Prescription Opioids

Opioids are a family of drugs that are usually prescribed to relieve pain, control coughs and diarrhea and treat addiction to other opioids.

Official Name

Street Name

M, morph (for morphine); meth (for methadone); percs (for Percodan, Percocet); juice (for Dilaudid)

What is it?

Opioids are a family of drugs that are usually prescribed to relieve pain. Examples include codeine (in Tylenol No. 2, No. 3 and No. 4), oxycodone, morphine, hydromorphone (Dilaudid) and fentanyl. Other medical uses include controlling coughs and diarrhea, and treating addiction to other opioids. Opioids can produce euphoria, making them prone to abuse. Some people use opioids for their ability to produce a mellow, relaxed “high.”

If you or someone you know uses opioids, it is a good idea to have a free naloxone kit. Naloxone is a medication that can temporarily reverse the effects of an opioid overdose and allow time for medical help to arrive.

Where does it come from?

Some opioids, such as morphine and codeine, occur naturally as a gummy substance collected from the seed pod of the opium poppy, which grows in southern Asia. Semi-synthetic opioids, such as hydromorphone or hydrocodone, are made by changing the chemical structure of these naturally occurring opioids. Synthetic opioids, such as methadone, are made from chemicals without using a naturally occurring opioid as starting material.

What does it look like?

Prescription opioids come in various forms, including as tablets, capsules, syrups, solutions and suppositories.

Who uses it?

Opioids are prescribed by licensed medical practitioners to people with acute or chronic pain. Opioids are also prescribed to people with moderate to severe coughs and diarrhea. The opioids methadone and buprenorphine are prescribed to treat addiction to other opioids.

Using prescription opioids for reasons other than their medical purpose is considered abuse. Much attention is given to the abuse of illegal opioid drugs, such as heroin. However, some of the most commonly abused opioids are prescription drugs, such as codeine-containing Tylenol, hydromorphone, oxycodone, morphine and others.

How does it make you feel?

Low doses of opioids suppress the sensation of pain and the emotional response to pain. They may also produce euphoria, drowsiness, relaxation, difficulty concentrating, constricted pupils, a slight decrease in respiratory rate, nausea, vomiting, constipation, loss of appetite and sweating. With higher doses, these effects are more intense and last longer.

The way opioids affect you depends on many factors, including:

• how much you use
• how often and how long you use opioids
• how you take them (e.g., by injection, orally)
• your mood, expectations and environment
• your age
• whether you have certain pre-existing medical or psychiatric conditions
• whether you’ve taken any alcohol or other drugs (illegal, prescription, over-the-counter or herbal).

How long does the feeling last?

The onset and intensity of the effects of opioids vary depending on how the drugs are taken. When taken orally, the effects come on gradually and are usually felt in about 10 to 20 minutes. When injected into a vein, the effects are most intense and are felt within one minute. When opioids are taken to relieve pain, the duration of the effect varies depending on the type of opioid taken. For many opioids, a single dose can provide pain relief for four to five hours.

Is it addictive?

When opioids are used as directed under medical supervision, there is little risk of addiction. However, the risk appears to be higher in people with a history of abuse or addiction.

Anyone who takes opioids regularly will develop physical dependence. Physical dependence is the result of the body adapting to the presence of the drug, and is not the same as addiction. A person who is physically dependent will experience withdrawal symptoms about six to 12 hours after last taking a short-acting opioid, such as hydromorphone, and about one to three days after last taking a long-acting opioid, such as methadone. With short-acting opioids, withdrawal comes on quickly and is intense; with longer-acting opioids, withdrawal comes on more gradually and is less intense.

Symptoms of withdrawal include:

• uneasiness
• yawning
• tears
• diarrhea
• abdominal cramps
• goosebumps
• runny nose
• craving for the drug.

Symptoms usually subside after a week, although some, such as anxiety, insomnia and drug craving, may continue for a long time. Opioid withdrawal is rarely life-threatening.

Is it dangerous?

Opioids can be dangerous if they are used without medical supervision. Here are some of the reasons why:

• Opioids are depressant drugs, which means that they slow down the part of the brain that controls breathing. All opioid drugs are dangerous when taken in large quantities or when taken with other depressants, such as alcohol or benzodiazepines. Signs of overdose include slow breathing, bluish skin and coma. If breathing stops, death can result.
• People who use opioids regularly for their pleasurable effects soon develop tolerance to these effects, which means they need to use more and more of the drug to achieve the desired effect. As the amount taken increases, so does the risk of overdose. If people with tolerance stop taking the drug, they lose their tolerance. If they then resume taking the same amount they took before they stopped, the risk of overdose is higher.
• Some people inject opioids to increase the intensity of the euphoric effect. Sharing needles carries a high risk of infection and disease (e.g., HIV, hepatitis). When pharmaceutical tablets or capsules are dissolved for injection, nondrug substances within these products can damage veins and organs.
• Regularly using large quantities of opioids during pregnancy can increase the risk of premature delivery and infant withdrawal. Pregnant women who are addicted to opioids are treated with methadone to prevent withdrawal symptoms.

What are the long-term effects of using it?

Long-term use of opioids can cause constipation, decreased interest in sex, menstrual irregularities and mood swings. Addiction to opioids can have devastating long-term social, financial and emotional effects.

Source:
Do You Know. Prescription Opioids © 2012 Centre for Addiction and Mental Health

Where can I find help, treatment and support?

• Treatment at CAMH: Access CAMH
• Help for families from CAMH
• ConnexOntario

Where can I find more information?

• A free tutorial on addictions is available on the Mental Health 101 page.
• Addiction: An Information Guide -->