Opioid Drugs Overview

What Are Opioids?

Opioid drugs are a class of drugs named after the receptor they interact with in the brain. They include various synthetic, semi-synthetic, and natural drugs derived from the opium poppy plant. Though often used interchangeably, opiates are a specific type of opioid that come naturally from the poppy plant. This sets them apart from other types of opioids which can be created in a laboratory.

When these substances bind to opioid receptors in the brain, they have a depressing effect on the nervous system, slowing down vital functions like heart rate and breathing. This accounts for their sedating and relaxing effects. They also affect how pain is perceived, which is why they are used by prescription as pain-killers. Opiates also affect the pleasure-sensing areas of the brain, which can cause feelings of euphoria at high doses.

What Drugs Are Opioids?

Opioid drugs include prescription medications and illegal drugs. These can be separated into three different categories:

Natural opioids

  • Opium
  • Codeine
  • Morphine

Semi-synthetics

  • Oxycodone
  • Hydrocodone
  • Heroin
  • Hydromorphone

Synthetics

  • Fentanyl
  • Methadone

Types of commonly used opioid drugs

Codeine

Codeine is itself used as a prescription drug, but it can also be combined with other substances to create semi-synthetic opioids. It reduces mild pain and helps alleviate coughs, which is why it’s an ingredient in prescription cough syrups.

Heroin

Heroin is an illicit substance that can be used as a powder or brown crystallized rock. It can be injected or smoked and causes intense feelings of pleasure and pain relief along with deep relaxation or stupor. Because of its high potential for addiction and overdose, it is classed as a Schedule I controlled substance by the US Drug Enforcement Administration (DEA).

Morphine

Morphine is one of the opioid drugs most commonly used for medical purposes. It is administered to treat severe pain, including round-the-clock pain treatment such as after surgery. It is also a key component in semi-synthetic medications like hydromorphone.

Fentanyl

Fentanyl is more potent than morphine and is also commonly prescribed to treat severe pain in cases of injury, cancer, surgery, or other severe trauma. Illicitly, Fentanyl can be combined with other substances to enhance their effects, making them far more dangerous.

Oxycodone

Oxycodone can come in various forms like capsules, pills, or liquids, and is prescribed to treat moderate pain. If abused, oxycodone can lead to intoxication that may result in symptoms of euphoria, dizziness, confusion, or drowsiness.

Methadone

Methadone may be prescribed to treat opioid dependence by replacing more dangerous drugs like heroin. This can help reduce withdrawal symptoms and stabilize drug users so they can focus on overcoming addiction.

Effects of opioid drugs

Typically opioid use results in the following symptoms:

  • Feelings of extreme relaxation
  • Drowsiness and tiredness
  • Confusion
  • Slowed breathing and heart rate
  • Slurred speech
  • Nausea
  • Constipation
  • Dry mouth
  • Itchiness

Using opioids at high doses or for extended periods will generally amplify their effects. Coma or death as a result of respiratory depression is possible. This may be preceded by cold, clammy skin and blue lips.

Adverse long-term effects of opioid use include:

  • Lowered testosterone
  • Mental health issues such as depression
  • Sexual dysfunction
  • Increased risk for cardiovascular issues like heart attacks
  • Bowel obstruction from continued constipation
  • Immune system suppression
  • Respiratory problems
  • Tolerance and dependence

What Is Opioid Abuse?

Opioid abuse occurs when drugs are taken at higher doses than prescribed, for extended periods of time, or combined with other substances. Though opioid drugs can be useful to relieve pain, their sedating and euphoric effects can be addicting, which can lead to a pattern of problematic use.

Signs of an Opioid Addiction

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), opioid use disorder can be identified using some common signs:

  • Continued non-medical use
  • Significant impairment or distress as a result of opioid use
  • Inability to control amount of drug used or length of time spent using
  • Continued use of opioids even when it interferes with important aspects of life such as work or family obligations
  • Making unsuccessful attempts to stop using
  • Experiencing cravings and urges to use
  • Increased time investment in drug use, including time spent getting the drug, using the drug, and subsequently recovering from drug use
  • Neglecting commitments or other activities that the user once found enjoyable
  • Tolerance, which is marked by an increased need for a drug to achieve the same effect
  • Withdrawal symptoms when drug use is discontinued

Only two or more of these symptoms are required to meet the criteria for opioid use disorder, though many signs may be present at any given time.

Using opioids with other drugs

When combined with other drugs, opioids’ effects may be compounded with unpredictable and potentially deadly results. When combined with other nervous system depressants, such as alcohol, marijuana, or benzodiazepines, opioids can lead to an increased risk of overdose. Since all nervous system depressants result in slowed heart rate and respiratory activity, a sudden and severe drop in the activity of these systems may unexpectedly lead to death.

When combined with nervous system stimulants such as speed, ecstasy, or crystal meth, opioids can create an enormous strain on major organs such as the heart and the kidneys. This can also increase the risk of accidental overdose or lead to cardiac issues like stroke.

Withdrawing from Opioids

Opioid withdrawal can be uncomfortable and even painful but is not commonly life-threatening. Discontinuation of opioid use when chemical dependence is present can lead to many symptoms including:

  • Anxiety and depression
  • Muscle cramps
  • Diarrhea
  • Fever and chills
  • Insomnia
  • Nausea and vomiting
  • Irritability
  • Abdominal cramps
  • Excessive sweating

When withdrawing from opioid drugs, medical detox is recommended. During medical detox, a staff of medical professionals monitors the individual for dangerous signs and helps alleviate uncomfortable symptoms of withdrawal. This may be done through medication-assisted treatment, using safer opioid replacements such as methadone and buprenorphine. Medication allows the individual to detox more comfortably and safely.

Getting Help (Treating Opioid Addiction)

While detox is undoubtedly an important part of opioid addiction treatment, it does not address underlying causes of use. That’s why medical detox is typically followed or done in conjunction with a treatment program that includes behavioral counseling, skills training, and peer group therapy. Using a holistic approach that encompasses not just the drug use, but other important systems like nutrition, life skills, relapse prevention, and physical health, individuals can develop a healthier lifestyle that makes relapse less likely.

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