About Opioids

Opioids are medically beneficial but highly addictive drugs even if used as directed.

What Are Opioids?

Opioids are medically beneficial but highly addictive drugs. Sometimes referred to as opiates or narcotics, they are made from the resin of the Asian poppy seed pod. They include heroin, morphine and opium as well as common prescription drugs such as OxyContin, Vicodin, codeine and Percocet. Opioids are useful for serious injuries and intense pain treatment, but they are also highly addictive.

While prescription opioids are usually taken in pill form, opioids can also be snorted, inhaled or injected — which releases the drug into the bloodstream quickly, causing intense euphoria, respiratory depression and nausea. Taking too many opioids can shut down respiration and cause overdose or death. Dependent users who quit taking opioids may struggle with a few days of flu-like withdrawal symptoms, possibly followed by intense cravings, which can last for years.

There are 3 main types of opioids:

  • Natural opiates are compounds that come from plants such as the opium poppy.
    Natural opiates include morphine, codeine, and thebaine.
  • Semi-synthetic opioids are created in labs from natural opiates.
    Semi-synthetic opioids include hydromorphone, hydrocodone, and oxycodone, as well as heroin.
  • Fully synthetic opioids are completely man-made.
    Fully synthetic opioids include fentanyl, pethidine, levorphanol, methadone, and tramadol.

Prescription opioids such as morphine and codeine are prescribed by doctors to treat pain and provide pain relief—when used as prescribed. However, opioids can produce a euphoric high, so they may be misused.

Source: What Are the Different Types of Opioids? (2020)

Dependence and Addiction

People often think dependence and addiction are the same when talking about substance misuse, but they are not. The difference between them is important, and key to successful medical treatment.

Physical dependence on opioids means that the body will experience physical symptoms when the substance is no longer ingested. Physical dependence to opioids is expected, but for some people, the withdrawal from these drugs can be very uncomfortable and they may need a plan to slowly decrease dosage or get medically supervised treatment.

Addiction, unlike physical dependence, does not happen to everyone who takes opioids, and is medically classified as a disease. Addiction is a change in behavior, caused by changes to the brain’s chemistry from the use of an addictive substance. Addiction may cause cravings that seem uncontrollable and the inability to stop or lessen the use of a substance, even if using the substance causes harm. The medical term for addiction to opioids is Opioid Use Disorder or OUD.

Source: Tolerance, Dependence, Addiction: What's the Difference? (2020)

Long term use of opioids, even those prescribed by a doctor, changes the way our bodies and brains work. When someone takes opioids, nerve cells in the body send fewer pain signals, and nerve cells in the brain produce dopamine, causing a sense of euphoria or pleasure.

Lots of everyday activities may cause the brain to release dopamine, the feel-good chemical, and give a feeling of pleasure — like eating sweet foods, laughing with friends, or going for a walk on the beach. But opioids cause a much stronger rush of dopamine than these everyday activities and, over time, the brain begins to lose the ability to produce enough dopamine on its own.

As days or weeks pass, someone using opioids may find they have to take larger amounts of opioids to achieve the same good feeling — this is called tolerance. Eventually, after serious, long-term use, some individuals’ brains can lose the ability to produce dopamine almost completely. These individuals are unable to find almost any pleasure in everyday activities they once enjoyed and may experience depression, anxiety, and physical symptoms called withdrawal. This is the beginning of opioid addiction, which may require professional help including medication.

Source: Drugs, Brains, and Behavior: The Science of Addiction (2020)