Opioids & Opiate Use

Opioids are powerful substances that are often found in prescription-strength painkillers such as Hydrocodone, Percocet, and Morphine. Illicit opioids, such as heroin and street produced fentanyl along with prescription opioids are widely blamed for the worldwide opioid epidemic that has claimed hundreds of thousands of lives. Occasional use of an opioid, such as is prescribed to control pain, does not always signify a problem, but frequent use can, and often does, lead to addiction.

 

If you suspect that you, or someone you know, are addicted to an opioid, call our admissions team at 833-397-3422 to learn about opioid addiction treatment programs available to help you recover. Sustained or repeat use of opioids can be dangerous and may heighten your risk of an opioid overdose.

 

History of Opioids

 

The opioid crisis is one of the most severe drug epidemics to have swept the nation in many years. From the late 1990s to present day the use of legal and illegal opioids has risen significantly with no signs of slowing anytime soon. Statistics provided by the Centers for Disease Control and Prevention states that “More than 191 million opioid prescriptions were dispensed to American patients in 2017—with wide variation across states”… And these are just the figures for legal and approved opioid dosage.

 

The origin of opioids for medical use dates back to the 1800s when the first known opioid analgesic-now known as morphine – was found. Since then Pop culture and media have had a large influence on the way the public perceives the use of opioids. Popular musicians and rappers often make subtle nods to the drug eliminating the harsh reality of the opioid epidemic. It could even be said that some endorse recreational use of harmful opiates in lyrical references.

 

This may explain why certain age groups have seen significant spikes in the nonmedical, recreational use of opioids, specifically the young adult population of 18 to 25 years old. However, this figure continues to expand with prescription opiates, users most frequently being adults ranging from 26 years and older. Studies have shown that certain demographics are more heavily impacted than others, but, in reality, opioid abuse and addiction can happen to anyone.

 

No one is safe from opioid addiction unless they vow not to ever take an opiate EVER.

 

What are Opioids?

 

Three words that might come to mind for those familiar with these substances are:

Powerful. Effective and Addictive.

 

If you’ve ever taken opioids, you know that they are powerful painkillers that can be highly effective in warding off pain associated with injury or illness. However, anyone that has taken them more than just a few days also knows that they can be highly addictive.

 

Opioids are the most potent painkillers that are known to man and they are constantly surrounded by controversy due to the highly addictive nature and the ease of access through a doctor’s prescription or on the streets. While the original opioids are derived from nature coming from the poppy plant there are three classes of opioids both natural and synthetic that have been recognized and identified in the medical world.

Natural Opioids

The first class of opioids is derived from nature from the iconic poppy plant. Poppy plants flourish across Central Asia and Latin America respectively and are used to create the most well-known opioids which are morphine and codeine.

 

Semi-synthetic

As the name suggests, semi-synthetic opioids are a hybrid production between the natural opioid found in nature and the hands of a lab scientist. This branch of opioids is the most infamous from its use on the black market, heroin. Or its legal counterpart, Oxycodone which is generally prescribed to individuals who are having difficulty managing high levels of pain for various reasons.

 

Fully-synthetic

Opioids such as fentanyl, methadone, tramadol, or carfentanil are 100% chemical compositions made by man. Fentanyl is the most powerful synthetic opioid in this class, its potency is 50%-100% higher than morphine which is nature made. Synthetics are known for their usage in “cutting” heroin and cocaine and often used as knock-off painkillers.

 

What are opiates?

Opiates are powerful substances that are extracted from the poppy plant and are manipulated into various formulations and compounds known as opioids. The most commonly known opioids include:

  • heroin
  • morphine
  • fentanyl

Opioids vs Opiate

 

Opioids and opiates are terms often used interchangeably to mean the same thing. There are instances though, where an opioid and an opiate are actually different in the case of opiates vs opioids. For example, an opioid is usually a reference given to the medical-grade form of medication that is derived from the opium poppy. For example, under this guidance, morphine would be considered an opioid. Likewise, opiate is the term most often used to describe the semi-synthetic or fully-synthetic version of these drugs. For example, under this guidance, Methadone would be an opiate as would Hydrocodone.

 

Opioids

 

A label given explicitly to the natural drug derived from the opium poppy plant. As mentioned above. The opium poppy can be transformed into a few varieties of prescription drugs such as morphine, codeine, and thebaine. Opioids are generally associated with their prescription use and often recreational abuse. In 2018 approximately 1.7 million people in the United States struggled with the use of prescription painkillers, which were directly linked to opioid pain relievers. And an astounding 526,000 people were impacted by the use of heroin.

 

Opiates

 

encompass all classes of opioids which are natural, semi-synthetic and fully synthetic- but is most closely associated with the semi-synthetic and fully synthetic forms. It is important to note the term opiate also includes heroin which is not a legally approved substance. The statistics correlated with opiate use are astounding.

  • 2 million people had an opioid use disorder in 2018
  • 3 million people misused prescription opioids in 2018
  • 130 people die every single day because of opioid-related drug use

 

After evaluating the number of overdoses and substance abuse across the United States, it can prompt hard-hitting questions…

  • Are there alternatives to pain management rather than opioids?
  • What is the difference between opioid vs. opiate? And is one better than the other?
  • Why are opioids so easily prescribed?
  • Does the potential risk of becoming addicted outweigh the benefits of pain relief?

 

What are Opioids Used For?

Several situations can prompt the use of opioids. Opioids are most frequently used as painkillers following receipt of a prescription from a doctor.  So what are opioids prescribed for? Doctors often prescribe opioids following a surgical procedure or injury such as a broken bone.

  • The first and most common use of opioids is for the purpose of pain management. Various classifications of pain can lead to an opioid prescription. Opioids may be prescribed for acute, chronic, and non-chronic pain relief. Opioids are also frequently used to manage pain levels in individuals who are diagnosed with various types of cancer and other severe illnesses that are likely to result in difficult to control and hard to cope with pain.
  • Prescription or non-prescription use following an invasive minor, major, or elective surgery. Generally, short term use prescribed as part of post-recovery care treatment.
  • Pain relief from injury following a car crash or major accidents.
  • Opioids both prescription and non-prescription are frequently abused by individuals who are suffering from anxiety, depression, and other mental health disorders. 16% of Americans who have mental health disorders receive over half of all opioids prescribed in the United States.
  • Recreational throughout all demographics, especially in individuals who are experimental and enjoy feelings of pleasure.
  • Other examples of what opioids might be used for are cough, or those suffering from gastrointestinal pain such as abdominal cramps or disorders like Irritable Bowel Syndrome (IBS),

 

Opioid Prescribing Guidelines

 

The Center for Disease Control and Prevention (CDC) has published several opioid prescribing guidelines for medical practitioners who prescribe opioids to follow and adhere to. The guideline was created to help in the prevention of opiate abuse, to monitor frequent prescription fills, and to create an overall safer experience for patients. Essentially, the guideline involves requiring doctors to perform the following steps when prescribing opioids:

Evaluate When the Need to Prescribe Opioids for a Patient is Necessary 

This involves:

  • Discussing options with the patient
  • Creating a treatment plan

Determine What Individual Patient Needs Are

This involves determining the:

  • Level of dosage
  • Frequency of dosage
  • Pain management
  • Termination of opioid use

Manage Expectations and the Inherent Risks of Opioid Use

This involves steps to ensure patient risk mitigation, including:

  • Implementing drug testing
  • Diagnosing opioid misuse
  • Introducing benzodiazepines as part of the treatment plan

It is essential to ensure that one’s primary care practitioner is following the guidelines directed by the CDC.

 

Opioid Dose & Administration

The dosage of opioids should be carefully evaluated by a patient’s primary care physician before administration and beginning a treatment plan.

Along with the CDC’S guideline for prescription opioid dispensing doctors use a special formula to determine what opioid dose should be given to their patients. The formula works to determine:

  • The daily amount of consumption.
  • The calculated total morphine milligram equivalent (MME) by its subsequent conversion table.
  • The total when both are added together

Doctors realize that opioid prescribing is essential, and a low dosage of 20 to 50 MME’s is recommended for short term use only to help avoid addiction. High dose opioids of 50 MME’s daily equate to a higher risk of overdose. This type of prescribing can double the chance of a patient overdosing accidentally.

Opioid Administration

The most popular forms of administration include:

  • Oral consumption via traditional tablet, capsule or liquid form;
  • Opioid patches;
  • Absorption via nasal passage via spray, snorting or smoking;
  • Intravenous or Intramuscular injection;
  • Suppositories.

 

Types of Opioids & Opiates

Pharmacology has provided many types of opioid drugs for patients, the most frequently prescribed are Morphine, Hydrocodone, Oxycodone, and Fentanyl. Heroin continues to be the most popular illegally abused opioid substance, often found on the streets and resulting in significant figures in regards to opiate addiction. Common types of opioids are synthesized from the poppy plant and produced in formulations with other substances. They include:

  • Morphine: Morphine is a naturally opioid created from the opium poppy plant. Morphine is recommended for short term use and is ill-advised for patients with underlying breathing problems.
  • Hydrocodone: Hydrocodone is one of the most known types of opioids semi-synthetic narcotic, hydrocodone is primarily prescribed for severe pain with the intention of short term use.
  • Oxycodone: Oxycodone is a semi-synthetic narcotic, it’s presence is frequently found in Percocets and Tylox. Many individuals who begin the use of Oxycontin find it incredibly difficult to stop.
  • Fentanyl: Fentanyl is a fully synthetic opioid that is frequently used by cancer patients for pain management purposes. “Fentanyl is 50 to 100 times more potent than morphine” and many times is blended with heroin. Users may not realize that they are using fentanyl, and the significant increase in strength over heroin can lead to fatal overdose.
  • Heroin: Heroin Is one of the most notorious types of opiates that is highly addictive and illegal. “Heroin-involved overdose deaths have increased by nearly 5 times since 2010 (from 3,036 in 2010 to 14,996 in 2018).”

 

What Do Opioids Look Like?

With the various types of narcotics that are prevalent, one might wonder…

What do opioids look like?

While opioids can be diverse in appearance, the general form opioids appear as might be tablets, pills, or capsules. It is not unusual to see liquid or patch form as well, especially with general prescription use. Opium, another opioid found on the streets, traditionally has a dark brown look. On the other hand, heroin is a brown or white powdery substance that may also come in the form of black tar heroin in which it is black with a sticky texture similar to tar.

 

Street Names for Opiate Drugs

Street names for opiate drugs are often created for recreational users to casual discuss different drugs or for drug dealers to sell their products while remaining inconspicuous and under the radar. Here is a list of some of the most common opiates street names.

  • Tar- a nickname for heroin such as black tar opium or a.k.a opium tar. This serves as the base of this particular opiate.
  • Dog Food – a nickname frequently referenced is dog food heroin or heroin dog food due to the chunky texture and dark brown color.
  • Brown sugar – a nickname for a diluted form of heroin which is brown and grainy in texture and might resemble brown sugar, hence brown sugar heroin.
  • Lean – a nickname earned from the dizzying side effect. Codeine Lean is usually created to resemble a candy-flavored drink. The opioid is derived from liquid codeine cough syrup.
  • Sizzurp – is a mix of codeine, soda and cough syrup – hence the term “sizzurp.”
  • China girl or China White – references to the opioid Fentynal which can be found in a white powder form.
  • Watson – are small hydrocodone pills with the name “Watson” imprinted on the tablet.  Other common nicknames include Watson Lortab or Lortab 10 Watson or just Tabs.
  • D’s – the opioid street name for Diluadid or Hydromorphone. D’s are a composition of the opioid Hydromorphone and nicknamed D’s for the brand name, Dilaudid.
  • Perks / Perk 30s – nicknames often reference Percocet which is a medication partially composed of Oxycodone and often referred to as Perk 30s or Perk 30, 30s, or blues in respect to the pill color.

 

Opioid Analgesics Side Effects

 

The use of opioids does tend to prompt Opioid analgesics side effects in the body. Even though many individuals who are regular substance users may not notice opioid side effects immediately, they may appear slowly over time with gradual use. The long term use of opioids is never recommended and has been proven to worsen the condition of the patient when abused. Some opiate side effects that can occur can be mild to life-threatening even without overdosing.

Physical Effects of Opioids on the Body

The effects of opiates on the body can range from barely noticeable to fatal.

  • Nausea
  • Vomiting
  • Dizziness
  • Confusion
  • Opioid effects on the body can cause reduced motor coordination or loss of motor function

Extended use of opioids can produce additional effects such as:

  • Reduced breathing capacity
  • Hormonal imbalances
  • Lowered immune system efficiency
  • Slowed breathing rates
  • Cardiac arrest

 

Psychological Opioids Effects on the Brain

The psychological impact on cerebral function is immense. A 2016 study in the Annals of Family Medicine found that about 10 percent of people prescribed opioids developed depression after a month of taking the drugs.

 

Extreme caution is advised for individuals with mental health disorders or those who believe they might have a mental health disorder such as anxiety or depression. While the use of opioids can produce a short term euphoric experience, the longer they are in use by people who have mental health disorders- the worse their disorder can become. Some of the effects of the opiate on the brain can last for months or years after discontinuing use. Mental health disturbances can be directly linked to opioid effects on the brain especially from developing dependence and addiction to the substances over time.

 

How Long Do Opioids Stay in Your System?

Akin to many altering substances, several elements can contribute to the length of time that traces of narcotics can last in the body. While some of these factors can be manipulated by personal usage habits, most of these elements are directly linked to bodily function. The amount of time that opioids stay in your system will depend on several factors including:

  • The dosage that is prescribed.
  • How often the opioid is being used.
  • Whether there is low or high dosage use.
  • The method of opioid administration into the body? Injection, oral, or other forms of opioid use.
  • The age of the substance user and the ability of their body to process the drugs.
  • Individual metabolic rate and processing functions of the liver, kidneys, and other organs.
  • The overall health of the user’s liver and kidneys or the lack thereof.

As one can see there are many elements that factor in when asking,  “how long do opioids stay in your system?” The answer to this question greatly varies and can become even more complicated when different drug testing systems are used. Detection times vary for various types of drug tests. For example:

How Long Do Opiates Stay in Your Blood?

While blood testing for opioids is less common, the answer to the question “ How long do opiates stay in blood” can vary. Blood tests for opioids may detect traces of opioids in a 2 to 12-hour window. Metabolites can be detected in the blood slightly longer. Attempting to flush one’s system with fluids and by other means will not work to eliminate opioids from the bloodstream. Time is the only true method to the elimination of opioids from the body.

How Long Do Opiates Stay in Your Urine?

One of the most common questions asked is “ How long do opiates stay in urine?” or “How long do opioids stay in urine?” Urine drug tests are the most common form of drug testing and are used all across the country to detect substance abuse. Many employees are mandated to take drug tests at random or prior to employment and often wonder, “How long do opiates stay in your urine.” Traces of opioids can last in urine up to 5 days after the last use of opioids.  However, metabolites are detected for slightly longer and may be present in urine tests for up to two weeks depending on the frequency of use and the amount taken.

How Long Do Opiates Stay in Your Hair?

The chemical composition of opioids can remain in hair follicles for a long time. To answer the question of, “how long do opioids stay in your hair,” we must think about the average hair follicle drug testing. Most hair follicle tests can detect opioids for about 3 months, but in some cases follicle tests can detect opioid use for even longer than that. If you’re concerned about opioid use and the detection of opioids on a drug test, it may be time to consider a greater problem. You could be suffering from opioid addiction.

If you or someone you know is struggling with opioid addiction, call our admissions department at 833-397-3422 to learn more about the opioid addiction treatment options available at our Florida drug rehab center.

How Long Do Opiates Stay in Your Saliva?

The amount of time that opioids can be detected in your saliva can vary. Opioid saliva tests may vary from person to person based on various factors associated with the method of use and metabolism. However, opioids can be detected in saliva very soon after use and generally for up to 96 hours.

 

How Long Do Opiates Stay In Your System While Pregnant?

It is seldom recommended to use opioids while pregnant or breast-feeding. So when one might ask, “How long do opiates stay in your system while pregnant,” there really is no exact figure to the time-frame that traces of opioid usage can be detected after discontinued use. Opioids are easily absorbed by the growing fetus and can cause birth defects or preterm labor. Post-partum, the lasting effects of opioids in breast milk are dependent on two elements: the mother’s body chemistry and metabolism and the dosage of opioids being consumed. Every substance that a mother consumes has the potential to be absorbed and transferred to her child by breastfeeding. This is an incredibly high risk to take.

 

Why Are Opioids So Addictive?

The never-ending question is, why are opioids so addictive?

Opioids are narcotics. It is widely accepted that narcotics are frequently addictive substances. Narcotics have the power to turn people with no substance abuse history or usage into active drug users. But besides the fact that opioids are narcotics, they cause addiction because they evoke chemical changes in the brain that result in distinct reactions.

Are opioids addictive even after one use? The answer is, sometimes. Although, addiction rarely forms after a single-use, it’s the repeated use that leads to physical dependence and subsequent addiction to opioids. When an opioid is used the brain’s neurotransmitters release endorphins into the body. This creates an overwhelmingly positive experience for the user while eliminating the feeling of pain. The absence of pain in the body and waves of euphoria and pleasure can be incredibly difficult to turn down, especially for someone that has an addictive nature. This may leave the user with an insatiable craving for more. After each dose of an opioid, the potential for cravings and dependence becomes stronger and more intense.

If you or someone you love struggles with opioid addiction, or if you believe you are misusing your opioid prescription, call our admissions team at 833-397-3422 to discuss treatment options.

 

References

Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008, October). Opioids and the treatment of chronic pain: controversies, current status, and future directions. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2711509/

 

Sciences, N. A. of, Engineering, & Medicine, and. (2017, July 13). Trends in Opioid Use, Harms, and Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK458661/

 

National Institute on Drug Abuse. (2020, April 17). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis#five

 

Davis, M. A., Lin, L. A., Liu, H., & Sites, B. D. (2017, July 1). Prescription Opioid Use among Adults with Mental Health Disorders in the United States. Retrieved from https://www.jabfm.org/content/30/4/407

 

CDC Guideline for Prescribing Opioids for Chronic Pain. (2019, August 28). Retrieved from https://www.cdc.gov/drugoverdose/prescribing/guideline.html

 

Scherrer, J. F., Salas, J., Stock, E. M., Ahmedani, B. K., Sullivan, M. D., Burroughs, T., … Laurel A. Copeland. (n.d.). Jeffrey F. Scherrer. Retrieved from http://www.annfammed.org/content/14/1/54

 

Weiss, R. D., Potter, J. S., Griffin, M. L., McHugh, R. K., Haller, D., Jacobs, P., … Rosen, K. D. (2014, August). Reasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074437/

 

Understanding the Epidemic. (2020, March 19). Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html

 

Sciences, N. A. of, Engineering, & Medicine, and. (2017, July 13). Trends in Opioid Use, Harms, and Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK458661/