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What are Opioids?

Opioids are a group of natural, semi-synthetic, and synthetic drugs that are derived from opium, a byproduct of the opium poppy. This, in turn, is used to synthesize morphine, codeine, oxycodone, and other narcotic painkillers, which form the basis for the molecular structure of all opioids/opiates. Opioids are classified as Schedule II narcotics, which means they’re highly addictive but have a medicinal or therapeutic purpose.

These drugs are sold illegally on the streets and prescribed to manage acute pain as well as chronic conditions. They work by binding to the opioid receptors in the brain, which triggers the release of the “feel good” chemical dopamine and other endorphins to the pleasure and reward center of the brain. This causes a euphoric feeling that mitigates pain and discomfort and is prized by recreational users.

It’s this sensation that abusers chase initially, but it doesn’t last long after regular use begins. The brain becomes accustomed to artificial stimulation from the narcotic source and ceases to release endorphins on its own. Habitual users continue to take opioid-based drugs just to feel normal and ward off the withdrawal symptoms associated with opioid addiction, which are often unbearable and potentially deadly.

Opioid vs Opiate

The words are often used interchangeably, but there’s a difference between opioids and opiates. Opioid drugs are those that are manufactured from natural plant sources. The most notorious of these is hydrocodone, which accounts for the majority of all prescription opioid abuse. Hydrocodone is manufactured with acetaminophen, which lessens the effects of the narcotic component of the medication. Americans account for 99 percent of all hydrophone use, and it’s the most prescribed and frequently diverted of this class of pain medications. It’s most commonly sold under the brand names Vicodin, Lortab, and Norco.

  • Abstral (Fentanyl)
  • Anexsia (hydrocodone & acetaminophen)
  • Avinza (morphine sulfate)
  • Butrans (Buprenorphine)
  • Co-Gesic (Hydrocodone & Paracetamol)
  • Demerol
  • Dilaudid (hydromorphone)
  • Dolophine (Methadone)
  • Duragesic (Fentanyl)
  • Embeda (Morphine & Naltrexone)
  • Exalgo (Hydromorphone Hydrochloride)
  • Fentora (Fentanyl)
  • Hycet (Hydrocodone & Acetaminophen)
  • Hycodan (Hydrocodone Bitartrate & Homatropine Methylbromide)
  • Hydromet (Hydrocodone & Homatropine)
  • Hysingla (Hydrocodone Bitartrate)
  • Ibudone (Hydrocodone & Ibuprofen)
  • Kadian (Morphine Sulfate)
  • Liquicet (Hydrocodone & Paracetamol)
  • Lorcet (Hydrocodone & Acetaminophen)
  • Lortab (Hydrocodone & Acetaminophen)
  • Maxidone (Hydrocodone & Acetaminophen)
  • Methadose (Methadone)
  • Morphabond (Morphine)
  • Norco (Hydrocodone & Acetaminophen)
  • Nucynta ER (Tapentadol)
  • Onsolis (Fentanyl)
  • Oramorph (Morphine)
  • Oxaydo (Oxycodone HCI)
  • OxyContin (Oxycodone Hydrochloride)
  • Palladone (Hydromorphone Hydrochloride)
  • Percocet (Oxycodone & Acetaminophen)
  • Percodan (Oxycodone & Aspirin)
  • Reprexain (Hydrocodone & Ibuprofen)
  • Rezira (Hydrocodone & Pseudoephedrine)
  • Roxanol-T (Morphine)
  • Roxicet (Oxycodone & Acetaminophen)
  • Sublimaze (Fentanyl)
  • Targiniq ER (Oxycodone & Naloxone)
  • Tussicaps & Tussionex (Hydrocodone & Chlorpheniramine)
  • Tylenol 3 (Codeine & Acetaminophen)
  • Vicodin (Hydrocodone & Acetaminophen)
  • Vicoprofen (Hydrocodone & Ibuprofen)
  • Vituz (Hydrocodone & Chlorpheniramine)
  • Xartemis XR (Oxycodone & Acetaminophen)
  • Xodol (Hydrocodone & Acetaminophen)
  • Xtampza ER (Oxycodone)
  • Zohydro ER (Hydrocodone)
  • Zolvit (Hydrocodone & Acetaminophen)
  • Zutripro (Hydrocodone, Chlorpheniramine, & Pseudoephedrine)
  • Zydone (Hydrocodone & Acetaminophen)


Other types of opioids are either partially or fully synthetic, and these are classified as opiates. The most notorious and deadly of these is fentanyl, which has up to 100 times the potency of morphine. Fentanyl is illegally manufactured and sometimes used to cut heroin because it’s cheaper to make. It has increased the overdose rate from narcotic painkillers by more than 100 percent since it appeared on the scene a few years ago. Of the 72,000 deaths due to overdose in 2017, close to 30,000 were due to fentanyl.

The drug is indicated for use in hospice settings for those with a high opioid tolerance to manage severe, chronic pain associated with terminal illnesses. Fentanyl is sold under the brand names Actiq, Duragesic, and Subsis. A relative newcomer to the market of dangerous narcotics is the synthetic opiate carfentanil, which is used for large mammals in veterinary medicine and has up to 1,000 times the potency of fentanyl.

In the real world of opioid addiction, the opioid vs opiate question may not matter much. Of the two most dangerous types of opioid-based drugs, heroin, and fentanyl, one is naturally derived and the other is synthetic. Those with opioid use disorder are just as hooked no matter the source.

Why Are Opioids So Addictive?

Many factors enter into the epidemic of opioid abuse and dependency, not the least of which are over-prescribing medication and the creation of more potent forms of the drug. Dependency means that the body has become accustomed to the presence of the drug in the system and built up a tolerance, requiring higher dosages to obtain the same effect. When the drug is withdrawn, unpleasant symptoms like nausea, stomach cramps, panic, irritability, and muscle spasms occur. Without medical supervision, the only way to stop the withdrawal symptoms is to keep using the drug.

Addiction is diagnosed when the dependence crosses the line into a physical and psychological craving that overrides all sense and reason. Those with a substance use disorder will continue to seek out the drug regardless of physical harm, its effect on their life or any other negative consequences. Without treatment to manage the addiction, death at some point is a near certainty.

Opioid-based drugs mimic the same endorphins that the brain creates naturally when external stimuli relay a message that the body is experiencing pain. The release of endorphins that creates pleasurable feelings also triggers a response to repeat the behavior creating them. This is necessary for the survival of our species, but it also leads to addictive behavior and compulsion. When this natural defense mechanism is artificially created, the brain can no longer function properly on its own, compounding the problem.

Who’s at Risk for Opioid Addiction?

No one starts taking prescription medication or uses recreational drugs with the intention of becoming addicted. While various types of opioids are responsible for the current crisis in America, most people who take prescription pain relievers in the short term, as directed, do so without negative effects.

There are several factors that contribute to the opioid epidemic. Awareness of the dangers of new, stronger, and more addictive forms of drugs means fewer prescription renewals and a shorter duration for new prescriptions. This has led to widespread drug diversion and theft as well as people turning to more dangerous street drugs in order to self-medicate.

The rise in heroin and fentanyl addiction, in conjunction with unreliable dosages, high tolerance, and varying strengths from dose to dose of street drugs, is in direct relation to the rise in death by overdose. Other factors that raise the odds of becoming dependent on opioid-based drugs are:

  • Personal or family history of substance use disorder
  • Early age of first use
  • Poverty and/or unemployment
  • Living in a high-risk environment
  • Tendency toward risk-taking behavior
  • History of mental health issues or undiagnosed/untreated mental health issues
  • Prior history of attendance in drug or alcohol rehab

More Opioid Addiction Statistics

There is hardly a family that hasn’t been personally affected by the opioid epidemic. It cuts across all demographics and knows no race, class, or political affiliation. According to the National Institute on Drug Abuse (NIDA), between 21 and 29 percent of those taking opioids for chronic pain abuse them, up to 12 percent of that group develop an opioid use disorder, and close to 80 percent of those in treatment for heroin addiction started with prescription pain medications. The rise in intravenous drug use has also increased rates of infectious diseases like HIV and Hepatitis C.

Opioid addiction is among the most troubling issues facing our society, but the situation isn’t hopeless. There’s help available for those who need it. All you have to do is pick up the phone.

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