What is the most important information I should know about opiates?
- Opiate medications such as Vicodin, OxyContin, Dilaudid, and Percocet are often prescribed to treat pain.
- Such medications can be habit-forming and may lead to tolerance, dependence, and withdrawal even when taken as directed.
Opiates, sometimes known as narcotics, are a type of drug that act as depressants on the central nervous system (CNS). Opiates come from opium, which can be produced naturally from poppy plants; opioids are chemically synthesized opiate-like drugs.
Some of the most common opiates and opioids include:
- Morphine (Kadian, Avinza)
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin, Percocet)
An estimated 50 million adults in the U.S. experience chronic pain. Opioid pain relievers are often prescribed to treat injury-related, dental, and back pain. Such medications can be habit-forming and lead to dependence, addiction, and withdrawal, even when taken exactly as prescribed.
Opiates can be defined as any drug that comes from the opium alkaloid compounds that naturally occur in the poppy plant. These substances affect the opioid receptors in the brain and body to produce pain relief.
Opiates vs. Opioids
While an opiate is a naturally occurring compound found in poppy plants, an opioid refers to any natural or synthetic substance that binds to the opioid receptors in the brain to create opiate-like effects.
Types of Opiates
There are a few different types of opiates:
Morphine and codeine are the two most common opiates. Thebaine is not used on its own as a pain medication, but it is used to produce synthetic opioid pain medications, including hydrocodone and buprenorphine.
There are also a number of different synthetic and semi-synthetic opioids that have effects similar to those of natural opiates. Some of these include heroin, oxycodone, and methadone.
How Opiates Affect the Brain
Both humans and animals have opiate receptors in the brain. These receptors act as action sites for different types of opiates, such as heroin and morphine.
The reason the brain has these receptor sites is because of the existence of endogenous (internal) neurotransmitters that act on these receptor sites and produce responses in the body that are similar to those of opiate drugs.
Opiates and opioids bind to specific receptors in the brain, mimicking the effects of pain-relieving chemicals produced naturally.
These drugs bind to opiate receptors in the brain, spinal cord, and other locations in the body. This blocks the perception of pain.
Side Effects of Opiates
While opiates can relieve pain and create feelings of euphoria, they can also produce a number of unwanted side effects.
- Slowed breathing
Opiates can be utilized to relieve pain, but they can also cause side effects such as nausea, confusion, and drowsiness.
Tolerance, Dependence, and Withdrawal
While opiates are often very effective in treating pain, people can eventually develop a tolerance. When this happens, people require higher doses to achieve the same effects.
As opiate drugs become more tolerated, people may begin taking increasingly higher doses to experience the same pain-relieving effects and reduce symptoms of withdrawal. Symptoms of opiate withdrawal can include:
- Abdominal cramping
- Muscle aches
- Runny nose
What makes prescription opiates so potentially dangerous? They affect powerful reward systems in the brain. Over time, the brain needs these substances to continue experiencing rewards and avoid withdrawal.
Some people can even become addicted when taking them exactly as prescribed. Failing to take medications as directed or combining medications with other substances can increase this risk. There are also individual differences in genetic vulnerability to opiate addiction.
The risk of developing an addiction to opiates or opioids increases when taking high doses, when using these medications for prolonged durations, or when using extended-release or long-acting formulations.
Other risk factors include age, past substance use, environments that encourage misuse, and untreated mental health conditions. People who use opiates to control pain should contact their healthcare provider if they believe they may be developing a tolerance or addiction.
Opiate and opioid use are on the rise globally, so it may come as no surprise that abuse and addiction to such substances have also increased in recent years. According to official statistics:
- Opioid prescriptions peaked in 2012 and have declined since. While overall rates have dropped, the Centers for Disease Control and Prevention notes that it remains high in certain areas of the U.S., with more than 142 million opioid prescriptions in 2020.
- In 2019, opioids were involves in 49,860 overdose deaths. This accounts for 70.6% of all drug overdose deaths.
- About 75% of all people with an opioid addiction disorder end up switching to heroin as a cheaper source of opioids. Nearly half a million U.S. adults are addicted to heroin.
The CDC also reports that opioid deaths remained steady between 2010 and 2018 but increased significantly after, with 68,630 deaths in 2020.
How to Get Help
If you have developed a dependence or addiction to opiate or opioid medication such as Dilaudid, OxyContin, Vicodin, or Percocet, there are evidence-based treatments that can help. The first step is to talk to your doctor about what actions will help you stop using opiates.
Your doctor may recommend gradually tapering your medication over a period of time to help minimize the severity of withdrawal symptoms. They may also prescribe a medication such as buprenorphine or methadone to prevent withdrawal symptoms.
Treatment for opiate and opioid addiction often involves psychotherapy, medication, and support groups. In some cases, inpatient treatment or intensive inpatient therapy may be needed.
Types of therapy that are often utilized to treat opioid addiction include:
- Cognitive behavioral therapy (CBT): A type of therapy that address the thought and behavior patterns that contribute to addiction
- Motivational enhancement therapy (MET): A type of therapy that focuses on helping people increase their motivation to change
- Family therapy: An approach that focuses on relationships and family dynamics to support a person’s recovery
Medications such as Buprenorphine, and Naloxone may also support recovery from addiction. Many people find that 12-step programs and support groups can encourage abstinence and help people get the support they need.