Opioids and Opiates
Worldwide, 53 million people use opioids, says the United Nations Office on Drugs and Crime. The number is expected to grow with each passing year.
Opioids are painkillers, and rising use rates reflect our aversion to discomfort. When something hurts, we expect relief. Patients demand help, and doctors must give it to them.
But rising use rates also reflect the addictive chemical nature of opioids. These drugs are designed to flood our brains with pleasure, and when that happens, we feel physically incapable of quitting.
The opioid crisis in the country is real, and every day, people lose their lives to opioid overdose. Legislators and regulators hope to change that through tightening prescription rules and increasing penalties for illicit access. But every person who chooses to get sober also plays a role in helping a community to heal.
Opioid withdrawal is the first step toward healing, but it can be intensely uncomfortable. Detox programs may help, as they can ease discomfort so you can remain focused on getting better. Treatment programs may help you preserve the sobriety you gain in detox.
What Is an Opioid?
Opioids are prescription medications used to ease pain. The opioids we often talk about (such as Vicodin and OxyContin) are relatively new, but they stem from very old sources.
Prescription painkillers are made in laboratories, but they are structurally similar to natural painkillers. Specifically, opioids are very much like heroin.
Heroin is produced from the sap of a poppy plant, and Frontline reports the line of poppies that makes the right sap was cultivated in Mesopotamia in 3400 BC. It wasn’t until 1895 that people began using poppy sap products for pain. Previously, the drug was for recreational purposes.
Both prescription painkillers and heroin work by:
- Entering the bloodstream. Drugs can be swallowed, smoked, injected, or sniffed. They quickly attach to blood cells, so they can move throughout the body.
- Attaching to receptors. Opioid receptors are in the brain, the spinal cord, and the intestines. They look a bit like an electrical plug. They’re just waiting for opioids to connect to them.
- Triggering reactions. Every opioid works a little differently, says the National Institute on Drug Abuse. But all of them cause the release of dopamine. Users feel euphoria.
- Causing tolerance. With repeated use, people will need bigger doses to feel sensations once triggered by smaller amounts.
- Sparking dependence. In time, people aren’t able to release dopamine without opioids. And they feel sick without the drugs.
Understand the Terminology
If you hope to avoid the power of these drugs, you could ensure that you don’t take anything called an opioid. Unfortunately, the language we use to describe drugs has blurred over time, and that could mean you’re in danger without knowing it.
People can call Vicodin pills opioids, opiates, and narcotics. Technically, each term means something different. Experts define them this way:
- Opioids: These substances are made from synthetic ingredients. They may be structurally similar to natural drugs, but they don’t include natural ingredients. Vicodin, OxyContin, and fentanyl all fall into this category.
- Opiates: These substances begin as sap within poppy plants. Heroin is a classic example of an opiate.
- Narcotics: These substances are designed to kill pain. Both opiates and opioids could be considered narcotics.
Keeping track of the shifting terminology isn’t easy. For example, the United States Drug Enforcement Administration says painkillers made in laboratories, including morphine, could be considered a semisynthetic opioid. Some of the ingredients are natural.
While many organizations now simply call all these variations opioids, some still differentiate between the categories.
Natural opiates, from the poppy flower, Papaver somniferum, include: morphine, codeine, thebaine, papaverine, and narcotine. Opium is a drug that comes from the dried latex of this poppy plant. 12% of this latex is morphine but it also contains codeine and thebaine and various non-analgesic alkaloids.
Common Opioid Drugs
Opioids are popular, in part, because they are so prevalent. There are many different types available, and some people in pain know to ask for the drugs they need by name.
Common opioid drugs include:
- Codeine. This painkiller is designed for people dealing with mild to moderate pain, says the U.S. Food and Drug Administration (FDA). Pure codeine pills are available, but the drug is also combined with other ingredients to help people overcome pain combined with coughing.
Codeine blocks the sensation of pain, but it doesn’t address swelling or underlying disease. It is sometimes combined with aspirin or acetaminophen to deliver well-rounded relief.
- Hydrocodone. This opioid is designed for moderate pain relief, and the most popular version of the drug is sold as Vicodin. Each Vicodin tablet contains both the opioid and acetaminophen to deal with the pain’s cause.
People who take too much Vicodin can develop life-threatening organ failure due to the high doses of acetaminophen they ingest every day.
- Morphine Sulfate. This form of opioid is made for people in severe pain. They need medications that can control discomfort around the clock, and MS Contin does just that.
This medication releases its power over time, so one pill should bring all-day relief. But people who abuse it can crush and snort the pills to override the time release. That gives them all the power of the pill at once.
- Oxycodone. This medication is made for severe pain, and it also comes with a time-release function. Again, people with addictions can crush and snort the pills to get all the power in one dose. The most infamous form of oxycodone on the market is OxyContin.
- Dilaudid. This is a very strong opioid medication, and it’s made for people with a tolerance to other opioids. If you’ve been taking OxyContin for months due to cancer pain and the pills no longer help you, this would be another option your doctor could try.
Dilaudid is deadly for people who have no opioid tolerance. They can overdose on the first hit.
- Fentanyl. This medication is for persistent, moderate pain. The most popular form of fentanyl, Duragesic, is sold as a patch. Patients can put the product on their skin and get a low dose all day long. But people with addictions can extract the gel in the patch and ingest it or inject it.
Why Are Opioids So Addictive?
Opioids were made to help people in pain, and their discomfort is real. Enduring a broken bone, a torn ligament, or a lacerated arm without painkillers isn’t just inhumane; it can be life-threatening. But these medications work in such a way that abuse can be likely.
When opioids enter your body and they latch to your brain, large amounts of dopamine begin swirling through your cells. That’s often associated with feelings of relaxation and pleasure.
People explain that they feel like they’re floating and that nothing can harm them. They feel connected to themselves and others in new ways.
Some people who take medications for pain grow attached to euphoria, and they find it’s difficult to stop. Others grab pain pills from friends and family members, and they also find it hard to quit once they have started.
This isn’t a moral failing or lack of character. This is a medical condition caused by the transformation opioids can bring. It’s serious, and once it’s in progress, it’s hard to stop.
The Opioid Crisis Is Real
This isn’t the first time officials have been worried about opioid abuse. As National Public Radio points out, one of the first opioid epidemics took hold in the late 1800s. Doctors said then that we needed to stop abusing the drug or face mass destruction. We didn’t listen, and we seem to be struggling with the same problems now.
In the late 1990s, experts explain, drug manufacturers developed the first opioids. They were powerful, and the chemists knew that. But the marketing teams explained that the drugs couldn’t spark addiction. Health care providers listened, and suddenly, the drugs were readily available.
You could get opioids via:
- Urgent care clinics. See a doctor you’ve never met before, describe your pain, and walk out with a prescription.
- Primary care doctors. Describe chronic pain, and get a prescription that could last for years.
- Dentists. Even routine cleanings could qualify you for pain control.
- Friends and family. Open up a medicine cabinet, and you’re likely to find opioids inside.
It wasn’t until people started dying at record-breaking rates that officials knew something had to change. Between 1999 and 2017, more than 700,000 people died due to overdose, the Centers for Disease Control and Prevention says.
And it’s this death rate that makes opioids more dangerous than other drugs. People are using other substances (like meth) at high rates. But opioids take more lives, and therefore, they get more attention.
Officials are hoping to curb the tide by tightening prescription rules. Doctors have to do more to hand out the pills, and patients have to do more to get their orders filled. Penalties for manufacturing drugs are growing more severe too.
What Does Opioid Withdrawal Feel Like?
When you’ve taken opioids regularly, your body grows accustomed to them. In time, you can’t feel normal without them. To get better, you must let your body adjust to sobriety. You’ll do that through withdrawal.
Experts say opioid withdrawal typically lasts about a week, and it’s often described as flu-like. You may feel tired, achy, queasy, and unable to eat. You may also have very serious cravings for opioids that seem hard to ignore.
Take a stronger drug, and you’re likely to have a stronger withdrawal syndrome. People who take methadone, for example, have a longer-lasting withdrawal even though it tends to start late, researchers say.
You might also struggle with at-home withdrawal if you have poor physical health. Long-lasting anorexia and diarrhea can leave you feeling weak and too sick to get better.
How Detox Helps
You can go through at-home detox. But as we mentioned, some people struggle to get through this process due to their drug-taking habits, their health, or both. Others find that they simply can’t ignore their cravings, and they are at risk of relapse.
Medical detox helps, as doctors can use medications to ease your transition. These substances won’t get you high, but they can trick your body into thinking you’re taking opioids.
A smaller dose every day can give your body a sort of offramp to sobriety. It comes on slowly, but it can be remarkably powerful.
After detox, you can enroll in treatment programs that may help you preserve your newfound sobriety. Here, you’ll have the opportunity to pick up skills to help you fend off the next relapse trigger.
And you may come to understand why you started abusing drugs in the first place, so you can make your life stronger and your relationships tighter. That way, you’ll have no room for drugs to enter.
It tends to be a long-lasting process, as you might need to change many things about your life. But you might find that the work is pleasant, especially if you have sobriety to show for it.