side effects can be very serious. Opioids can harm the body and damage the brain. However, you can get positive benefits from prescription painkillers and minimize long-term side effects by working with your health care provider and being aware of how opioids are affecting you physically and mentally.

article references

Opioids dependence will happen to anyone taking opioids, whether legal prescriptions for pain management or illegal street drugs. Dependence is a natural, and normal, result of any kind of opioid uses.

This has nothing to do with personal weaknesses and everything to do with how opioids work in the brain and body. Opioids mechanism of action guarantees dependence: When they attach to opioid receptors in the brain and body, they replace the body’s own natural opioids (such as endorphins). The brain stops making endorphins and other opioids and instead relies completely on the opioids we feed it. The brain and body become easily dependent upon opioid drugs.

This doesn’t mean that everyone taking opioid painkillers becomes addicted. There is a difference between opioids dependence and opioids addiction. Someone can develop a dependence on opioids without being addicted.

Opioid addiction symptoms include compulsive drug-seeking and use even when the person faces negative consequences. Someone experiencing addiction engages in other harmful, self-destructive behaviors as well yet continues to use. Addiction is a brain disease because the substance(s) used changes the brain, and it is these brain changes that lead to negative behaviors.

Dependency is much different from addiction. In opioids dependency, the body becomes used to the amount of opioids in the system. If you’re taking prescription opioid painkillers, for example, over time, the strength you started with will no longer be effective. You’ll need a greater amount of the same drug to achieve the same pain-relieving effect.

Dependence on opioids happens like this:

• Tolerance builds over time, which means that the body becomes used to the drug’s presence.
• The body and brain rely on the drug for normal functioning.
• If you try to stop or even reduce the amount of the drug, your body and brain react with opioids withdrawal symptoms.

This dependence on opioids can, and does, happen even when someone is not addicted. It also happens with any opioid drug, legal or illegal, and it can happen even under a doctor’s care. Further, opioids dependence actually has two forms: physical dependence and psychological dependence.

Types of Opioids Dependence: Physical and Psychological

Physical dependence on opioids relates to the physical structure of the brain and the body. The body itself, from the basic cellular level (the opioid receptors) all the way to the system as a whole, reacts and responds to the presence of opioids. Once it’s accustomed to the presence of opioids, it must continue to have them in order to function. Physical dependence is a condition of the body.

Psychological dependence, on the other hand, has to do with the brain’s reward system. Opioids bring pain relief. So taking opioids offers the reward of feeling better. That is physical, of course, but it’s also psychological. The person taking opioids becomes mentally and emotionally dependent on them because he needs the reward of reduced pain.

Physical and psychological dependence is a given part of opioid use. How, though, does someone know if she has become dependent on opioids? Certain symptoms indicate dependence.

Symptoms of Opioids Dependence

The biggest indicator that someone has become dependent on opioids, including prescription painkillers, is that she needs more to achieve the same level of pain control. A doctor might need to prescribe higher doses or add additional daily doses, but the level of pain relief remains the same.

Another sign of opioids dependence is the inability to reduce or stop taking the medication. Any attempt to reduce the amount of opioids in the system is met with opioids withdrawal symptoms.

Opioid dependence withdrawal symptoms aren’t dangerous, but they can be extremely uncomfortable. They include physical and mental symptoms such as

• Anxiety
• Irritability
• Cravings
• Confusion
• Rapid breathing
• Yawning
• Runny nose
• Salivation
• Goosebumps
• Chills
• Stuffy nose
• Muscle aches
• Nausea and/or vomiting
• Abdominal cramps
• Diarrhea
• Sweating
• Enlarged pupils
• Tremors
• Loss of appetite

Opioid Dependence Treatment

Dependence is uncomfortable, and it can keep people chained to opioid use. Happily, opioid dependence treatment is available.

Some opioid dependence treatment options include

• Outpatient treatment in special facilities/clinics
• Inpatient treatment/hospitalization
• Counseling
• Support groups

Sometimes medication is used to treat opioid dependence withdrawal symptoms and prevent relapse. Opioid antagonists can be used. They block the opiate receptors in the brain and body and include opioid drugs such as

• Methadone
• Buprenorphine
• Naloxone
• Naltrexone

Sometimes other medications are used to treat opioid dependence. Clonidine, for example, is a blood pressure medication that works to reduce dependence, and non-opioid pain medications can be used as well.

In addition to treating opioids dependence with medications, counseling and social support, including support groups, are trusted methods, too. Counseling helps people learn skills and strategies for dealing with dependence. Support groups provide connections to people experiencing something similar and can be an excellent resource for healing.

Opioids dependence is treatable. Because it can happen easily, it’s something that many people have experienced. Working with a medical or mental health professional and seeking support from others who have experienced dependence can be empowering and help you overcome opioids dependency.

article references

"When you look at love, you're looking into the face of appreciation."

Throughout the history of mankind, we as a world culture have made love out to be mysterious, complex, difficult, and undefinable. It's the subject of endless poems and literary works. There is an enormous amount of material available out there about love, a lot of it contradictory.

We've been given the impression that to define love is near to impossible. Maybe there's a fear that if we define it, it would somehow be less powerful...less impactful...less exhilarating. Maybe we like the mystery of it. But is it really that complicated? Perhaps the complications surrounding love come from all "stuff" we add on to this powerful emotion. Let us drop all the baggage surrounding relationships and define what it is we are experiencing in the moment of love.

Basic Components of Love

What do you feel when you love someone? If distilled down to its core components, what would those be? Yes, love is an emotion, a feeling, a wanting, and a "being". We know it feels good, but what specific feelings, wantings, and beings are present when we feel love? Here are the common denominators of love...

• Love is Accepting.
  Acceptance is labeling someone as "okay" and having no particular desire to change them. Who they are is perfectly fine with you. You pose no condition on whether you will love them or not. This is called unconditional love. When your love IS conditional, the moment they step outside your set of conditions, love evaporates.

• Love is Appreciating.
  Appreciation is one step beyond acceptance. Its when your focus is on what you like about another. We look at them and feel this sweeping appreciation for who they are, their joy, their insights, their humor, their companionship, etc. When someone says they are "in love" with another, they mean their appreciation is so enormous for this person that it consumes their every thought.

• Love is Wanting Another to Feel Good.
  We want those we love to be happy, safe, healthy, and fulfilled. We want them to feel good in all ways, physically, mentally and emotionally.

How Do We Express Love?

We don't always express our love. Love is a feeling and the expression of that feeling is separate. It's an action. There's a practical reason we don't always express our love for another. It's an issue of TIME. We only have 24 hours in a day (if you make it up that way). If the expression of love was a core ingredient to love, we would have to be stingy with who we loved, because there simply wouldn't be enough time to demonstrate our love for everyone! If you see the distinction between the feeling and the expression, you can then love endless numbers of people.

Attention

Love expressed is when you give your attention, your time, your focus to someone. Webster defines attention as "the giving of one's mind to something."

There are many ways in which we give our attention to another. We use our five senses. Our ears to listen. Being completely present with the one who is speaking. Our eyes, watching another, undivided attention. Tasting/smelling? (I'll let you figure that one out). Touching, giving a hug, holding a hand, a caress, or sexual expression. How you express your love depends on the type of relationship.

Most people are not in the mood for sex twenty four hours a day, seven days a week. Sometimes people get sick, tired, stressed out or simply don't have time. This is normal. However, if the feeling of not wanting sex persists, you might be experiencing a sexual aversion.

Sexual aversions can occur when:

• You are with the a person for the wrong reasons (e.g. obligation)
• You and your significant other are fighting and you do not feel emotionally close
• You dislike the way the person smells or looks
• You have trouble teaching a person how you like to be touched
• You are experiencing flashbacks of sexual trauma

If you are experiencing a sexual aversion to your partner, talk to him/her about it. Most sexual aversions can be worked through with good communication skills. What you may soon realize is that what you thought was a sexual aversion, was simply you and your partner had forgotten the importance of seduction. Without seduction, people often don't feel sexy, or in the mood.

Tips on Seduction

SEDUCTION
Good sex is frequently determined within the first few minutes even before the act. Yet, the topic of mood and atmosphere is not often deemed worthy enough warrant a discussion. Thus, in the stereotypic world, where men are supposed to initiate the process of seduction, one must wonder, how do they learn? What should they do, what happens when some men do not like the role of instigator, or feel uncomfortable with a woman's initiation, or are just plain confused. Getting the ball rolling is not always such an easy task.

This brings us to the next question, what exactly is meant by, seduction, initiation, and getting the ball rolling? Seduction, often conjures up bad connotations. Does seduction refer to a man telling a woman everything he thinks she wants to hear for the sole purpose of sex? This form of seduction could hurt. The word initiation might refer to a person trying to make the first contact. Lastly, getting the ball rolling may speak to the setting of boundaries. Interestingly, all these terms box men in. Women want honesty, yet complain when things are too direct, they want romance. They do value having the stage set, the process of wanting him, in other words seduction - which brings us back to square one. It almost seems like a vicious cycle!

According to sex therapist and author Dr. Bernie Zilbergeld, one way around this difficult situation is to think of this beginning process more of as an invitation. Invitations are something that most people are quite comfortable. Imagine how you ask others to join you for a walk, a bike ride, the movies, breakfast, shopping, or even just a conversation. An invitation sounds nice to most people. Most people enjoy being asked to participate in something? An invitation implies that the other person has the option to accept or decline. This is something that is fun for both people. In this situation, neither person has more control over the other person's action. Imagine a scene, where you are being cajoled into accepting an invitation to breakfast, shopping, the movies. Don't you enjoy having your partner sweeten the deal by describing in great depth, the most scrumptious waffle that this cafe serves, or how it is really a favor that they are doing for you by extending the invitation to this most luscious meal or even how it is so critical to their well-being, that you attend, and to prove it, they will pay. In these instances, there are often few dire consequences to either person if the invitation is rejected. How many women have you ever heard about being tide up and brought out to an elegant dinner, or shot to death because they were not in the mood to go to the movies? Yet, when it comes to sex, everything changes. Invitations turn to power & control problems. Communication stops.

According to Dr. Zilbergeld there are three important aspects to sexual initiation, or in this case sexual invitations:

"Willingness to extend an offer of something exciting to come: the actual invitation or seduction"

"Willingness to be rejected"

"Building of arousal"

The key aspect of extending an offer of something exciting to come: the actual invitation or seduction is to illicit desire, excitement and arousal, yet there is no one correct way to invite. Everyone reacts slightly differently. What turns one person on, may turn the next person off. People are all different. In fact, what works one day, with the same person may fail the next day. However, even with all these unknowns, there is one helpful rule to keep in mind. Invitations are most likely accepted when both people feel good about the relationship. In other words before trying to seduce your partner to bed, try to establish a connection with him/her. This might mean engaging in a meaningful conversation.

You could do this by exploring how the person's day was, asking them how their big meeting went, appreciating the fact that they did your dishes, or simply cuddling and saying how lucky you feel to have met her/him. The most direct thing you could ever say is "would you like to make love". This is simple and direct. The enticement would come from her mind. If she is in a similar state of mind, the two of you are in luck. Remember that at all times she is free to accept or to reject. You are merely inviting her.

However, on your end, you have not done much to entice her, thus the chances of her saying 'No' are greater. To increase her desire, pay attention to your language and gesture. To increase her excitement, try the following:

To increase a woman's excitement (or man's) try the following:

• Look online at sex toys together, or wander throughout your house looking for items that you could use as toys.
• Talk about what turns each of you on.
• Reminiscent with your partner about a sexual adventure that the two of you had that turned you on
• Begin by massaging her hand. Bring her fingers to your mouth. Kiss the back side, then the front. Let your tongue linger. Continue massaging. Nibble on her fingertips, slowly taking her whole finger into your mouth.
• Massage her head. Play with her hair. Run your hands through her flowing hair. Slightly pull on it, as if you were putting her hair into a ponytail, massage the back of her neck as if you were making love to her.
• Rub her temples. Let your let your fingers wander over her eyebrows, down her nose, follow the ridge of her lips, slowly bend down and kiss her forehead, continue to massage her. Let her feel your longing gaze.
• As her head lays in your lap, back flat on the ground, rub your hands along the muscles directly around her clavicle bones. Massage her sore muscles, touch her outer shoulders, let your hands occasionally wander near her breasts - but avoid touching her nipples at all cost.
• Make her want you, make her feel so excited that she can not but help herself to grab your hands and place them directly on her. This is all about desire and anticipation.
• There is also simple kissing. Kissing that starts off slow and easy, which slowly builds up speed and intensity. Very few people actually complain of too much kissing. Too much mood building. Too much anticipation. Half of good sex is attitude. Remember back in the days when you had never had sex, and were kissing your first love for the first time.

Kissing was super exciting. It may have felt like the gateway to everything else. Kissing was new, and for many lasted for hours on end. The kiss signified the beginning of an adult sexual relationship. This may not have been everyone's experience, but I think it is safe to say that for most people, the first kiss ever felt memorable and exciting. Please note, while very few people ever feel like they have overdosed on kissing, there is a time and place for fast hard passionate sex - that just does not include much kissing.

Again, having just done all this 'work' to entice her, she still may say 'No'. The idea of the other person being free to accept or reject brings us to the second important aspect of sexual initiation. The willingness to be rejected and not take it personally. Sometimes, people are just not in the mood. Maybe they are stressed out from work, enjoying their TV program, looking forward to sleep, hungry or just finished masturbating and are feeling sore. Sometimes a No simply just means No, and has no reflection on the person doing the asking.

Written by Alex Robboy, MSW, QCSW, LCSW,CAS

"Alex" Caroline Robboy has been practicing therapy for over a decade. In 1996, she began specializing in sex therapy. Since that time she has published in journals and magazines, lectured to healthcare professionals and been featured in several national periodicals and books. Currently "Alex" Caroline Robboy practices couples counseling and sex therapy in Philadelphia, Pennsylvania.

"Alex" Caroline Robboy earned her Masters in Social Work, a Certificate of Advanced Studies in Human Sexuality Education and a Post-Masters Certificate in Marriage Counseling & Sex Therapy from the University of Pennsylvania. Alex Robboy is an American Association of Sex Educators, Counselors and Therapist certified sex therapist, and an American Board certified sexologist.

Opioids tolerance is a legitimate concern of people taking prescription painkillers. Tolerance means that the body and brain get used to the amount of opioids in the system. Because the body and brain adapt to the presence of these drugs, someone taking prescription opioids needs more painkillers to provide the same amount of relief.

Tolerance is not the same thing as opioids dependence or addiction. If someone has developed dependence, he will experience opioids withdrawal symptoms when he stops taking the opioid drug. Addiction is a disease involving the brain and means that someone can no longer control opioid use.

If you need more of your opioid painkiller to dull your pain to the same level as you were getting with a lower dose, you might have developed a tolerance of opioids. It doesn’t come from lack of control or compulsive use, so how does tolerance develop?

How Tolerance of Opioid Pain Medication Develops

Opioid mechanism of action makes it is fairly easy to become tolerant of painkillers, even when you’re following your doctor’s instructions for how to take them. The predictable pattern of tolerance development is often referred to as the tolerance trajectory.

The trajectory, or path, that opioid use takes is this: Someone begins taking opioids for pain as prescribed. Eventually, that dose isn’t as effective, and she needs more. The doctor increases the dose, and it works until it doesn’t. The pattern of increasing doses just to maintain the same level of pain relief happens because tolerance has developed.

Tolerance develops in different ways:

• At the cellular level when opioids bind to opiate receptors, enzymes are released that fire chemicals in the cell. Eventually, the enzymes adapt to the opioid and cease to react. Now more painkillers are needed in order to trigger pain-relieving reactions.
• Body systems experience changes. For example, brain chemistry grows accustomed to the painkillers and thus needs more to spring into pain-relieving action.
• In response to prolonged opioid presence, the body changes the way it metabolizes the painkillers. This leads to a reduced opioid concentration in the blood, and more are needed to compensate.
• Sometimes learned tolerance is at work. Someone taking opioid painkillers learns to function well with the levels of opioids in his system. His functioning has adapted, but the pain is still there, so he needs a greater amount of opioids.

You won’t notice the inner workings of tolerance development, but you’ll recognize tolerance if you no longer feel the effects of the painkiller and instead feel more pain. As a result, you’ll find yourself needing to take opioids more frequently or take a stronger dose. A doctor has to prescribe the increase, so if you do need to see a doctor for this reason, it would be a good opportunity to discuss the possibility of opioids tolerance with him.

Effects and Dangers of Opioids Tolerance

A tolerance of opioids can have serious negative consequences. It increases the risk of dependence, addiction, and opioid overdose. Overdose is a particular risk because with opioids, it can happen fairly easily and unintentionally as the levels in the system increase.

Opioid tolerance has another negative effect that affects future pain and the need for pain medication. Tolerance doesn’t fully disappear. It lasts into the future even when medications are stopped.

Therefore, if you need prescription painkillers down the road, you’ll have to start at a higher dose than you’d otherwise need because your system is still accustomed to a certain level of opioids. Further, chances are high that you’ll “max out” on prescription painkillers. Tolerance will develop with each new dose until it’s unsafe to take higher or more frequent doses. If that happens, pain won’t be completely relieved.

Opioid Tolerance Help. Is Opioid Tolerance Reversal Possible?

So far, drug replacement therapies don’t work for opioid tolerance. While using an opioid antagonist like methadone can help with addiction, it doesn’t help to reverse tolerance.

That said, researchers are working on developing a drug replacement therapy that does work. Additionally, many are hopeful that adding a very low dose of an opioid antagonist called naltrexone with oxycodone (the combination is known as Oxytrex) will help oxycodone work longer. This doesn’t reverse tolerance, but it seems to prolong its development.

Even though opioid tolerance can’t be fully reversed, there are ways to deal with it once it happens.

• Stop taking opioid painkillers (done gradually and often with help).
• Give your brain and body time to heal and recover.
• Seek alternate methods of pain relief, such as going to interdisciplinary chronic pain programs, working with a physical therapist or personal trainer (many specialize in movement for pain management), or attending support groups for people living with chronic pain.

Developing a tolerance to opioid pain meds is undesirable, but it doesn’t mean that you are addicted to drugs, and it doesn’t mean you can’t take other measures to manage your pain.

article references

An opioids list can be an important reference to have. Knowing which drugs are opioids is a way to be informed regarding your own healthcare. It’s important, too, to know how they rank from strongest to weakest. Having this knowledge will help you have control over your own health. Opioids are highly addictive, and being informed allows you to communicate with your doctor regarding safe pain treatment (Commonly Abused Prescription Medications).

The below opioids drug list contains opioids names. The opioids brand names are names of prescription painkillers available. The opioids street names list contains illegal drugs.

The painkillers are listed in order from strongest to weakest. Strength ranking of opioids is challenging. There are a number of factors that influence the amount of pain relief someone will get from a prescription painkiller, including:

• The route of administration (intravenous, oral, intramuscular, etc.)
• An individual’s metabolism
• An individual’s level of opioid tolerance

To make the ranking as objective and clear-cut as possible, opioids are often rated according to how they compare with morphine. What amount of medication is needed to achieve the same relief response as morphine’s? They’re either stronger than morphine, about the same as morphine, or weaker than morphine.

List of Prescription Opioids by Strength (Strongest to Weakest)

Stronger than morphine:

• Fentanyl
• Oxymorphone
• Hydromorphone
• Levorphanol
• Methadone
• Oxycodone

Morphine Equivalent

• Morphine
• Tapentadol
• Hydrocodone

Weaker than Morphine

• Vicodin
• Norco
• Percocet
• Percodan
• Demerol
• Pethidine
• Codeine
• Tramadol
• Lavdanum (Opium Tincture)

List of Street Names for Prescription Opioids

The above prescription painkillers often end up in the wrong hands and illegally sold and used. This list presents some commonly misused opioid painkillers and their street names.

Fentanyl

• Apache
• Duragesic
• Sublimaze
• Dance fever
• Actiq
• TNT
• China white
• China girl
• Tango and Cash
• Jackpot
• Friend
• Goodfella

Oxycontin

• Oxy
• Hillbilly heroin
• Kickers
• Oxycottons
• Killers
• OC

Methadone

• Amidone
• Fizzies
• Chocolate chip cookies

Morphine

• Roxanol
• Miss Emma
• M
• White stuff
• Monkey
• Duramorph

Percocet and Percodan

• Percs
• Percodoms

Vicodin or Lorcet

• Vikes
• Watson-387

Codeine with Robitussin or Tylenol

• Captain Cody
• Cody
• Schoolboy

Codeine with Glutethimide

• Doors & fours
• Pancakes and syrup
• Loads

Demerol

• Pain killer
• Demmies

List of Illicit Opioids

These opioids are not prescription pain meds obtained and sold illegally. Instead, they are street drugs that don’t have a legal form.

Heroin

• H
• Big H
• Smack
• Junk
• Dope
• Horse
• White horse
• China white
• Skunk
• Skag
• Brown sugar
• Hell dust
• Thunder
• Chiva

Opium

• Gum
• Black stuff
• O
• Big O
• Block
• Dopium
• Gee
• God’s medicine
• Black Pill
• Hop
• Toys
• Chinese tobacco
• Pox
• Joy plant
• Easing powder
• Dream stick
• Gun
• Zero

One of the reasons that the United States is experiencing an opioid epidemic is that opioids are so widely available. Know which drugs are opioids to prevent accidental misuse and overdose.

article references

20 questions to help determine if you have a problem with prescription drug abuse or addiction.

If you are unsure whether you have a problem with prescription drugs, here are 20 questions that will help you decide whether to seek professional help for prescription medication abuse or addiction:

1. Has your doctor, spouse or anyone else expressed concern about your use of medications?
2. Have you ever decided to stop taking pills only to find yourself taking them again contrary to your previous decision?
3. Have you ever felt remorse or concern about taking pills?
4. Has your efficiency or ambition decreased since taking pills?
5. Have you established a supply for your purse or pocket or to hide away in case of emergency?
6. Have you ever been treated by a physician or hospital for excessive use of pills (whether or not in combination with other substances)?
7. Have you changed doctors or drug stores for the purpose of maintaining your supply?
8. Have you received the same pill from two or more physicians or druggists at approximately the same time?
9. Have you ever been turned down for a refill?
10. Have you taken the same mind- or mood-affecting medication for over a year only to find you still have the same symptoms?
11. Have you ever informed your physician as to which pill works best at
    which dosage and had him adjust the prescription to your recommendations?
12. Have you used a tranquilizer or a sleep medication for a period of months or years with no improvement in the problem?
13. Have you increased the dosage, strength or frequency of your medication over the past months or years?
14. Is your medication quite important to you; e.g., do you worry about refills long before running out?
15. Do you become annoyed or uncomfortable when others talk about your use of medications?
16. Have you or anyone else noticed a change of personality when you take your medication, or when you stop taking it?
17. Have you ever taken your medication before you had the associated symptom?
18. Have you ever been embarrassed by your behavior when under the influence of your prescription drug?
19. Do you ever sneak or hide your pills?
20. Do you find it impossible to stop or to go for a prolonged period without your pills?

If you have answered YES to three or more or these questions, you may be at serious risk of having a problem with prescription medications. The good news is that treatment is available.

(Reprinted and slightly adapted from "There's More to Quitting Drinking than Quitting Drinking" by Dr. Paul O.)

Sources:

• PrescriptionDrugAbuse.org

Posttraumatic stress disorder (PTSD) self-help is defined as self-guided improvement; doing things on your own or within a PTSD support group to help yourself manage the symptoms of PTSD and the effects PTSD has had on your life. One of the most important ways you can help yourself is to learn all you can about PTSD, including PTSD causes, symptoms and treatments. In addition, finding a therapist who is experienced in treating trauma-related disorders, including PTSD, can be very helpful in the healing process.

We’ve included where to get self-help for PTSD and self-help techniques for PTSD, so keep reading on.

Where to Get Self-Help for PTSD?

You can get PTSD self-help information and guidance from the Veteran’s Adminstration (VA), from PTSD self-help books, and through PTSD self-help worksheets as well as using other tools and mental health management skills provided in therapy. PTSD support groups are another important form of PTSD self-help.

The Veteran’s Administration, part of the U.S. Department of Veterans Affairs, has various resources on its website, including how to get in touch with the VA in your area and a section on the disorder. The PTSD page includes information about where to find peer support groups and also about an app, called PTSD Coach, that can help you track your symptoms and more.

Another way to find PTSD support groups is through your county mental health agency, community mental health centers and local veterans groups. Your doctor may also be able to direct you to support groups in your area.

Support groups, either led by a professional or peer-run, focus on personal day-to-day experiences of living and coping with PTSD. These groups offer you a chance to connect with other people who are going through the same or similar struggles. This helps remove the sense of isolation that often comes with PTSD. While they won’t necessarily reduce symptoms, support groups complement traditional treatment by providing an additional outlet to work through what you’re dealing with.

Get PTSD Self-Help Through Books and Worksheets

PTSD self-help books cover topics such as demystifying PTSD treatment options and guidance on how to cope with symptoms. There are also PTSD self-help workbooks, such as The PTSD Workbook, and other books featuring stories from survivors of trauma. These can help remove the sense of isolation through identification with another person’s experience. These books can be found online or in the self-help section at bookstores.

PTSD self-help worksheets are tools to help track how you are affected by your PTSD symptoms and how to make positive changes. The worksheets tend to focus on things such as identifying triggers and associated feelings, which is a step in learning how to manage them. These worksheets can be obtained through medical professionals, some self-help books, and online.

Self-Help Techniques for PTSD

PTSD self-help can be as simple as going back to the basics and as involved as a lifestyle change. Here are a few self-help methods to cope with PTSD and its symptoms.

1. Use grounding techniques. You can cope with PTSD-related anxiety by controlling your anxious breathing, being aware of your surroundings, and many other anxiety grounding techniques. Practicing these can help you cope with triggers and bring you out of an anxious or dissociative state and back to the present world.
2. Challenge negative thoughts and feelings of helplessness. When facing feelings of worthlessness or self-blame, it’s best to stop and think, ‘Is that really true?’ Also, try to think of reasons the thought isn’t true. This will likely be a challenge. In the beginning, asking a loved one to help may be beneficial.
3. Create or maintain a healthy lifestyle. Eating healthy, getting enough sleep and exercise, and avoiding use of drugs and alcohol are ways to contribute to a healthy lifestyle, which contributes to positive mental health.

Not everyone will choose the same PTSD self-help methods, and that’s okay. It’s a matter of knowing what options are available and forming a plan that will work for you. PTSD can make things challenging, but self-help can make those challenges more manageable.

A phone call from a suicidal person who says I'm so depressed and have thoughts of suicide can induce panic and fear. Learn how to help the person who feels suicidal.

1. Be yourself. "The right words" are unimportant. If you are concerned, your voice and manner will show it.

2. Listen. Let the person unload despair, ventilate anger. If given an opportunity to do this, he or she will feel better by the end of the call. No matter how negative the call seems, the fact that it exists is a positive sign, a cry for help.

3. Be sympathetic, non-judgmental, patient, calm, accepting. The caller has done the right thing by getting in touch with another person.

4. If the caller is saying "I'm so depressed, I can't go on," ask The Question: "Are you having thoughts of suicide?" You are not putting ideas in his head, you are doing a good thing for him. You are showing him that you are concerned, that you take him seriously, that it is OK for him to share his pain with you.

5. If the answer is "yes," you can begin asking a series of further questions: Have you thought about how you would do it (PLAN); Have you got what you need (MEANS); Have you thought about when you would do it (TIME SET). 95% of all suicidal callers will answer no at some point in this series or indicate that the time is set for some date in the future. This will be a relief for both of you.

6. Simply talking about their problems for a length of time will give suicidal people relief from loneliness and pent up feelings, the awareness that another person cares, and a feeling of being understood. They also get tired -- their body chemistry changes. These things take the edge off their agitated state and help them get through a bad night.

7. Avoid arguments, problem-solving, advice giving, quick referrals, belittling and making the caller feel that has to justify his suicidal feelings. It is not how bad the problem is, but how badly it's hurting the person who has it.

8. If the person is ingesting drugs, get the details (what, how much, alcohol, other medications, last meal, general health) and call Poison Control at (800) 222-1222 in the US. A shift partner can call while you continue to talk to the person, or you can get the caller's permission and do it yourself on another phone while the caller listens to your side of the conversation. If Poison Control recommends immediate medical assistance, ask if the caller has a nearby relative, friend, or neighbor who can assist with transportation or the ambulance. In a few cases, the person will initially refuse needed medical assistance. Remember that the call is still a cry for help and stay with him in a sympathetic and non-judgmental way. Ask for his address and phone number in case he changes his mind. (Call the number to make sure it's busy.) If your organization does not trace calls, be sure to tell him that.

9. Do not go it alone. Get help during the call and debrief afterward.

10. Your caller may be concerned about someone else who is suicidal. Just listen, reassure him that he is doing the right thing by taking the situation seriously, and sympathize with his stressful situation. With some support, many third parties will work out reasonable courses of action on their own. In the rare case where the third party is really a first party, just listening will enable you to move toward his problems. You can ask, "Have you ever been in a situation where you had thoughts of suicide?"

The most important pain-coping resource is the help of a trained mental health professional. A person who feels suicidal should get help, and get it sooner rather than later.

By David L. Conroy, PhD. Reprinted with permission.

The National Hopeline Network 1-800-SUICIDE provides access to trained telephone counselors, 24 hours a day, 7 days a week.

Or for a crisis center in your area, visit the National Suicide Prevention Lifeline.