What Are Opioids?

Some opioid medications are made from the poppy plant, while others are made by scientists in a lab. Opioids include prescription medications used to treat pain, as well as fentanyl and heroin.

Prescription Opioids

Prescription opioids or pills are prescribed by doctors to treat moderate to severe pain such as sports injuries, dental work, cancer, and severe chronic pain. When taken as prescribed, they are reasonably safe and can reduce someone’s pain in both the short, and long term. But even though they are prescribed by a doctor they can have serious risks and side effects when misused or not taken as prescribed. Common types include oxycodone (OxyContin), hydrocodone (Vicodin), morphine, Percocet, and codeine.


Heroin is an illegal, highly addictive opioid that is typically injected but can also be snorted or smoked. It is typically sold as a white or brownish powder, but also sold as “black tar” heroin which is sticky like roofing tar or hard like coal.


Fentanyl is an opioid drug that is 50x more powerful than heroin. Medically, it is used to treat severe pain and for surgeries. It is now being made illegally, sold on the streets for its “heroin-like” effect, and often mixed with heroin, cocaine, methamphetamine, imitation or fake pills, and other drugs – with or without the individual who is taking its knowledge. Due to its high potency, even the smallest amount can lead to an overdose. Illegally made, or distributed Fentanyl is now the most common drug involved in drug overdose deaths in the United States. Click here to learn more about fentanyl and dispel the myths.

Connection Between Prescription Opioids & Heroin

Prescription opioids and heroin are chemically similar and can produce similar effects. In many communities, heroin is cheaper and easier to get. Because of this, people who become addicted to prescription opioids may switch to using heroin instead.


Xylazine, or "tranq", is a powerful animal tranquilizer used by veterinarians and is not approved or safe for human use. It is often mixed with other drugs, and people unknowingly use it in combination with other drugs, specifically fentanyl, increasing the risk of overdose death. It can be consumed, inhaled, or injected. No matter the route of entry, xylazine can cause severe infections, wounds, and tissue damage. Although naloxone will not reverse the effects of xylazine, naloxone should still be given even if the cause of a suspected overdose is unknown. Rescue breaths are important because xylazine slows down breathing. For more information, visit the California Department of Public Health’s page on xylazine here.



Cocaine is a powerful, addictive, stimulant drug. It’s a white, fine, crystal powder. It is snorted or rubbed into people’s gums. It can also be dissolved and injected, or injected in combination with heroin, called a "Speedball". Cocaine is processed with ammonia or sodium bicarbonate (baking soda) and water, then heated to remove the hydrochloride to produce a smokable substance known as "crack" cocaine. Sometimes street dealers mix other drugs into cocaine such as amphetamine or fentanyl. This is dangerous for people using cocaine who don’t realize it contains fentanyl. As there has been an increase in overdose deaths among cocaine users that may be attributed to the addition of fentanyl.


Methamphetamine is a powerful and addictive stimulant that impacts the central nervous system. It’s usually a white powder, but crystal meth looks like glass fragments or shiny, bluish-white rocks. It can be smoked, swallowed as a pill, snorted, or injected. Fentanyl is sometimes added to methamphetamine without the user knowing.


What are benzodiazepines?

Benzodiazepines, or "benzos", are central nervous system depressants that slow brain activity. They’re prescribed to treat anxiety, panic, acute stress reactions, and sleep disorders. Even when prescribed by a doctor, use can lead to misuse and substance use disorder (SUD).

Benzodiazepines and Opioids

Taking opioids with benzodiazepines can increase the risk of overdose because both types of drugs can cause sedation and suppress breathing, which causes overdose fatality.