About Opioids
What are Opioids?
- Opioids are a class of drugs used to reduce pain.
- Found in the Opium Poppy plant, and others are synthetic (man-made)
Difference between "Opioid" and "Opiate"
The word “opiate” applies specifically to drugs directly derived from the poppy plant. Heroin, morphine and codeine, for example, are all opiates.
- Opiates are naturally occurring chemicals found in the opium plant. More than 20 opiates are found in opium, but six occur in large amounts. Of those six, only 4 are used by the medical industry: morphine, codeine, thebaine and papaverine.
Partially or fully synthetic opioids, like prescription OxyContin or illicit fentanyl, are made in a lab. The word “opioids” includes all formulations of these drugs: plant-derived, semi-fully-synthetic.
- It is important to note that while all opiates are opioids, not all opioids are opiates.
Basic History on Opioids
The earliest reference to opium growth and use is in 3,400 B.C. when the opium poppy was cultivated on lower Mesopotamia (Southwest Asia). The Sumerians referred to it as the “joy plant.” The Sumerians soon passed it on to the Assyrians, who then passed it to the Egyptians. As people learned of the power of opium, demand for it increased.
Opium was known to ancient Greek and Roman physicians as a powerful pain reliever. It was also used to induce sleep and give relief to the bowels. Its pleasurable effects were also noted. The trading and production of opium spread from the Mediterranean to China by the 15th century.
Types of Opioids & Opiates
Opiates:
- Morphine
- Codeine
- Thebaine
- Papaverine
Semi-synthetic opioIds:
- Heroin
- Oxycodone
- Hydrocodone(vicain, lortab)
- Hydromorphone (dilaudid)
- Oxymorphone (opana ER)
Synthethic opioids:
- Methadone (dolophine, methadose)
- Fentanyl
- Meperidine
- Tremadol (ultram, ultracet)
Your Brain on Opioids
Opioids act by attaching to and activating opioid receptor proteins, which are found on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors, they inhibit the transmission of pain signals. Opioids can also produce drowsiness, mental confusion, nausea, constipation, and respiratory depression.
They also affect brain areas that control emotion. In addition, opioids also activate reward regions in the brain causing euphoria – or high – that underlies the potential for misuse.
Most Commonly Abused Opioids
Prescription opioids
These can be prescribed by doctors to treat moderate to severe pain, and are often prescribed following surgery or injury, or for health conditions such as cancer.
- Common types are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone.
- Hydrocodone products are the most commonly prescribed in the U.S. for a variety of indications including dental, and injury related pain.
Fentanyl
Fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is prescribed in the form of transdermal patches or lozenges.
The illegally used fentanyl most often associated with overdoses is made in labs. This is sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays or made into pills.
- It is 50-100 times more potent than morphine.
- Synthethic opioids like fentanyl are now the most common drugs involved in drug overdose deaths in the U.S.
- Most recent cases of fentanyl-related overdose and death in the U.S. are linked to illegally made fentanyl.
- It is often mixed with heroin and/or cocaine as a combination product to increase its euphoric effects.
- It takes very little to produce a high with fentanyl, making it a cheaper option. This is why some drug dealers mix it with other drugs. This is especially risky when people taking drugs don’t realize they might contain fentanyl as a cheap but dangerous additive.
Heroin:
Heroin is an opioid made from morphine.
- It can be a white or brown powder, or a black sticky substance known as black tar heroin. It typically is sold “cut” with sugars, starch, powdered milk, or quinine.
Pure heroin is a white powder with a bitter taste that predominantly originates in South America and to a lesser extent, Southeast Asia. Highly pure heroin can be snorted or smoked.
Black tar heroin is sticky like roofing tar or hard like coal and is predominantly produced in Mexico. The dark color associated with black tar heroin results from crude processing methods that leave behind impurities. Impure heroin is usually dissolved, diluted, and injected into veins, muscles or under the skin.
- Heroin users can snort, swallow or inject the drug. Intravenous injectors can feel changes within 7-8 seconds, while people who inject into muscle feel changes within 5-8 minutes.
Understanding Addiction, Dependence and Tolerance
Dependence: occurs as a result of physiological adaptations to chronic exposure to a drug. It is often a part of addiction, but are not the same. Those who are dependent, will experience unpleasant physical withdrawal symptoms when they abruptly reduce or stop use of the drug.
Tolerance: (or the need to take higher doses of a med to get the same effect) often accompanies dependence. When tolerance occurs, it can be difficult for a physician to evaluate whether a patient is developing a drug problem or has a medical need for higher doses to control his/her symptoms.
Addiction: involves other changes to brain circuitry and is distinguished by compulsive drug seeking and use despite negative consequences.
For More Information Visit:
Opioid Overdose crisis. National Institute on Drug Abuse. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
What is the U.S. Opioid Epidemic. U.s. Department of Health and Human Services. https://www.hhs.gov/opioids/about-the-epidemic/index.html
What are Opioids. John Hopkins Medicine. https://www.hopkinsmedicine.org/opioids/what-are-opioids.html