What Are Opioids?

doctor imageOpioids are a class of drugs naturally found in the opium poppy plant. Some prescription opioid drugs are made from the plant directly, and others are made by scientists in labs using the same chemical structure. Opioids are often used as medicines because they contain chemicals that relax the body and can relieve pain. Prescription opioids are used mostly to treat moderate to severe pain. Opioids can be highly addictive, and overdoses and death are common. Heroin is one of the world’s most dangerous opioids, and is never used as a medicine in the United States.

What’s the relationship between prescription opioids, heroin, and fentanyl?

Heroin and prescription opioids are chemically similar and can produce a similar high. Heroin is often cheaper and easier to obtain than prescription opioids, so some people switch to heroin instead. The majority of Americans using heroin (including those in treatment) reported misusing prescription opioids prior to using heroin. While prescription opioid misuse is a risk factor for starting heroin use, only a small fraction of people who misuse pain relievers switch to heroin, suggesting that prescription opioid misuse is just one factor leading to heroin use.

Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. It’s typically used to treat patients with severe pain and patients with chronic pain who are physically tolerant to other opioids. When prescribed by a physician, fentanyl is often administered via injection, transdermal patch, or in lozenges. However, the fentanyl and fentanyl analogs associated with recent overdoses are produced in clandestine laboratories. This non-medical fentanyl is often mixed with or substituted for heroin or sold as tablets that mimic other opioids. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.

How do prescription opioids affect the brain?

Opioids bind to and activate opioid receptors on cells, especially those involved in feelings of pain and pleasure. When opioids attach to these receptors, they block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body. This release can strongly reinforce the act of taking the drug, making the individual want to repeat the experience.

What are common prescription opioids?

  • Hydrocodone (Vicodin®)
  • Oxycodone (OxyContin®, Percocet®)
  • Oxymorphone (Opana®)
  • Morphine (Kadian®, Avinza®)
  • Codeine
  • Fentanyl

Popular slang terms for opioids include Oxy, Percs, and Vikes.

How do people misuse prescription opioids?

Prescription opioids used for pain relief are generally safe when taken for a short time and used exactly as prescribed by a doctor. However, people may misuse prescription opioids by:

  • Taking the medication in a way or dose other than prescribed
  • Taking someone else’s prescription medication
  • Taking the medication for the effect it causes—to get high

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.