The opioid epidemic started back in the 90s, riding in on a wave of painkillers coming in off the streets and from the doctor’s office alike. A surge in heroin production as well as an abundance of unused, stolen and resold prescription opioids led to a nation with thousands of people addicted to and dependent on opioids, both of the prescription drug kind, and the illegally-produced kind. Rather than waning, the crisis has actually grown over the decades, reaching an all-time high of over 42,000 deaths in 2016, and an official declaration by the HHS that the opioid epidemic is a public health emergency.
The US consumes by far most of the world’s opioid supply, with overdose deaths occurring throughout the country, from coast to coast. Combatting this crisis requires a committed and dedicated approach from every angle, including policy, law enforcement, healthcare, and education. Every American can do their part by educating themselves and their loved ones on the dangers of opioid use, what opioids are and how they work, as well as how to recognize opioid abuse and how to treat it.
The majority of opioid consumption in the opioid crisis today is in fact heroin, which is an illegal substance with no real medical value in the US. However, the opioid crisis was first fueled through the over-prescription of opioid-based prescription drugs, which, despite heavy regulation and changes in policy, continue to contribute to nationwide prescription drug abuse.
What Are Opioid-Based Prescription Drugs?
Opioid-based drugs are synthetically or naturally derived from opium, the psychotropic extract of the poppy plant. First discovered and cultivated in ancient times, in the civilizations of Mesopotamia, opium is one of the oldest drugs on the planet.
Aside from being highly addictive, opium was also known for its analgesic and anesthetic properties, and when modern medicine was in its infancy, more concentrated derivatives of opium – including morphine and heroin – were marketed as anesthetics and analgesic drugs, both pre- and post-surgery. It didn’t take long for morphine overuse to be recognized as dangerous, and both morphine and heroin became highly-regulated drugs in the post-WWII era, with heroin being banned in most nations since the early to mid-20th century.
Today, opioid-based drugs continue to contribute in modern healthcare, usually for analgesic purposes as we’ve since discovered more effective anesthetics. Commonly-prescribed opioid-based prescription medication includes codeine, hydrocodone (Vicodin), and the extremely potent drug fentanyl, which is reserved for terminal pain, and severe cancer pain. Morphine is still used in post-operative care.
Other less common opioid-based drugs still exist, including carfentanil, a derivative of fentanyl that is roughly 100 times as potent, used typically only in veterinary medicine due to its extreme potency. Described as a “nerve gas” due to how easily it can be inhaled, carfentanil has also been mixed into batches of illegal heroin sold throughout the United States, leading to a number of overdoses due to poorly-mixed batches.
When people talk about opioid-based prescription drugs, they typically mean one of the following drugs:
- Hydrocodone (Vicodin)
- Oxycodone (Oxycontine, Percoset)
- Hydromorphone (Dilaudid)
- Fentanyl (Duragesic)
Morphine is also sold under the brand name Kadian, as well as MS Contin.
How Do Opioids Kill Pain?
Opioids are primarily used as analgesic medication, which means that they’re specifically prescribed to kill pain. Morphine, hydromorphone, and oxycodone are all very powerful painkillers capable of numbing a wide variety of pain – but how?
All neurons possess a number of different receptors, which intercept neurotransmitters and other chemicals in order to communicate and facilitate the various functions for which they’re used. Opioid receptors, named such because of the effects that opioids have on them, exist on neurons throughout the brain and nervous system, and these receptors accept the opioids and begin blocking out pain signals throughout the body.
It’s as simple as that, really. The opioids attach to the cells in the brain, gut, spinal cord, and other areas throughout the body, and send out a message stopping the spread of pain signals. Opioids do this more effectively than any other drug known to man, but at a cost. While they’re very effective at stopping pain, there are several reasons why these drugs are also considered dangerous.
Why Are Opioids Dangerous?
The two major reasons why opioids are considered dangerous is that they can cause serious side effects (including death), and they are highly addictive. More so than many other drugs, opioids are among the most addictive drugs on the planet. Rather than simply block out pain the way over-the-counter medication like NSAIDs and paracetamol do, opioids also induce a reaction in the brain by increasing the release of dopamine, heavily changing your mood. Their effect on the brain also seems to convince your mind that you need more of the drug than you actually do, causing you to seek opioids out even when you aren’t in pain, or when it’s been prescribed that you should be taking less.
Most people who struggle with an opioid addiction never took the drug for pain to begin with. Since people who are prescribed medication usually only take the dosage prescribed to them, they are at a lesser risk of developing an addiction. On the other hand, people who start taking prescription drugs illegally and are more liberal with their consumption of opioids, or people who started on heroin, are much more likely to struggle with addiction as their drug use continues.
This leads to serious issues over time, including drug tolerance, wherein a previous dosage is no longer enough to elicit the same level of high it used to elicit. This can quickly take a turn for the worse by causing you to take more of the drug than before, eventually reaching levels that cause you to shut down physically.
Opioids affect the nervous system in a similar fashion to an anesthetic or a sedative, causing sleepiness, shallow breathing, and a slow heartrate. An overdose on opioids can cause unconsciousness, followed by respiratory arrest and death. Naloxone and other opioid inhibitors can block the effects of opioids on the brain and stop an overdose, but if applied too late, the overdose can still cause brain damage and paralysis due to oxygen deprivation.
How Is Opioid Addiction Treated?
Opioid addiction is treated at times through a combination of medication, therapy, and residential treatment. Rehab facilities and sober living homes specialize in helping opioid addicts find a place to fully recover from their addiction by giving them programs and schedules to help keep themselves occupied, learn to deal with a number of physical and emotional problems without the use of opioids, and slowly wean off their addiction through the use of methadone, naloxone, or buprenorphine.