Opioids are drugs that interact with receptors in the body to help relieve pain. They are prescribed for severe pain for short-term use, often after accidents or surgeries. Over 11% of Americans experience daily chronic pain, and opioids have been a good source of pain relief.

Opioids can have adverse side effects and are easy to abuse. In the past few years, opioid addiction rates have vastly increased, resulting in many overdose deaths.

What Is an Opioid?

Opioids (sometimes referred to as narcotics) are drugs that interact with receptors in the body to help relieve pain. They can also produce feelings of euphoria, drowsiness, and a calming effect. These properties make opioids highly addictive.

When you experience pain, what you’re feeling is your nerves communicating to your brain that part of your body is injured or healing. Opioids work with sites in the brain and nervous system known as opioid receptors to stop pain messages from reaching the brain, effectively telling your mind to not feel pain.

Opioids are often prescribed to treat severe or chronic pain, often after accidents or surgeries. They may also be prescribed for more general issues, like back pain, muscle pain, and arthritis. Due to their highly addictive properties, they are generally intended for short-term use only.

A distinction is sometimes made between opiates (which are derived naturally from the opium poppy) and opioids (which are synthetic). In most cases, the term opioids is used to refer to the entire class of drugs, including illegal opioids like heroin. Both natural and synthetic opioids are equally addictive.

Taking Opioids Safely

When used responsibly, opioids can be a good source of pain relief. Millions of Americans experience chronic pain daily, and doctors often prescribe opioids as a way to manage this pain.

Opioids are most often used for short-term pain relief. This is the safest way to prevent opioid dependence or addiction. Always follow the directions your doctor gives you  when taking opioids, and never take more than you are prescribed. If you are concerned about addiction, speak to your doctor before taking the drug.

300%
increase in U.S. opioid prescriptions since 1999 However, Americans do not report feeling more pain.CDC

Prescription opioids can cause some side effects, including:

  • Constipation
  • Drowsiness
  • Nausea
  • Vomiting

Opioids can have strong and dangerous interactions with certain medications, including sleeping pills and some antidepressants, so let your doctor know about any medications you are taking before starting an opioid prescription. Never drink alcohol while taking an opioid.

Like any drug, opioids should be kept in a safe place, out of reach and inaccessible to children. It’s also important to keep opioids away from anyone who may have a drug problem. You should never take opioids that are not prescribed to you, as this is an easy way to develop a dependence. It is also illegal.

Types of Opioids

There are many different types of opioid, both legal and illegal. Legally prescribed opioids typically come in pill form, though some can be delivered in liquid form or absorbed through the skin using a patch.

Generally speaking legal opioids are only available through a prescription or at a medical facility, such as a hospital or rehabilitation clinic.

Most Common Legal Opioid Drugs
Morphine
Morphine is one of the most powerful and effective opioids, and is typically only found in controlled settings, like hospitals. Morphine is usually administered in liquid form through an injection or intravenous (IV) drip, although it can sometimes also be found in tablet form.
Fentanyl
Fentanyl is an incredibly strong opioid and is said to be up to 100 times more potent than morphine. In an effort to control the substance and keep it safe, fentanyl was made into a patch for chronic pain management. It can also be used as a sedative and anesthetic for certain medical procedures. Fentanyl use has been on the rise in recent years, causing many overdose deaths in the U.S., U.K., and Canada.
Oxycodone
Oxycodone can be found on its own or combined with other drugs like acetaminophen. It is often produced as an extended-release tablet that makes its effectiveness last longer. Many people know oxycodone by its brand names, which include OxyContin and Percocet.
Hydrocodone
This opioid is one of the more common prescription pain drugs. It is one of the key ingredients in Vicodin and Lortab, combined with acetaminophen. It can also be produced alone. Zohydro, the first pure hydrocodone drug, was approved by the U.S. Food & Drug Administration (FDA) in 2014.
Codeine
Codeine is a moderate opioid, and is used to treat mild to moderate pain. It is often prescribed with acetaminophen or aspirin.

Not all opioids are legal. Heroin is an illegal, addictive, and highly dangerous opioid drug. Unfortunately, some patients who develop an addiction to prescription opioids later turn to heroin, as this drug is much easier to obtain.

It is also illegal to buy, sell, or share a prescription opioid like Oxycontin. This includes taking an opioid prescribed to a friend or to someone in your family other than yourself. Opioids are only intended to be used as prescribed and by the person they are prescribed to.

The Dangers of Opioid Use

Opioids are extremely addictive, and misuse can result in addiction, overdose, and ultimately, death. The feelings of pain relief and euphoria that they produce can quickly lead to physical dependence and addiction.

After the prescription runs out, many dependent users turn to illegal opioid abuse. This can include buying prescription drugs illegally from a dealer or over the internet, or using heroin as a cheaper and more accessible alternative. Often, heroin is mixed with opioids like fentanyl, creating stronger and more dangerous drug cocktails.

Since many opioids are prescribed by doctors, people often mistakenly believe that these drugs are a safe way to get high, but this is not true. In many cases, opioid abusers were not previously treated with a prescription, and instead started taking illegal prescriptions bought from dealers and friends.

Opioid Dependence and Addiction

Though the terms are often used interchangeably, dependence and addiction are different and are caused by reactions in different parts of the brain.

Opioid dependence: Opioid dependence occurs when extended use results in physical dependence and bodily changes. The body adapts to the drug, which impacts tolerance and leads the patient to require more of the drug to achieve a certain effect. Dependence is also categorized by withdrawal, or harsh physical and mental symptoms when not using the drug.

Opioid addiction: Addiction is the compulsive use of a drug in which the user is unable to stop. Opioid addiction causes disinterest in other activities and people, and often comes hand in hand with physical dependence. However, it is possible to be dependent without being addicted.

Due to the addictive nature of opioids and the unpleasant side effects of withdrawal, it is very hard for those who develops an addiction to stop taking the drug on their own. If you or someone you love is abusing opioids, it’s important to seek help.

Warning Signs of Opioid Abuse
  • Pupils that appear very small or like pinpoints, even in dim light.
  • Withdrawal symptoms, including sweating, diarrhea, nausea and vomiting, restlessness, and anxiety.
  • The presence of empty pill bottles in the person’s home despite them never receiving a prescription, or after it has ended.
  • Pills belonging to someone who has a prescription going missing.
  • Withdrawing from social activities, or becoming more irritable around people.
  • Missing work.
  • Spending more money than usual, and being secretive about where the money went. This can include selling off things of value.
  • Stealing money from a loved one.
  • Signs of intravenous drug use. This includes the presence of syringes or burnt spoons in the person’s home, and needle marks on their arms, legs, or elsewhere on the body. They may suddenly start wearing more concealing clothing to cover this up, such as long sleeves.
  • Complaints of being sick, having a cold, or having the flu that seem irregularly frequent and clear up very suddenly.
  • Sleepiness, reduced alertness, and nodding off at strange times.
  • Neglecting personal hygiene.

The first step to overcoming an opioid addiction is seeking help. Treatment centers, support systems, and drugs like methadone and buprenorphine can all be used to help a person overcome their addiction to opioids and get their life back on track. Speak to a medical professional about the right steps toward recovery.

Opioid Overdose

Misusing opioids can cause a person to overdose, which can be fatal. In the U.S., the number of overdoses and resulting deaths from opioid use has increased steadily in recent years. Overdoses are more likely in cases where the drug is taken in a way that produces rapid effects, like crushing and snorting a pill, or when opioids are mixed with other drugs or alcohol.

63%
of drug overdoses in the U.S. involve opioidsCDC Morbidity and Mortality Weekly Report

The signs of a possible opioid overdose include:

  • Slow or stopped breathing
  • Unconsciousness
  • Vomiting
  • Limpness
  • Shaking
  • Damp, cold skin
  • Fingernails and lips that appear blue or purple

If you suspect an opioid overdose, call 911 immediately. Inform the operator that it may be an overdose and, if you know, tell them what drug was involved. This will help the emergency medical services to act quickly when they arrive on the scene.

If administered in time, the drug naloxone can reverse the effects of an overdose and save lives. Since opioid overdoses are extremely common, many emergency first responders carry naloxone nasal sprays or autoinjectors.

The Opioid Epidemic

It’s estimated that in 2015, about 2.7 million people lived with opioid addiction or dependence in the U.S. That number has been steadily growing for the past decade, and the number of overdose deaths nearly quadrupled from 2000 to 2014. Public health officials and politicians are pointing to the opioid epidemic as the biggest drug crisis of the country’s history.

In 2015, heroin-related deaths surpassed gun homicides for the first time. The following year, over 64,000 people experienced a fatal overdose from heroin and other drugs.

One of the reasons for this spike is an increase in opioid prescriptions. Prescriptions jumped from 76 million in 1991 to nearly 207 million in 2013, and in 2015 alone, one in three U.S. adults were prescribed opioids for pain treatment. Since some patients share their pills with friends and family members, more and more people are taking opioids when they don’t need them.

Policy makers and health officials are working hard to address the opioid epidemic. In the past few years, doctors have been actively trying to prescribe fewer opioids to treat pain, and prescribe them for no more than seven days. Companies are also trying to come up with new pain relievers to replace the addictive opioids.