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Opioid and Heroin


Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and others available legally by prescription.

Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused. Regular use, even as prescribed by a doctor, can lead to dependence. When misused, opioid pain relievers can lead to overdose incidents and deaths.


Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of various opium poppy plants. Heroin comes in many forms, including white or brown powder, or a sticky black substance known as black tar heroin.

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved with feelings of pain and pleasure. It can also affect a person's heart rate, sleeping and breathing.

Research suggests that the misuse of prescription opioid pain medicine is a risk factor for starting heroin use. Heroin use can lead to addiction, a form of substance abuse disorder. A person can overdose on heroin.

Drug Overdose Overview

Overdoses occur when a person takes more than the medically recommended dose of a drug. Generally, in an overdose, the therapeutic effects of the drug are experienced at a heightened level. Side effects can become more pronounced, and other effects not seen with normal use may take place. Some overdoses can worsen a person's chronic disease, such as asthma.

Overdose symptoms include:

  • Vital sign (temperature, pulse rate, respiratory rate, blood pressure) values can be increased, decreased, or absent.
  • Sleepiness, confusion, and coma.
  • Skin that is cool and sweaty, or hot and dry.
  • Chest pains.
  • Abdominal pain, nausea, vomiting and diarrhea.

If an overdose is expected, seek medical care from your doctor, your local poison center, or the emergency department of your local hospital. Specific and accurate information including the name of the drug, the amount of the drug ingested, and the time the drug was taken will be needed to help identify symptoms.

Naloxone Dispensing

Opioid and heroin overdoses can be reversed with the drug naloxone when administered right away. A Standing Order for Naloxone distribution was issued by the State Health Officer in 2017. Read more about Naloxone Dispensing in Alabama.

Opioid and heroin abuse disorders can be treated with a variety of effective medications including methadone, buprenorphine and naltrexone.

Naloxone Training

  • Online Naloxone training is available for first responders and others.
  • Instructions for administering Narcan ® are available. (Spanish version)

Overdose Response Resource Cards. These cards were developed for first responders to give to those who would benefit from free naloxone, including friends,family, or communities that may encounter overdoses. Resources for treatment, recovery, and free naloxone are listed on the card. 

  • Online training with an instructional video and instructions for requesting free naloxone that will be mailed to their home.
  • ROSS Helpline number where help is available 24/7.
  • RRC provides information and resources
  • Overdose Response Resource Card

Data Driven Prevention Initiative (DDPI) on Opioid Abuse

In 2016, the Alabama Department of Public Health (ADPH) received three year funding from the Center for Disease Control, Data-Driven Prevention Initiative (DDPI) on Opioid and Heroin Abuse and Overdose to address this crisis within Alabama. ADPH leveraged existing partnerships among healthcare, public safety, education, treatment, federal, state, and local government to facilitate the development of a statewide prescription drug and heroin abuse prevention plan. Learn more about the DDPI on Opioid Abuse.

Overdose Data to Action (OD2A)

In 2019, the Alabama Department of Public Health (ADPH) received multiyear funding from the Center for Disease Control, Overdose Data to Action (OD2A) to continue the fight against opioid deaths due to overdose, OD2A fits into CDC's broad framework to address the opioid crisis based on five key strategies:

  1. Conduct Surveillance and Research
  2. Build State, Local, and Tribal Capacity
  3. Support Providers, Health Systems, and Payers
  4. Partner with Public Safety
  5. Empower Consumers to Make Safe Choices

OD2A supports jurisdictions in collecting high quality, comprehensive, and timely data on nonfatal and fatal overdoses and in using that data to inform prevention and response efforts. OD2A focuses on understanding an tracking the complex and changing nature of the drug overdose epidemic and highlights the need for seamless integration of data into prevention strategies.

Alabama Opioid Overdose and Addiction Council

The Council was created in August of 2017 by an executive order of Governor Kay Ivey, and tasked with developing a strategic plan “that establishes recommendations for policy, regulatory and legislative actions to address the overdose crisis in Alabama.” The Council and its subcommittees met several times since then, and submitted a formal plan to the Governor. Read the news release: Attorney General Steve Marshall, Mental Health Commissioner Lynn Beshear and Acting State Health Officer Dr. Scott Harris Announce Issuance of Opioid Council Report (01/24/18)

Upon the retirement of Mental Health Commissioner Lynn Beshear, Commissioner Kimberly G. Boswell was sworn in on December 16, 2020, and assumed her appointment to the Alabama Opioid Overdose and Addiction Council alongside Dr. Scott Harris, State Health Officer and Attorney General Steve Marshall.

The Council’s report is presented to Governor Kay Ivey each year. The initials report presented a four-pronged action plan to address prevention of opioid misuse, intervention within the law enforcement and justice systems, treatment of those with opioid use disorders, and community response that engages the people of Alabama in finding solutions at a local level. Subsequent years show the progress that has been made in the endeavor.

Per the governor's order, six standing committees were assembled to explore the problems and made recommendations. The workgroups are identified below:

  1. Data
  2. Prescriber-Dispenser
  3. Rescue
  4. Treatment-Recovery
  5. Prevention-Education
  6. Law Enforcement
  7. Community Engagement
  8. Workforce

Council Reports to the Governor are available below:


Page last updated: August 10, 2022