What is Nicotine & Cotinine?

Nicotine is a highly addictive stimulant naturally found in tobacco plants and commonly consumed through cigarettes, cigars, vaping devices, and smokeless tobacco. Once absorbed, the body rapidly metabolizes nicotine into cotinine, a stable and longer-lasting biomarker used in toxicology testing. Cotinine is preferred for screening because it remains in the system longer and provides a more accurate indication of recent nicotine exposure.

• Nicotine appears in tobacco products (leafy material), vape liquids (clear to colored fluids), patches, gums, and lozenges formulated for cessation.

• Cotinine is not a drug or consumable substance—it’s a metabolite detected in biological samples (urine, saliva, blood) for screening purposes.

Nicotine is typically inhaled through smoking or vaping, or absorbed through oral or dermal products like chew, gum, or patches.

• Medical/therapeutic uses: Nicotine replacement therapies (NRT) such as gum, lozenges, and patches are FDA-approved to help smokers quit by delivering controlled, lower doses of nicotine.

• Recreational use: Smoking, vaping, or using smokeless tobacco products for stimulation, stress relief, or habit, often leading to dependence. Vaping has significantly increased nicotine exposure among young adults and teens.

Effects:

• Increased alertness and mild stimulation

• Elevated heart rate and blood pressure

• Relaxation or stress relief due to dopamine release

• Reduced appetite

• Dizziness or nausea (especially in new users)

• Headaches

• Withdrawal symptoms such as irritability and cravings

• Increased risk of cardiovascular disease with chronic use

• Reduced lung function and respiratory symptoms from smoking/vaping

• High addiction potential and difficulty quitting

What are Opiates?

Opiates are a class of drugs derived directly from the opium poppy plant and include substances such as morphine, codeine, and heroin. They are central nervous system depressants that act on opioid receptors to relieve pain, produce sedation, and create feelings of euphoria. Pharmaceutical opiates (like morphine and codeine) are used medically for pain management, anesthesia support, and cough suppression. These medications typically appear as tablets, capsules, oral syrups, or injectable liquids in regulated clinical settings.

Illicit opiates—particularly heroin—are commonly found as powder (white, tan, or brown), sticky tar-like substances (“black tar heroin”), or compressed forms depending on how they are manufactured. These forms are often snorted, smoked, or injected recreationally to achieve intense euphoria, but they carry significant risks due to unknown purity, adulterants, and high addiction potential. Misuse of pharmaceutical opiates, whether crushed and snorted or injected, also represents a major pathway to opiate dependence.

Effects:

• Pain relief and deep physical relaxation

• Sense of euphoria or “rush” (especially with heroin)

• Slowed breathing and heart rate

• Drowsiness and sedation

• Constricted (“pinpoint”) pupils

• Nausea and vomiting

• Itching or flushed skin

• Impaired coordination and slowed reaction time

• High risk of tolerance, dependence, and addiction

• Potential for respiratory depression leading to overdose

What are Synthetic Cannabinoids?

Synthetic cannabinoids—often referred to as K2, Spice, K3, K2P, or “herbal incense”—are man-made chemicals designed to activate the same receptors in the brain as THC (the active ingredient in cannabis). However, their chemical structures vary widely, and the compounds evolve frequently as manufacturers attempt to bypass regulations and testing technologies. These substances do not structurally resemble natural cannabis; instead, they belong to diverse chemical classes that can produce unpredictable and sometimes dangerous effects.

Because there is no single “synthetic cannabinoid” formula, researchers classify these substances into several major chemical families, each with its own structural backbone. Newer generations are often modifications of earlier compounds, created to remain legal or avoid detection. This rapid evolution is why toxicology programs, law enforcement, and medical providers struggle to keep up with identification and screening.

These products typically appear as loose, shredded plant-like material in small foil packets, though users may also encounter them in liquid cartridges. They are smoked, vaporized, or occasionally mixed into edibles. The effects are unpredictable because formulations change frequently, and batches often contain mixtures of multiple synthetic chemicals. These substances have no approved medical use and are associated with significant toxicity, including severe agitation, hallucinations, seizures, cardiac events, and fatalities.

Effects:

• Intense and unpredictable intoxication

• Severe anxiety, panic, or agitation

• Hallucinations or psychosis

• Elevated heart rate and high blood pressure

• Nausea and vomiting

• Confusion or disorientation

• Seizures

• Kidney damage in severe cases

• Violent or bizarre behavior

• High risk of overdose due to unknown potency

What is Morphine?

Morphine is a potent opioid analgesic derived from the opium poppy and is classified as a Schedule II controlled substance in the U.S. Medically, it is prescribed to manage moderate to severe pain, particularly in post-operative care, trauma settings, cancer pain, and palliative care. Pharmaceutical morphine is available as tablets, capsules, oral solutions, and injectable formulations, often appearing as white or colored tablets, clear liquids, or sterile solutions in vials.

Illicit or recreational morphine typically originates from diverted prescription supplies. Users may swallow, crush and snort pills, or inject liquid formulations to achieve rapid euphoria and sedation. Recreational misuse carries high risk due to morphine’s strong respiratory-depressant effects and its significant potential for dependence and overdose.

Effects:

• Pain relief and reduced perception of discomfort

• Euphoria or sense of well-being

• Drowsiness and sedation

• Slowed breathing and decreased respiratory drive

• Constricted (pinpoint) pupils

• Nausea or vomiting

• Constipation

• Itching or flushed skin

• Impaired coordination and mental clouding

• Risk of dependence, tolerance, and withdrawal

What is Rohyphnol?

Rohypnol, the brand name for flunitrazepam, is a powerful benzodiazepine known for its strong sedative, muscle-relaxant, and amnesic properties. It is significantly more potent than most other benzodiazepines. Although widely used in some countries for treating severe insomnia or as a pre-anesthetic medication, Rohypnol is not approved for medical use in the United States due to its high abuse potential and strong central nervous system–depressant effects.

Rohypnol typically appears as small tablets, historically white but more recently green with a blue dye that dissolves into liquids to discourage covert use. In illicit settings, the drug may be crushed, dissolved, or swallowed. Recreational misuse is often driven by its intense sedative and calming effects or by its ability to enhance or modulate other substances, such as alcohol or opioids. Illicit use is strongly associated with sexual assault cases because of its capacity to cause profound sedation, disorientation, and anterograde amnesia.

Effects:

• Extreme sedation and drowsiness

• Muscle relaxation and decreased motor control

• Reduced anxiety and a sense of calm

• Impaired judgment and slowed reaction time

• Slurred speech and dizziness

• Significant memory impairment or blackouts

• Confusion and disorientation

• Decreased coordination and balance

• Respiratory depression at high doses or when mixed with alcohol

• Risk of dependence, withdrawal, and dangerous polydrug interactions

What is Oxycodone?

Oxycodone is a semi-synthetic opioid medication derived from thebaine and used medically for moderate to severe pain management. It is available in immediate-release and extended-release formulations (e.g., OxyContin®, Roxicodone®), and typically appears as tablets or capsules in various colors, sizes, and imprints depending on manufacturer. In clinical use, it is taken orally under strict medical supervision due to its high abuse potential.

Recreationally, oxycodone may be swallowed, crushed and snorted, or—in more serious misuse cases—dissolved and injected to intensify its euphoric and sedative effects. Because it directly activates the brain’s opioid receptors, oxycodone carries significant risks for dependence, respiratory depression, overdose, and transition to stronger illicit opioids if misused.

Effects:

• Pain relief and relaxation

• Euphoria or a sense of well-being

• Drowsiness and sedation

• Slowed breathing and respiratory depression

• Constricted “pinpoint” pupils

• Nausea or vomiting

• Itching or flushed skin

• Impaired coordination and slowed reaction time

• Constipation

• High risk of tolerance, dependence, and withdrawal symptoms