Substance Types and Effects: Opioids

Opioids are either derived from, or chemically similar to, compounds found in opium poppies. Opioids include:

• Medications that can be used appropriately by doctors to relieve pain, including:
  • Prescription painkillers like oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and codeine
  • Synthetic fentanyl
• Heroin and illegally manufactured fentanyl

How do you take them?

Opioids can be used appropriately several ways. They can be taken orally as a pill, or they can be administered by an oral film patch, which dissolves in the mouth. Opioids can also be administered intravenously to manage pain, most often in surgical situations.

Prescription opioids can be misused a number of ways, too. They can be taken orally as a pill, but in higher dosages than prescribed, or without a prescription at all. They can also be crushed up and inhaled or injected. Heroin can be inhaled, injected, or smoked.

What are the medical uses for opioids?

There are appropriate and medically necessary uses for prescription opioids. They are effective in treating certain types of pain, or helping people recover from complex medical procedures. Pain resulting from things like broken bones and cancer can be effectively treated with opioids.

Opioids have medical uses as well as serious risks.

What’s more, one of the most effective treatments for opioid addiction actually involves the use of medications—some of which contain opioids—which can help ease withdrawal and reduce cravings to help maintain recovery.

That’s why opioid prescriptions should be personalized to suit each patient’s unique needs and carefully monitored by health care providers.

How do opioids affect the body?

These drugs bond to opioid receptors in the human body and brain, blocking pain. In addition to providing pain relief, opioids can produce feelings of euphoria and relaxation—especially when misused (taking the wrong dosage, using without a prescription).

Side effects of opioids can include nausea, confusion, and depression. Opioids also quickly build both tolerance and physical dependence, which can lead users to take larger and larger doses in order to feel the same relief. This can lead to addiction and overdose. 

What does misusing opioids feel like?

When misused, opioids flood the brain with dopamine. This process creates intense feelings of euphoria, and also encourages the brain to repeat the behavior, which can lead to addiction.

Many people with addiction are attempting to soothe or heal themselves in some way. 

For people addicted to opioids, these drugs are often providing them with something that they're not getting out of daily life. People who’ve had opioid use disorders say these drugs created feelings of warmth, happiness, and acceptance inside of them. They describe feeling good in a way they’d never really experienced before. These feelings can motivate someone to continue to use, even when that use is putting their health at risk or causing problems in their life.

What are some signs that someone is misusing opioids?

• Drowsiness and disorientation
• Slurred speech or slowed movements
• Moving in and out of consciousness, even while sitting up or in a social situation (this is often referred to as nodding off or nodding out)

What happens when someone overdoses on opioids?

During an opioid overdose, a person’s breathing becomes dangerously slow, and then stops completely. With the opioid suppressing neurological signals, the heart rate slows down, too. 

How can people who use opioids reduce risks?

• If prescribed, always take opioids as directed by your doctor
• Never combine opioids with alcohol or benzodiazepines—this mixing can increase fatal overdose risk
• Never use alone
• Always start with a low dose, especially if you’re using opioids again for the first time in a while (a period of abstinence reduces tolerance, which can put you at greater risk of overdose)
• Have naloxone nearby, and make sure someone knows how to use it
• Prevent infections by using clean needles and kits

Structurally, additional harm reduction measures like overdose prevention sites and fentanyl testing strips can save lives.

How can an opioid use disorder be treated?

There are several highly effective treatment options for opioid addiction. The gold standard is medications—including methadone, buprenorphine, and naltrexone—which greatly reduce the risk of deadly overdose, reduce cravings, and help many patients achieve lasting recovery. Therapy, support groups, and other treatments work well, too.