Understanding Opioid Use

Today's opioid epidemic

The United States continues to face the impact of the opioid epidemic. Over 107,000 people died of a drug overdose in 2021 - a 15% increase from the previous year. In response to rising rates of opioid misuse, states have developed opioid prescribing guidelines. Yet overdose deaths continue to rise. This rise is largely due to synthetic (lab-made) opioids on the illicit drug market. 

Fentanyl, a common synthetic opioid, is roughly 100 times more potent than morphine and 50 times more potent than heroin. It often appears in other illicit drugs, such as cocaine or methamphetamine. It is also pressed into, counterfeit (fake) prescription pills. In 2022, the Drug Enforcement Administration (DEA) found that 60% of fake prescription pills had potentially lethal doses of fentanyl.

It can be difficult to tell the difference between a real prescription pill and a counterfeit pressed pill. The images below, courtesy of the DEA, show fake and real prescription pills side-by-side. Can you tell which is genuine? Click the arrow at the bottom of each image to find out which is which.

A fake Oxycodone pill next to a real M30 pill in a dish

Genuine (left) and counterfeit (right) Oxycodone

A fake Xanax® pill next to a real Xanax® pill

Genuine (left) and counterfeit (right) Xanax

What is opioid use disorder?

Opioid use disorder (OUD) is a type of substance use disorder (SUD). Like other chronic diseases, SUD is progressive and treatable. If left untreated, it can change how the brain functions. 

Facts about OUD:

What do opioids do to the brain?

When people use opioids, the brain releases chemicals that produce a euphoric feeling (i.e. "the high"). For people at risk of OUD, the brain becomes dependent on opioids. Opioid dependence means that more frequent or powerful opioids are needed to feel the desired effect. After a while, people may need opioids to feel their baseline level of wellness. Without opioids, people can begin to experience withdrawal. Withdrawal is a painful, whole-body response that makes it difficult to stop using.

Can people recover from OUD? Is treatment available?

Recovery from an OUD is possible. This journey is unique to each person. For some, it might involve the use of Medications for Opioid Use Disorder (MOUD), also known as Medication Assisted Treatment (MAT). This treatment uses medication to help people recover without feeling the symptoms of withdrawal.

If people can recover and treatment is available, what role does harm reduction play?

Treatment and MOUD are not the answer for every person. Access to resources is not the same in every community, and people may not be ready or want to stop using drugs. Harm reduction aims to save lives and minimize harm regardless of whether people decide to stop using substances. Learn more about the principles of harm reduction.