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