Opiates are designed and used as analgesic medications for chronic pain. Most opioids are extremely strong painkillers that are only appropriate for severe pain associated with terminal illness or recovery from major surgery. Their potential for addiction is so strong that the use of opioid medications is more strictly regulated than other prescription drugs.
Nonetheless, there’s been an opioid crisis among the US population for more than a decade. This is partly due to doctors being too relaxed about who they prescribe pain medication to, but the illegal market for these drugs is also booming.
If you or someone you care about is going down the slippery slope of an opioid use disorder, we can help. Call Recovery Works today at +1-778-430-1212 to start making the changes necessary for a happy future.
The Three Types of Opioids
There are three different opiate classes. Natural opioids are found in the opium poppy plant, while synthetic opiates are synthesized substances with a molecular structure that mirrors that found in opium. Semi-synthetic opiates are directly derived from natural sources, but they don’t occur naturally.
There is another class of opioids, but these are found naturally within your body. They’re called peptides, and they act as neurotransmitters called endorphins, dynorphins, enkephalins and endomorphins. You activate these naturally occurring chemicals through exercise, to help you deal with stress and pain and to increase feelings of pleasure associated with eating, sex and other functions.
Physical dependence and opioid addiction occur because opioid drugs mimic these substances, binding to opioid receptors and tricking your brain and body into relying on an external substance to feel balanced.
Read on to find out more about the three types of opioids, with examples of the most commonly abused substances within each category.
Natural opioids are alkaline, base chemical compounds containing nitrogen. They occur in a particular breed of opium poppy that’s native to the eastern Mediterranean and western Asia.
Morphine was first isolated from the poppy plant in 1803 and has spawned a multitude of derivatives and synthetic copies. In addition to acting as a pain management solution, morphine can treat severe cases of diarrhea because one of its side effects is constipation.
Morphine is primarily used in clinical settings, but a doctor might prescribe it to someone in an extended-release form following surgery. It’s not given for an extended period of time because of how addictive it is, and its production is strictly controlled, so it’s not often found as a street drug.
Codeine is a medication that’s used to treat mild pain. Also, like most other opiates, it causes constipation, so it’s also used to treat diarrhea. It’s available in low doses without a prescription, but even these low doses can cause addiction in some individuals. Just like morphine, it’s a naturally occurring opioid substance that comes directly from the poppy plant. Medications like codeine can be particularly dangerous because using pills prescribed by the doctor doesn’t feel like drug abuse.
Thebaine is an opioid alkaloid that makes up a minor component of opium but has different effects. It works as a stimulant of the central nervous system, unlike morphine and codeine, which are depressants. It’s not used clinically as an isolated substance, but it’s the main alkaloid extracted from the Iranian opium poppy. This is used to synthesize a variety of semi-synthetic opioids, such as oxycodone, hydrocodone, oxymorphone, naloxone and naltrexone.
Fully synthetic opioids like methadone and fentanyl are entirely man-made, but their molecular structure mimics that of opioid alkaloids. In 2018, there were 31,000 deaths involving the use of synthetic opiates, excluding methadone. According to the CDC, that’s a huge 67% of all opioid-related deaths and a 10% increase in synthetic opioid overdose deaths in 2017. Illegally produced fentanyl, as opposed to pharmaceutical fentanyl, is thought to be the main cause of this drastic increase.
Fentanyl, brand name Duragesic, is a potent analgesic whose predominant clinical use is in the treatment of terminal cancer. It’s so strong that the dosage is much lower than other opiate medications, but it also has a rapid onset and the effects wear off relatively quickly compared to other opioids. The substance is used as an anesthetic in less developed countries around the world.
First synthesized in 1960, Fentanyl is around 100 times stronger than morphine. It’s available as a lollipop, a transdermal patch and buccal tablets. Unfortunately, fentanyl is increasingly being cut with street heroin. Not only does this make the heroin more addictive, encouraging users to fall deeper into addiction, but it’s also much more deadly. If someone doesn’t know they’re taking the drug, they can easily overdose because of the extremely high potency.
Tramadol is sometimes mistakenly not classed as an opioid painkiller, and people tend to think of it as being safer and less addictive than it is. The medication is a combination of a synthetic opioid and monoamine uptake inhibitors. It’s available in capsules and tablets and is fairly widely prescribed as a painkiller.
Although it’s not as strong and the effects aren’t as pronounced as some other opiates — it’s about one-tenth as strong as morphine — prolonged or heavy use is still highly likely to lead to addiction.
Methadone’s most common use is as a treatment for people who are struggling with an opioid use disorder. It’s also used for chronic pain relief due to its high potency, long-lasting action and affordable. Despite being chemically different from morphine or heroin, it affects the same receptors in the brain.
The long duration makes it useful in treating opiate addiction because people in recovery only need to use it once a day. This helps to ease withdrawal symptoms, and higher doses can even block the euphoric effects of morphine, heroin and similar substances. Although street methadone is available and might cause euphoria in someone who isn’t used to the effects of opioids, it doesn’t cause a high in therapeutic doses.
This synthetic opioid analgesic treats moderate to severe pain, and it’s sometimes used for rigor or shivering. Meperidine isn’t suitable for long-term use because it potently irritates the central nervous system. While it used to be prescribed widely due to its relative low potency as an opiate and the resulting lowered risk for addiction, it’s fallen out of favor due to its toxicity.
Semi-synthetic opioids are made using naturally occurring opium substances, such as morphine, thebaine or codeine. These medications are created in laboratory settings using derivatives from opium poppy plants. In most instances, the results are highly potent and addictive. While this is excellent for their clinical use as opioid pain medications, it makes the potential for substance abuse and cross-addiction much higher.
Heroin is perhaps the most famous of the street opioids. Most people think of heroin as the most potent and addictive drug of all. However, it’s not as strong as fentanyl or several of the other substances on this list. When it’s injected intravenously, it causes an initial rush of euphoria followed by several hours of sedation.
It was used extensively as an over-the-counter medication in the United States until 1924, when its potential for harm was realized. By the end of the 20th century, it had gained the reputation as the most deadly and dangerous drug in the world. It has a high potential for drug overdose and it’s certainly life-threatening, but it’s not the strongest opioid.
Also known by the brand name Dilaudid, hydromorphone is similar in structure to morphine but around eight times more potent as a painkiller. It has a fast onset and an additional use as a cough suppressant, although this is rare. The tablets dissolve in water without heat, and this easy preparation of prescription pills makes it a prime candidate for illicit drug use.
Also known as Percocet and OxyContin, Oxycodone is one of the most widely prescribed opiates on the market. OxyContin was synthesized in 1996, and by 2001 it was the best-selling branded narcotic painkiller in the US.
High rates of prescription also led to a wide availability on the street, so it also quickly became one of the most widely abused prescription medications in the country. While Percocet contains other substances, addicted persons realized that OxyContin could release a high dose of fast-acting oxycodone. It’s thought to be one of the major contributors to the opioid crisis.
Buprenorphine is similar in structure to morphine, which scientists derive it from, but it’s thought to be around 25 times more potent. This strong receptor affinity makes it useful for treating acute and chronic pain, but it also makes it an excellent treatment for opioid use disorder. It prevents other opioids from binding to receptors in the brain, preventing their antagonist or analgesic activities in the brain.
Hydrocodone is commonly known by the brand name Vicodin, and it’s synthesized from codeine. It’s used as a cough suppressant and to treat mild to moderate pain, but it’s usually combined with another substance like ibuprofen or acetaminophen. Out of all the prescription drugs in the United States, hydrocodone is one of the most frequently seen among substance abuse statistics.
Its widespread availability makes it a popular choice for young adults and teenagers. Acetaminophen has the potential to damage the liver, so prolonged use of Vicodin is dangerous for more than just its opiate properties.
Are Street Opiates More Addictive Than Prescription Opioids?
In most cases, street drugs contain unknown quantities of the active substance, and they’re often mixed with other drugs. While some drug dealers might cut drugs with non-active substances to save money, others take a more deadly approach. For example, cutting heroin, cocaine or synthetic cannabinoids with fentanyl makes them much stronger and much more addictive. This means there’s a strong likelihood the user will become addicted to the fentanyl and will therefore buy more.
When doctors are prescribing substances, you know exactly what’s in them. However, that doesn’t mean they’re less addictive by any means.
What Are the Signs and Symptoms of Opioid Addiction?
Opioid addiction is a serious illness that requires medical attention to overcome. These drugs hijack your brain and body, tricking them into believing you need them to function. This physical dependence isn’t all in the mind, though. Opioid withdrawal is so severe because the body goes into shock when it thinks it’s not getting what it needs. Most people need to go through this process in a clinical setting to ensure their safety and well-being.
Some of the most common signs of opioid addiction include:
- Using opioids in any way other than directed by a physician
- Taking opiates even when the person isn’t in pain
- Paraphernalia such as small spoons, needles, foil, crushed pills or blister packs
- Being preoccupied with obtaining a substance
- Asking other people if they have opiates
- Mood swings
- Changes in sleeping
- Weight loss
Is Rehab Open During COVID-19?
Rehab is certainly open during COVID-19. We know that addiction doesn’t take a break because there’s a global pandemic. In fact, it’s made many people’s relationship to substances worse as they deal with health anxiety and potential changes like job loss and bereavement. At Recovery Works, we’ve gone over and above to implement even stricter hygiene measures. Everyone who comes in must test negative for the coronavirus, so there’s very little risk you’ll be exposed in our lovely clinic.
Get Help for Opioid Addiction Today
If you’ve been using opiate medication or illegal opioids and you’re worried you can’t stop, Recovery Works can help. Call our rehab center in Canada today at +1-778-430-1212 to speak to an addiction expert about the treatment available to you. We’ve helped thousands of people overcome addiction, and our caring team would be delighted to help you get on the road to recovery.