1. Created by the North Florida opioid and heroin task force
Signs of Opioid Misuse
Created by the North Florida opioid and heroin task force

2. What is an Opioid?
Opioids are a group of natural, partially synthetic, or synthetic drugs derived from the poppy plant or chemically synthesized in laboratory settings. This class of drugs includes both legal and illegal drugs.
Legally prescribed opioids include morphine, codeine, and oxycodone.
Illegal opioids include heroin, as well as synthetic fentanyl.

3. Why do people abuse opioids?
Opioids are used to help individuals cope with pain. They bind to natural opioid receptors in the brain, mimicking specific chemicals that are related to sensations of pain relief, pleasure, and reward.
However, since opioids have both pain relieving properties and positive psychological properties, they are among the most abused types of substances currently available.

4. Warning Signs of Opioid Misuse
A person misusing an opioid may display the following:
Reduced social interaction
Constipation
Drowsiness, even during normal conversation – Known as nodding off
Slowed breathing
Slow movement and reactions
Poor memory and concentration
Mood swings
Apathy and depression.
Anxiety

5. Once dependency increases:
Any money acquired may go for drugs, Necessary bills and items may be neglected. Alternately, as some people begin to sell drugs to support their addiction, they may have unexpected money or expensive items.
As a preoccupation with obtaining drugs and maintaining an addiction occurs, they may drop out of touch with family and friends. They may acquire whole new set of friends who are drug users.
They may commit illegal acts to get money for drugs and may be arrested.
A person will most likely begin to neglect work and school.

6. Once dependency increases cont’d:
They may show change in overall attitude and have outbursts of bad temper.
The person may appear jittery and be secretive.
They are likely to allow grooming and physical appearance to deteriorate.
Loans of money may be asked for and items from the homes of family members may go missing.

7. Red Flags: Small amounts of money, even coins, missing
Frequent quick trips out of the house (i.e. to get gas, cigarettes)and/or frequent visitors for short amounts of time
Pinpoint Pupils, or wearing sunglasses indoors to hide pupils
Weight loss due to decreased appetite
Appearance of laxatives or enemas to combat constipation
Wearing long-sleeves, to cover injection sites, even in the hottest weather
Burn holes in clothing, furniture, automobiles, etc.
Missing spoons or burn marks on the backs of spoons

8. Alternative methods of consumption
A person misusing opioids may do so in several ways to achieve a faster, more intense high.
These methods include:
Snorting – Pills can be crushed in order to snort, heroin can also be snorted in its powder form
Smoking- Pills and heroin may be smoked, but it is uncommon
Intravenous injection- Pills and heroin may be injected by combining them with liquid to inject into the body

9. Signs of snorting opioids
Sinus congestion, Sniffling, Stuffy nose
Hoarse throat
Snorting paraphernalia such as:
Empty/disassembled pens
Straws – usually cut in half for discrete possession
Rolled/folded dollar bills or pieces of paper
Small mirrors
Razorblades
White powdery residue on hard surfaces
Small bags or pieces of plastic with residue left behind

10. Signs of smoking opioids
Small glass or metal pipes, or plastic pens with burn marks
Sheets of aluminum foil with burn marks
Side Note: Smoking opioids is not very effective, therefore not as common as other methods

11. Signs of opioid injection
Long-sleeved clothing, to cover injection marks, even in the hottest weather
Missing spoons from the kitchen; or appear blackened/burnt on the underside
Burn holes in clothing or on bedding, on furniture, in car, etc.
Cups or shallow dishes with small amounts of water
Cigarette filters or small cotton balls
Shoelaces, belts or rubber bands used to constrict blood flow
Needles, especially small orange syringe caps