Opioids: What It Is, Types, Usages, Side-Effects, Overdose

Opioids, colloquially referred to as narcotics, are a class of powerful pain-relieving medications that are commonly prescribed to individuals suffering from severe pain or recovering from surgery. 

The types of opioids include both natural and synthetic substances, which are commonly used for pain relief but also present risks of addiction and overdose. Some of the most prevalent opioids in the U.S. are: Morphine, Codeine, Heroin, Fentanyl, Methadone, Oxycodone, Hydrocodone, Tramadol, Buprenorphine, Meperidine, Hydromorphone, Oxymorphone, Tapentadol, Carfentanil, Nalbuphine.

Opioids are used to treat multiple types of pain, including pain following surgery, injury, and chronic conditions, as well as cancer-related pain in palliative care. They relieve severe pain from musculoskeletal injuries, burns, and sickle cell crises, address cough and diarrhea, and manage opioid use disorder through medication-assisted treatment.

Opioids produce various side-effects effects such as drowsiness, nausea, vomiting, constipation, respiratory depression, itching, and low blood pressure, along with serious risks like tolerance, dependence, and overdose. They also trigger neurological effects, including confusion, euphoria, dizziness, mood swings, and withdrawal symptoms.

Opioid overdoses result in pronounced physical effects that include respiratory depression, slowed or ceased breathing, extreme drowsiness, pinpoint pupils, and cold or clammy skin. Additional signs such as bluish lips or fingernails, weak pulse, unresponsiveness, seizures, vomiting, coma, and eventual death reflect the critical and life-threatening nature of opioid toxicity.

According to the CDC, in 2022, 81,806 opioid-involved overdose deaths occurred in the US, while 3.7% of US adults needed opioid use disorder (OUD) treatment. Only 25.1% of those needing treatment received medications for OUD, and 30% received treatment without medications. Treatment disparities were evident, with higher percentages of White adults receiving treatment compared to Black or Hispanic adults. Men received medications at higher rates than women (51.0% vs 39.5%), and adults aged 35-49 had the highest medication treatment rate (68.4%).

What Are Opioids?

Opioids are a class of powerful psychoactive drugs derived from or chemically similar to compounds found in the opium poppy plant. They function by binding to specific opioid receptors in the brain, spinal cord, and other areas of the body to reduce pain sensation, produce euphoria, and cause respiratory depression. This category includes both prescription pain medications like oxycodone, hydrocodone, and morphine, as well as illicit substances such as heroin and illegally manufactured fentanyl. 

Under the US Controlled Substances Act, opioids are distributed across Schedules I-V based on abuse potential and medical use: Schedule I includes heroin (no accepted medical use), Schedule II contains most prescription opioids like oxycodone and fentanyl, while Schedules III-V include progressively less potent formulations with decreasing regulatory controls. Their high potential for physical dependence, tolerance development, and addiction has contributed to a significant public health crisis.

How Do Opioids Work?

Opioids work by binding to specific receptors in the brain, spinal cord, and other areas of the body known as opioid receptors. These receptors are part of the body’s pain control system and are involved in regulating pain, mood, and reward. 

When opioids attach to these receptors, they block the transmission of pain signals and produce feelings of euphoria, relaxation, and well-being. This mechanism alleviates pain and leads to the release of dopamine, a neurotransmitter associated with pleasure and reward, reinforcing the desire to continue using the drug. 

Prolonged use of opioids results in tolerance, where higher doses are needed to achieve the same effects, and dependence, where the body adapts to the drug’s presence, causing withdrawal symptoms when not taken. This complex interaction with the brain’s reward system contributes to the potential for misuse and addiction associated with opioid medications.

What Are the 3 Classes of Opioids?

The three main classes of opioids are: natural opioids, semi-synthetic opioids, and synthetic opioids. Each class has distinct characteristics based on their origin, duration of action, and effects on the body.

Here are the three classes of opioids in detail:

• Natural Opioids: Derived directly from the opium poppy plant, natural opioids include substances like morphine and codeine. These are typically used for moderate to severe pain relief. Morphine is considered a long-acting opioid, while codeine tends to be shorter-acting. The effects on the body include pain relief, sedation, and potential respiratory depression.
• Semi-Synthetic Opioids: These are chemically modified versions of natural opioids, enhancing their potency or altering their properties. Examples include oxycodone, hydrocodone, and heroin. Semi-synthetic opioids are either short-acting (like heroin) or long-acting (such as some formulations of oxycodone). They provide strong pain relief but also pose significant risks for addiction and overdose, affecting the central nervous system profoundly.
• Synthetic Opioids: Entirely man-made in laboratories, synthetic opioids include drugs like fentanyl, methadone, and tramadol. Fentanyl is extremely potent and fast-acting and is used in surgical settings or for chronic pain management, while methadone is longer-acting and used in pain management and opioid addiction treatment. Synthetic opioids offer powerful pain relief but come with heightened risks of severe side effects, including respiratory failure and death, especially when misused.

What Are Drugs Considered Opioids?

15 drugs that are considered opioids are morphine, codeine, heroin, fentanyl, methadone, oxycodone, hydrocodone, tramadol, buprenorphine, meperidine, hydromorphone, oxymorphone, tapentadol, carfentanil, and nalbuphine. These medications are natural, semi-synthetic, and fully synthetic compounds that interact with opioid receptors in the body. See the complete list below for detailed information about each opioid and its specific classification:

1. Morphine: A natural opioid derived from the opium poppy, used for severe pain relief.
2. Codeine: A natural opioid, less potent than morphine,  used for mild to moderate pain and cough suppression.
3. Heroin: A semi-synthetic opioid derived from morphine, highly addictive and illegal in most countries.
4. Fentanyl: A synthetic opioid, significantly more potent than morphine, used for severe pain, especially post-surgery.
5. Methadone: A synthetic opioid used for pain management and in the treatment of opioid addiction.
6. Oxycodone: A semi-synthetic opioid derived from thebaine, used for moderate to severe pain.
7. Hydrocodone: A semi-synthetic opioid combined with acetaminophen for pain relief.
8. Tramadol: A synthetic opioid used for moderate to moderately severe pain. 6
9. Buprenorphine: A semi-synthetic opioid used for pain relief and in the treatment of opioid addiction.
10. Meperidine: A synthetic opioid, less commonly used due to its side effects, for moderate to severe pain.
11. Hydromorphone: A semi-synthetic opioid, more potent than morphine, used for severe pain.
12. Oxymorphone: A semi-synthetic opioid derived from thebaine, used for severe pain.
13. Tapentadol: A synthetic opioid used for moderate to severe acute pain.
14. Carfentanil: A synthetic opioid, extremely potent, used as a tranquilizer for large animals, not for human use.
15. Nalbuphine: A synthetic opioid used for pain relief, also acts as an opioid antagonist.

How Are Opioids Consumed?

Opioids are consumed through various methods, each with implications for effectiveness and safety, with the most common method being oral consumption via pills or capsules, which are swallowed whole. Some individuals crush these pills to snort the powder, increasing the risk of addiction and overdose. For faster relief or for those unable to take medications orally, opioids are also injected directly into the bloodstream, commonly used in medical settings. Opioids are also delivered transdermally through patches on the skin for slow release, convenient for long-term pain management. Other methods include suppositories for patients who cannot swallow pills or receive injections. Each route carries specific risks and benefits, emphasizing the importance of adhering to prescribed guidelines.

What Conditions Are Opioids Used for?

Opioids are used for acute pain, chronic pain, cancer pain, palliative care, severe musculoskeletal injuries, post-operative recovery, severe burn injuries, sickle cell crisis pain, neuropathic pain, pain associated with major trauma, cough suppression, diarrhea management, and opioid use disorder treatment.

Here are the usages of opioids in detail below:

1. Acute Pain (Post-Surgical or Injury-Related): Opioids bind to receptors in the brain and spinal cord to reduce pain perception after surgeries or traumatic injuries.
2. Chronic Pain (Non-Cancer Related): Opioids target pain pathways in conditions like arthritis or back pain when other treatments fail. Long-term use requires careful monitoring due to addiction risks.
3. Cancer Pain: Opioids alleviate severe pain caused by tumors, chemotherapy, or radiation therapy, improving the quality of life for cancer patients.
4. Palliative Care and End-of-Life Pain Management: Opioids control moderate to severe pain in terminally ill patients, ensuring comfort during the final stages of life.
5. Severe Musculoskeletal Injuries: Opioids block pain signals from fractures or dislocations, aiding recovery and reducing discomfort.
6. Post-Operative Recovery: Opioids manage pain after surgical procedures, allowing patients to rest and heal without excessive discomfort.
7. Severe Burn Injuries: Opioids reduce excruciating pain from burns, enabling patients to tolerate wound care and rehabilitation.
8. Sickle Cell Crisis Pain: Opioids relieve acute pain episodes caused by blocked blood flow in sickle cell disease, improving patient outcomes.
9. Neuropathic Pain: Opioids target nerve-related pain in cases where other therapies fail to provide adequate relief.
10. Pain Associated with Major Trauma: Opioids manage debilitating pain from severe injuries like those from accidents or combat situations.
11. Cough Suppression (e.g., Codeine): Codeine acts on the brain’s cough center to suppress persistent coughs in respiratory conditions.
12. Diarrhea Management (e.g., Loperamide): Loperamide slows gut motility, providing relief for diarrhea or irritable bowel syndrome.
13. Opioid Use Disorder Treatment (e.g., Methadone, Buprenorphine): Methadone and buprenorphine reduce cravings and withdrawal symptoms in individuals overcoming opioid dependence.

What Are the Side Effects of Opioids?

The effects of opioids are drowsiness, nausea, vomiting, constipation, respiratory depression, itching, sweating, dry mouth, decreased libido, fatigue, tolerance, dependence, slowed heart rate, low blood pressure, and overdose, confusion, euphoria, dizziness, mood swings, and withdrawal symptoms.

Here are the side effects of opioids in detail below:

• Drowsiness: Opioids suppress central nervous system activity, causing sedation. This is a short-term physical effect that occurs when starting treatment or after dose increases.
• Nausea: Opioids stimulate the brain’s chemoreceptor trigger zone, leading to nausea. This is a short-term physical effect that diminishes as the body adjusts.
• Vomiting: Opioids activate the vomiting center in the brainstem, causing vomiting. This is a short-term physical effect most common in opioid-naïve patients.
• Constipation: Opioids decrease gastrointestinal motility by binding to gut receptors, leading to constipation. This is a long-term physical effect that persists with continued use.
• Respiratory Depression: Opioids depress the brainstem’s respiratory centers, slowing breathing rates. This is a short-term physical effect and a serious risk at high doses.
• Confusion: Opioids impair neurotransmitter activity, leading to disorientation. This is a short-term neurological effect common at higher doses.
• Euphoria: Opioids activate the brain’s reward system, releasing dopamine and creating pleasure. This is a short-term neurological effect contributing to misuse.
• Dizziness: Opioids disrupt balance and coordination by affecting the vestibular system. This is a short-term neurological effect causing lightheadedness.
• Itching: Opioids stimulate histamine release or act on skin receptors, causing itching. This is a short-term physical effect without an allergic reaction.
• Sweating: Opioids interfere with hypothalamic temperature regulation, leading to excessive sweating. This is a short-term physical effect.
• Dry Mouth: Opioids reduce saliva production by impacting salivary glands. This is a short-term physical effect commonly reported by users.
• Decreased Libido: Opioids suppress hormone production, particularly testosterone, reducing sexual desire. This is a long-term physical effect.
• Fatigue: Opioids depress central nervous system activity, causing tiredness. This is a short-term physical effect more pronounced at higher doses.
• Tolerance: Repeated opioid use reduces receptor sensitivity, requiring higher doses for the same effect. This is a long-term physical adaptation.
• Dependence: Prolonged opioid use leads to physiological reliance, where withdrawal occurs if use stops. This is a long-term physical adaptation.
• Withdrawal Symptoms: Abrupt cessation of opioids causes anxiety, muscle pain, and insomnia due to disrupted neurotransmitter balance. These are short-term physical and neurological effects.
• Slowed Heart Rate: Opioids depress autonomic functions, reducing heart rate. This is a short-term physical effect posing risks for individuals with cardiovascular conditions.
• Low Blood Pressure: Opioids cause vasodilation and reduce cardiac output, leading to hypotension. This is a short-term physical effect causing dizziness or fainting.
• Mood Swings: Opioids alter brain chemistry, leading to irritability, anxiety, or depression. These are short-term neurological effects during misuse or withdrawal.
• Overdose: Excessive opioid use overwhelms the central nervous system, causing respiratory failure and unconsciousness. This is an acute physical effect potentially leading to death.

What Are the Overdose Effects of Opioids?

The overdose effects of Opioids include respiratory depression, slowed or stopped breathing, extreme drowsiness, pinpoint pupils, and cold or clammy skin, representing life-threatening conditions requiring immediate intervention.

Here are the common overdose effects of opioids in detail below:

• Respiratory Depression: A severe physical effect where breathing becomes dangerously slow or shallow, potentially leading to oxygen deprivation and life-threatening complications. According to Khanna, A.K.’s 2021 study, ‘Opioid-induced respiratory depression increases hospital costs and length of stay in patients recovering on the general care floor, ’ opioid-induced respiratory depression occurs in up to 46% of patients on the general care floor, leading to significant clinical and economic consequences. Patients experiencing one or more respiratory depression episodes face longer hospital stays (6.4 vs 5.0 days, p = 0.009) and substantially higher hospital costs ($21,892 vs $18,206, p = 0.002). The financial impact is particularly pronounced, with propensity weighted analysis demonstrating 17% higher costs for affected patients (p = 0.007), with expenses increasing exponentially as the length of stay extends.
• Slow or Stopped Breathing: A critical physical symptom of opioid overdose, causing insufficient oxygen supply to the brain and other organs,  resulting in death if untreated.
• Extreme Drowsiness: A physical effect marked by excessive sedation, impairing alertness and functioning and indicating high opioid levels in the body.
• Pinpoint Pupils: A distinctive physical sign of opioid use or overdose, where pupils become abnormally constricted, even in low light.
• Cold or Clammy Skin: A physical symptom of opioid overdose, caused by reduced blood flow, signaling a severe and life-threatening condition.
• Bluish Lips or Fingernails: A physical sign of oxygen deprivation due to respiratory depression, indicating a medical emergency requiring immediate intervention.
• Weak or Absent Pulse: A severe physical symptom of opioid toxicity, reflecting cardiovascular collapse and requiring urgent medical attention.
• Unresponsiveness: A critical physical and psychological state where the individual cannot be awakened or respond to stimuli due to excessive opioid consumption.
• Seizures: A rare but severe neurological effect caused by extreme opioid toxicity, indicating significant brain dysfunction and requiring emergency care. According to Palamar, J. J.’s 2024 study, ‘National and regional trends in fentanyl seizures in the United States, 2017–2023.’, between 2017 and 2023, HIDTA-affiliated agencies seized a total of 66,303 fentanyl samples across the United States, with 67.3% (44,623) in powder form and 32.7% (21,664) in pill form. The percentage of seizures in pill form substantially increased from 10.3% in 2017 to 49.0% in 2023, resulting in 115.6 million individual pills being confiscated in 2023 alone. While the South had the highest number of powder seizures, the West showed the steepest increase in seizures overall, with 77.8% of Western seizures being in pill form. This regional disparity indicates a significant shift in the illicit fentanyl market toward pill formulations, particularly in Western states.
• Vomiting: A physical response to opioid overdose, increasing the risk of choking or aspiration, especially if the person is unresponsive.
• Coma: A profound state of unconsciousness caused by severe opioid-induced central nervous system depression, posing a high risk of death. According to Sayed, H. Y.’s 2024 study, ‘Cardiovascular effects and clinical outcomes in acute opioid toxicity: A case-control study from Port Said and Damietta Governorates, Egypt.’, coma affected 64.7% of opioid toxicity cases, while shock occurred in 39.2% of patients. Elevated cardiac enzymes (Troponin-I and CK-MB) were significantly correlated with increased ICU stays and higher mortality rates. Sinus bradycardia was present in 51% of cases as the most common cardiovascular abnormality.
• Death: The most severe outcome of opioid overdose, resulting from prolonged respiratory depression, cardiovascular failure, or complications like aspiration.

Can You Die from an Opioid Overdose?

Yes, you can die from an opioid overdose. Opioid overdoses occur when a person takes opioids in larger quantities than their body tolerates, leading to life-threatening symptoms such as respiratory depression, slowed or stopped breathing, and eventual brain damage or death. 

According to data from the National Institute on Drug Abuse (NIDA), prescription opioid overdose deaths in the United States have shown significant fluctuations over the past two decades. Deaths rose dramatically from 3,442 in 1999 to a peak of 17,029 in 2017, followed by a decline to 14,139 by 2019. The COVID-19 pandemic period saw a temporary increase to 16,416 deaths in 2020 before declining again to 14,716 in 2022. While prescription opioids are no longer considered the primary driver of the overdose epidemic, the increasing involvement of fentanyl in these fatalities since 2014 remains a serious concern.

How Do Opioids Affect the Brain?

Opioids affect the brain by binding to specific receptors known as opioid receptors, which are naturally present in areas of the brain responsible for pain regulation and reward processing. 

According to Blackwood, C. A.’s 2021 study, ‘The molecular neurobiology and neuropathology of opioid use disorder, ’ opioid causes significant structural brain abnormalities that vary depending on the specific drug. The cerebellum, cerebrum, globus pallidus, and corpus callosum are most commonly affected, with conditions ranging from leukoencephalopathy and brain edema to hydrocephalus and reduced gray matter. 

Opioids alter neural connectivity in crucial regions, including the frontal cortex, cingulate cortex, and basal ganglia. Heroin users exhibit decreased volume in the hypothalamus, nucleus accumbens, and putamen, while morphine and oxycodone users demonstrate defects in brain connectivity that impact perception. 

With 46,802 opioid-related fatalities reported in the U.S. in 2018 and approximately 9.9 million people misusing prescription opioids that year, these structural abnormalities likely contribute to the cognitive deficits observed in patients suffering from opioid use disorder, reinforcing the public health crisis that continues to cost an estimated $78.5 billion annually.

How Does Opioid Use Lead to Addiction?

Opioid use leads to addiction by altering brain chemistry, creating dependency through repeated stimulation of the brain’s reward system. Regular use causes tolerance, withdrawal symptoms, and compulsive drug-seeking behavior, resulting in opioid use disorder (OUD), a chronic condition marked by an inability to stop despite harmful consequences.

Opioid addiction, or opioid use disorder (OUD), is a chronic disease characterized by compulsive opioid use despite negative consequences. Opioids, which include prescription painkillers like oxycodone and illegal drugs like heroin, act on the nervous system to relieve pain and produce feelings of euphoria. This euphoria leads to misuse, even when opioids are prescribed appropriately.

How Regular Use Leads to Addiction

1. Initial Use and Euphoria: Opioids bind to receptors in the brain, triggering the release of endorphins that reduce pain and create a sense of well-being or euphoria. This pleasurable effect motivates repeated use.
2. Tolerance Development: With continued use, the brain adapts by reducing its natural production of endorphins and desensitizing opioid receptors. This leads to tolerance, where higher doses are required to achieve the same effect.
3. Dependence Formation: Over time, the body becomes dependent on opioids to function normally. Stopping or reducing use triggers withdrawal symptoms such as muscle pain, nausea, insomnia, and severe cravings.
4. Compulsive Use and Addiction: The brain’s reward system becomes hijacked by opioids, impairing self-control and decision-making. Users prioritize drug-seeking behavior over responsibilities and relationships, even when aware of the harm caused.

What Is Opioid Dependence?

Opioid dependence is a physiological state in which the body becomes reliant on opioids to maintain normal function. It develops after prolonged use of opioids, whether prescribed or illicit. Unlike addiction, dependence does not necessarily involve compulsive behavior or psychological cravings. A person who is dependent still has control over their opioid use, but stopping abruptly leads to withdrawal symptoms such as nausea, sweating, and irritability.

When opioids are used regularly over time— for pain management—the brain adjusts by reducing its natural production of endorphins and desensitizing opioid receptors. This adaptation results in tolerance, where higher doses are needed to achieve the same effect. Eventually, the body becomes dependent on opioids to regulate normal functions, such as pain perception and mood stabilization. If opioid use is stopped suddenly, withdrawal symptoms occur, compelling continued use to avoid discomfort.

What Is the Risk of Opioid Overdose?

The risks of opioid overdose include severe respiratory depression, where breathing becomes dangerously slow or stops completely. Without immediate treatment using naloxone, these breathing problems quickly lead to brain damage or death. 

According to a study named ‘Opioid crisis: Addiction, overprescription, and insufficient primary prevention, ’ published in The Lancet Regional Health – Americas, the opioid crisis has reached alarming levels in the USA, with 15.8 deaths per 100,000 people recorded in 2019. Canada follows with 6.4 deaths per 100,000 people. Globally, opioid overdoses claim more than 100,000 lives annually, with many deaths linked to fentanyl, which is 50-100 times more potent than heroin or morphine. Despite decreasing prescription rates in the USA since 2013, opioid-related mortality continues to rise. Other countries in the Americas show lower but concerning death rates, with Guyana, Bolivia, and the Dominican Republic reporting less than 2 deaths per 100,000 people.

The dangers are particularly high with illicit opioids like heroin, as users cannot verify the drug’s strength or purity. Even prescription opioids carry substantial overdose risks, as their high potency means that taking just slightly more than prescribed triggers a potentially fatal response.

What Are the Types of Opioid Addiction Treatment?

The types of opioid addiction treatment include comprehensive medical interventions, structured rehabilitation programs, and flexible care options. From medically supervised detoxification and medication-assisted therapy to intensive residential care and outpatient support systems, treatment approaches vary in intensity and duration. Explore the detailed breakdown below to understand how each opioid addiction treatment option supports recovery from opioid dependency.

• Medication-Assisted Treatment (MAT): Medication-assisted treatment (MAT) provides an effective approach to treating opioid addiction by using medications to manage withdrawal symptoms and cravings. Common medications in MAT include methadone, buprenorphine, and naltrexone. Methadone and buprenorphine function as opioid agonists, activating brain receptors similarly to other opioids but with longer-lasting and less euphoric effects. Naltrexone acts as an opioid antagonist, blocking the effects of opioids in the brain.
• Inpatient Opioid Addiction Treatment: Inpatient treatment, or residential treatment, requires clients to stay in a facility for intensive care addressing opioid addiction. This option benefits individuals needing a structured environment to overcome addiction. During inpatient treatment, clients engage in therapeutic activities, including medication-assisted treatment, individual therapy, group therapy, and support for co-occurring mental health disorders.
• Partial Hospitalization Program (PHP): Partial Hospitalization Programs (PHP) deliver structured, intensive opioid addiction treatment between outpatient care and inpatient supervision. PHP participants engage in daily multi-hour treatment sessions across multiple weekdays, integrating medication-assisted treatment, individual therapy, group counseling, and mental health disorder management. The program incorporates comprehensive support through case management, vocational guidance, and family therapy services. PHP treatment benefits individuals transitioning from inpatient/IOP programs, those experiencing relapse, or patients with escalating addiction symptoms.
• Intensive Outpatient Treatment (IOP): Intensive outpatient treatment (IOP) delivers structured opioid addiction care several days weekly for multiple daily hours. IOP serves individuals requiring intensive addiction treatment without 24-hour medical supervision. The treatment protocol integrates medication-assisted therapy, personalized counseling, group sessions, and dual diagnosis mental health support. IOP serves two primary patient groups: recovery transition patients completing residential programs and individuals balancing recovery with life obligations. The treatment schedule consists of 3-hour daily sessions across 3-5 days, totaling 9-15 weekly treatment hours. Treatment duration spans 8-12 weeks based on patient progress and recovery goals.
• Outpatient Opioid Addiction Treatment: Outpatient addiction services deliver opioid treatment while patients maintain regular daily activities. Treatment combines medication assistance, individual/group therapy sessions, and mental health disorder support. The program functions as a transition pathway for inpatient/IOP graduates returning to daily routines plus individuals requiring moderate support levels.

What Are Common Opioid Brand Names?

Some common brand names for prescription opioids include OxyContin, Percocet, Vicodin, and Demerol. Heroin is an example of an illicit opioid, and fentanyl is a powerful synthetic opioid that is prescribed or sold illegally.

How Do You Safely Use Opioids to Manage Pain?

To safely use opioids for pain management, follow these guidelines:

• Assessment and Monitoring: Ensure thorough patient evaluation and ongoing monitoring to assess pain and function, using tools like the PEG Assessment Scale.
• Risk Stratification: Identify patients at higher risk for opioid use disorder, such as those with a history of substance abuse or mental health conditions.
• Prescription Guidelines: Adhere to clinical guidelines for opioid prescribing, such as those provided by the CDC, which emphasize careful consideration of benefits and risks.
• Dose Management: Start with the lowest effective dose and gradually increase as needed, avoiding high doses unless necessary.
• Alternative Treatments: Consider non-opioid pain management options when possible.

What Is the Difference Between Opioids and Opiates?

Opioids and opiates are used interchangeably, but technically, opiates refer specifically to natural substances derived from the opium poppy, such as morphine and codeine. Opioids, on the other hand, include both natural opiates and synthetic or semi-synthetic drugs that mimic their effects, such as oxycodone and fentanyl.

Which Types Of Opioids Are the Strongest?

The strongest opioids include synthetic and semi-synthetic opioids like fentanyl, which is significantly more potent than natural opiates like morphine. Other potent opioids include hydromorphone and oxymorphone. According to the NIDA, fentanyl is a powerful synthetic opioid that is 50 to 100 times more potent than morphine. It has become the most common drug involved in overdose deaths in the United States. Drug dealers mix fentanyl with heroin, cocaine, methamphetamine, and MDMA because it takes very little to produce a high, making it a cheaper option, but this creates a dangerous situation when users are unaware of its presence.

How Are Opioids Made?

Opioids are made naturally from the opium poppy (e.g., morphine and codeine), semi-synthetically (e.g., oxycodone and hydrocodone), or synthetically (e.g., fentanyl). Natural opioids are extracted from the poppy plant, while semi-synthetic and synthetic opioids are created through chemical modification or synthesis in a laboratory.

Is Opioid Addiction Treatable?

Yes. Opioid addiction is treatable through a combination of medication-assisted treatment (MAT), behavioral therapies, and support groups. Effective treatments include medications like methadone and buprenorphine, alongside counseling and therapy to address psychological dependence and prevent relapse.