What are opioids?

Opioid medicines may be prescribed by doctors to manage pain. If they are used in this way, they can be effective medications. However, there are risks, especially if they are not used properly.

Opioids used in pain management include codeine (Panadeine Forte, Nurofen Plus), tramadol, fentanyl, oxycodone (OxyContin, OxyNorm, Endone), tapentadol (Palexia), morphine, and hydromorphone.

Opioid medications are prescription only in Australia, and are taken through tablets, capsules, injections, liquids, or patches. Doctors prescribe different forms and strengths depending on the patient’s needs. Opioid medicines are legal with a prescription, however using them without a prescription, or misusing them, is considered illicit drug use. Misuse refers to using an opioid differently to how it was prescribed, including taking opioids for a longer period of time or at a higher dose than prescribed. For more information, visit the Department of Health and Aged Care’s ‘Drug laws in Australia’ page.

Versions of common pharmaceutical opioids are manufactured for the illegal drug market. The lack of regulation and quality control in the illegal drug market means people purchasing these do not know the purity, dose, or strength of the opioid they are taking. This increases the risk of negative effects, including overdose.

Sometimes, specific opioids are prescribed as part of opioid dependence treatments. For people with opioid dependence, these medications can help them recover by attaching to opioid in the central nervous system and reducing the withdrawal symptoms, desire for more opioids, and harms associated with opioid use. They also reduce the ‘high’ users feel when they take other opioid drugs. These medications are prescribed as part of short or long-term treatment plans.

Opioids used in dependence treatment include buprenorphine (Suboxone, Subutex), and methadone (Biodone Forte). They are taken through injections, tablets, films, or as liquids, usually under pharmacist supervision.

Naloxone is a medication that can temporarily reverse the effects of an opioid overdose, by preventing opioids from attaching to opioid receptors. It is given through an injection or nasal spray. As the effects of naloxone are temporary, it is important to call 000 for an ambulance. See below for more information on opioid overdose and naloxone.

Some opioids, including heroin (see factsheet) and opium are illegal to make, sell, or possess in Australia.

Heroin (see factsheet) can be a fine powder, granules, or rocks. It is usually injected, but is also snorted, smoked, or heated and the vapours inhaled.

Opium is a dark brown gum extracted from the opium poppy, that is smoked, taken as a pill, or drunk in a tincture.

Using prescription opioids at a frequency, quantity or by a person other than as directed on the prescription is considered illicit drug use. to the 2022-2023 Australian secondary schools’ survey, 1 in 100 students (1%) had used pharmaceutical opioids in the past month either without a prescription or not as directed, and 1 in 500 (0.2%) had used heroin in the past month.

New types of opioids emerge on the illegal market. They can have increased risk as their effects may be different to what people expect.

Nitazenes are an example of emerging opioids that have been detected in Australia. Nitazenes are strong synthetic opioids that were originally developed as medicines. However, they were not approved for medical use due to safety concerns. Recently, nitazenes have been found in drugs sold as heroin, MDMA, and ketamine. As nitazenes can be much stronger than the drugs people think they are taking, this increases the risk of overdose and negative effects. Visit theknow.org.au for more information about emerging drugs of concern.