An opioid is a prescription medication for severe pain. It’s not just one type of medicine; it’s a class of drugs that blocks pain signals between the body and the brain, telling you you’re not in pain. But opioids are among the riskiest prescription medications because it doesn’t just relieve or manage chronic pain.
One of its most infamous brands is OxyContin, which has been credited for sparking the Opioid Crisis. The epidemic of opioid misuse and overdose still occurs to this day, with close to 500,000 people who’ve died from overdose from 1999 to 2019.
What are the Risks and Side Effects of Opioid Use?
Opioids naturally come from opium poppy plants. Poppy plants are also a source of heroin, which is a Schedule I drug under the United States Drug Enforcement Administration (DEA) classification. As poppy plants are a source of prescribed opioids, this class of drugs are prone to abuse.
Opioids are susceptible to substance abuse because aside from pain relief, they also create a feeling of euphoria. They may calm emotions and give you a sense of pleasure, triggering the release of endorphins and making them highly addictive.
As such, the DEA classifies opioids, like oxycodone and fentanyl as Schedule II drugs. When taken, some people may experience the following opioid side effects:
- Nausea
- Sleepy or tired
- Confused
- Drowsy
- Constipated
Prescription opioids are still subject to misuse even when taken according to how the doctor prescribed it. Some people develop a tolerance to an opioid, making them take more than what they’re supposed to take for their chronic back pain or knee pain. Traditionally, doctors only prescribed opioid medicine for severe pain and not chronic or long-term pain.
How do opioid drugs promote tolerance?
Repeated use over time diminishes the body’s ability to release endorphins, leaving the person vulnerable to opioid overdose.
Opioid dependence can lead to accidental or fatal overdose because people addicted to it feel the need to increase their dosage.
What are the 5 Symptoms of Opioid Overdose?
Most people who take opioid medication and develop a tolerance tend to take other drugs. If oxycodone isn’t available, heroin, cocaine and synthetic opioids deliver the next-best high. Some people who misuse opioid drugs combine the pills with other illicit drugs, increasing the risk for overdose.
It’s crucial to distinguish when a person is on an opioid high or when they’ve overdosed.
The 5 signs to observe are:
1. They’re conscious but can’t speak
2. They’re choking or making gurgling sounds
3. They have slow, shallow breathing
4. Their skin turns pale blue or gray; fingernails and lips go dark
5. Their body goes limp or they lose consciousness
With OxyContin overdose, some people who misuse the prescription opioid experience the following as well:
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They may vomit
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They may have a seizure
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They may fall into a coma
First responders to an overdose incident follow a process that often starts with getting the person on opioid medication to respond to stimuli. If the person does react, the goal is to keep them conscious and to take them to the hospital for monitoring.
If the person is still unconscious, a single dose of naloxone must be administered. A second dose follows if the person is still not responding within two to three minutes. Naloxone is also known as Narcan, a medication that reverses the effect of an opioid overdose.
What’s the Gold Standard in Treating Opioid Addiction?
A document from the Substance Abuse and Mental Health Services Administration (SAMHSA) outlines the gold standard for treating opioid misuse.
Much like any substance abuse, treatment for opioid use disorder combines three approaches to stop the abuse.
Psychosocial therapies
- Behavioral therapy
- Individual or group counseling
Medication-assisted treatment
- Buprenorphine
- Naltrexone
- Methadone
Community-based recovery support
- Recovery support services
- Substance use disorder treatment programs
The document from the SAMHSA further underscores the necessity of integrating a prevention program to address opioid abuse. In doing so, early intervention opportunities may prevent the following health care problems, all of which increase the risk for opioid overdose:
- High rates of hospital and emergency department readmissions
- Ineffective referrals
- Incomplete treatment
What are Commonly Abused Opioids for Severe Pain?
Oxycodone isn’t the only form of opioid prone to misuse. The brand using oxycodone, typically OxyContin, has been overprescribed with questionable marketing tactics from its leading maker, Purdue Pharmaceuticals, which misrepresented the addiction risk of the drug.
The U.S. Food and Drug Administration approval of the oxycodone brand, initially labeling it as reducing the chances of abuse because of the drug’s “delayed absorption.” The green light from the FDA may have convinced more doctors to prescribe the opioid even for chronic pain, a medical recommendation that’s avoided owing to the drug’s addictive qualities.
But later studies and investigations eventually proved OxyContin claims of “less than one percent addictive” was false. And instead of the opioid working for 12 hours, six hours was the more common experience of many people who took it.
Other physicians have engaged in criminal behavior, setting up what’s called “pill mills” to prescribe these potent pain relievers to anyone who will pay cash, even if they’re pain wasn’t real.
The combination of the opioid formulation, its addictive qualities and gross regulatory failures all contributed to the Opioid Crisis.
Other opioid medications prone to misuse are:
- Oxycodone and acetaminophen (Percocet, Roxicet)
- Meperidine (Demerol)
- Fentanyl (Actiq, Abstral, Duragesic, Fentora)
- Morphine (Kadian, MS Contin, Morphabond)
- Hydrocodone (Hysingla, Zohydro ER)
- Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
- Oliceridine (Olynvik)
- Oxycodone and acetaminophen (Percocet, Roxicet)
- Codeine
What are the Risk Factors for Opioid Misuse?
When 11.5 million adults who misuse opioids were asked about their reason for taking the prescription medicine, about 63 percent said they needed to relieve physical pain. Some 11 percent intentionally took higher dosage to get high or feel good; 10 percent wanted to be relaxed and about 4 percent misused it to get some sleep.
Other reasons for the drug abuse were experimentation, to increase or decrease the effects of other drugs they were taking and that they just had to have it because they were hooked on it.
Not everyone who’s prescribed opioids respond in the same way; some get addicted, others don’t. Some situations, conditions make some people more vulnerable to the bad effects of prescription opioids:
- Stressful circumstances
- Risk-taking or thrill-seeking behavior
- Heavy tobacco use
- History of severe depression or anxiety
- History of drug or alcohol rehabilitation
- Family history of substance abuse
- Young age
- Contact with high-risk people or high-risk environments
- Poverty
Pain can prevent someone from living the life they want to live. It can debilitate a person to a degree that they’re willing to give any treatment promising relief a try. Even if that treatment leaves devastating results in its wake, like the ones prescription opioids have left across the country.
Work with your doctor on pain management. Ask about alternatives. And learn how to best manage opioid medication when it’s been prescribed for you.
