Opium

How is opium used?

Opium can be smoked, eaten raw or as a pill, or made into a tincture/tea for drinking.^{2, 3}

Opium can also be manufactured into heroin and is a prerequisite for heroin production.²

Effects of opium

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

Opium can affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (where the drug is taken).

Onset and duration

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's swallowed or injected.⁴

In general, the effects of opium can be felt within 1 hour and can last up to 12 hours.^{5, 6}

When drunk in tea, it can take up to 2 hours for the full effects of opium to be felt.⁵

Effects

Effects can include:

• euphoria
• relaxation
• analgesia (pain relief)
• slower, shallower breathing
• lower heart rate
• impaired reflexes
• temporary constipation
• loss of appetite.^{7, 8}

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using opium may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take opium – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take opium will vary based on the individual and drug they’re using.⁹

Being in a good state of mind, with trusted friends and a safe environment before taking opium reduces the risk of having a bad experience.⁹

Overdose

If you take a large amount of opium or use a strong batch, you could overdose.

Your risk of overdose can also increase if you mix opium with alcohol or other drugs, including medications.

Opium overdose can cause death.¹⁰

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of opioid overdose can include:

• unconscious or non-responsive
• slow breathing, abnormal breathing, or not breathing at all
• slow or no heartbeat and pulse
• choking or gurgling sounds
• skin colour changes, especially lips and fingernails
• bluish-purple skin for people with lighter complexions
• greyish or ashen skin for people with darker complexions
• vomiting
• cool or clammy (wet and sweaty) skin
• small ‘pinpoint’ pupils.^11-13

Learn more on overdose and drug-related emergencies

Naloxone

Naloxone (also known as Nyxoid®/Narcan®) temporarily reverses the effects of opioid overdose (including opium). It’s available for free over the counter from most local pharmacies and can be administered by anyone, including family or friends and bystanders.¹⁴

If a person does not respond to the first dose after 3 minutes, give them a second dose. This can be repeated until the ambulance arrives.^{15, 16}

Find naloxone near you

Mixing with other drugs

Mixing opium with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• Opium and nitrous oxide (nangs): can increase the risk of unconsciousness and blackouts.
• Opium and methamphetamine/cocaine: can increase the risk of heart strain.
• Opium and alcohol/benzodiazepines/ketamine/GHB: can increase sedation and lead to unconsciousness, choking on vomit, and possible death.^{10, 17}

Using more than one drug or type of drug at the same time is called polydrug use.¹²

Reducing harm

There are ways in which you can reduce the risks associated with using opium:

• always carry naloxone for emergencies, and encourage family and friends to learn how to use take home naloxone – a medicine that can reverse the effects of an opioid overdose (more information on naloxone is provided below)
• avoid mixing drugs (polydrug use) – mixing opioids with depressant drugs such as alcohol or benzodiazepines can greatly increase the risk of overdose
• don’t use opioids alone and always tell someone what you’ve taken
• if using illicit opioids, always test a small amount to reduce overdose risk
• do not drive or operate machinery after use
• always use sterile injecting equipment and never share injecting equipment
• safely dispose of used injecting equipment.

Coming down

Opium is not known to cause comedown effects.

Long-term effects

Long-term effects can vary depending on how much, how often and how opium is consumed. Regular use may eventually contribute to:

• tolerance - needing to use more to get the same effect
• irregular periods and difficulty having children
• loss of sex drive
• constipation
• dependence on opium.^{7, 8}

Opium and mental health

Research has found a link between some mental health conditions and the risk of opioid overdose.^{18, 19}

There is evidence that as many as 1 in 3 people with an opioid use disorder also have post-traumatic stress disorder (PTSD).²⁰

People experiencing mental health concerns such as depression, anxiety, PTSD, psychosis, or bipolar disorder are also more likely to experience an opioid overdose compared to those without these conditions.¹⁸

This association has been seen across different groups, including people in emergency departments, veterans, and those in prison settings.¹⁸

Tolerance

Regularly taking opium can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.^{21, 22}

Tolerance to opium also affects other opioids (known as cross-tolerance). For example, tolerance to opium will also result in a higher tolerance to oxycodone or fentanyl.²³

Tolerance should return to normal within 1 – 2 weeks of not using opioids.²⁴

Dependence

People who regularly use opium may become dependent. They may feel they need to use opium to go about usual activities like working, studying and socialising, or just to get through the day.^{22, 25}

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²⁶

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²⁶

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²⁶

Withdrawal from opium can be potentially life-threatening.²⁷

If you, or someone you care about, is planning to stop taking opium after using it for a long time, it’s important to speak with a medical professional for guidance and supervision.

Withdrawal symptoms

Reducing, or stopping using opium after a period of regular use can lead to withdrawal symptoms.

These symptoms are described as flu-like, and can include:

• restlessness and irritability
• insomnia
• depression and crying
• diarrhoea
• sweating
• restless sleep
• muscle cramps
• nausea and vomiting
• fast heartbeat.²⁸

Withdrawal symptoms usually start six to 24 hours after the last dose and can last around seven to ten days.²⁸

Reduced tolerance and overdose risk

After withdrawing from opium, your body is no longer used to it and your tolerance drops.²⁴

This means if you use the same amount as before, it can be too much for your body and cause an overdose.²⁴

Always start with a lower dose after a break from opium.²⁴

Pregnancy and breastfeeding

Before pregnancy

There is research that shows opioid drugs can impact fertility.

Opioids can:

• affect menstrual cycles
• lower sex drive.
• lower testosterone levels
• reduce sperm quality and movement
• cause erectile dysfunction.^29-31

During pregnancy

Opioid use during pregnancy can harm the baby’s development.^{32, 33}

Opioids can pass to your baby via the placenta. This can affect the baby’s growth and result in a premature (early) birth, which has other health impacts on the baby.^{32, 40}

Other chemicals may be present in illegal or counterfeit (fake) opioid medication, and there is no way to know exactly how these will impact the baby or the pregnancy.³⁴

If you’re injecting opioids, it’s important to not share injecting equipment with other people. This protects you and the baby from bloodborne viruses such as HIV and hepatitis C.³⁵

After pregnancy

Opioid use during pregnancy can sometimes cause withdrawal symptoms in babies after birth. This is known as neonatal opioid withdrawal syndrome (NOWS).^{33, 36}

NOWS is easily diagnosed and treated, and not all babies will experience symptoms.³⁶

Breastfeeding your baby while using opioids in high doses is not recommended, as the drugs can be present in breastmilk and affect the baby.^{32, 37, 38}

If you’re planning to breastfeed, make sure you talk with your midwife or doctor about your use of opioids.³³

Getting help

If your use of opium is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is help and support.

• Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.