Opioid is the general term for a narcotic derived, ultimately, from the opium poppy. Opiates are natural opioids. Some of these drugs are prescribed to control pain while others, such as heroin, are illegal. All of them are similar in that they lock into receptors in the central nervous system, which is made up of the brain and the spinal cord.
Opioids can be problematic because along with pain relief many of them cause an intense euphoria when they are taken. This can lead to dependence and addiction. People can overdose on opioids, though the symptoms can be reversed by taking an opioid antagonist called naloxone. Naloxone also locks into opioid receptors, but it doesn’t produce the euphoria associated with opioids such as heroin. Here are some opioids:
Heroin or diamorphine is a synthetic opioid made from morphine, which is an opiate. Though it was created as a pain reliever by the same people who developed aspirin, heroin is now illegal. When it is pure, it is a white powder, though as a street drug it is rarely used in its pure form. It is snorted, smoked or injected. A type of heroin called black tar resembles asphalt and gets its color from the impurities that remain after it’s been processed.
The drug can easily pass through the blood-brain barrier, a physiological system that usually protects the brain from toxins. Once there, the body converts heroin into morphine, which then binds to mu-opioid receptors. The person feels a rush that can be very intense and may be accompanied by nausea and vomiting. After the rush, the person grows drowsy and “nods off.” Other initial effects of heroin are:
• Reduced mental function
• Slowed heart rate
• Slowed breathing
These symptoms appear because heroin, like all opioids, is a central nervous system depressant. A person who takes too much heroin can die if their breathing and heart rate are drastically slowed down by the drug.
Unlike heroin, fentanyl is legal but strictly controlled. Like other opioids, it is prescribed for pain. It is also 80 to 100 times stronger than morphine. An analog of fentanyl, carfentanil, is 100 times stronger than fentanyl. Both are used to ease the pain of end-stage cancer. Like heroin, dependency can develop with fentanyl, especially if the person takes it for a long time. Unlike heroin, it is not injected or snorted, but comes in the form of a tablet placed under the tongue, a film placed on the skin, a lozenge meant to dissolve slowly between the patient’s gum and cheek or a lollipop. A patient who is taking fentanyl must be monitored by and work closely with their doctor.
A person who is on fentanyl should not drink grapefruit juice or eat grapefruit. This is true if the patient is using any type of opioid, because grapefruit has a chemical that stops the body from metabolizing opioids. This intensifies the effect of the drug and can lead to sudden death even if the fruit or the juice is taken hours after the person has taken their opioid drug.
Methadone is also a legal opioid, but it is different from the others in that it is used to wean a patient from their dependency on another opioid. It can only be prescribed through an opioid treatment program, or OTP that is certified by the Substance Abuse and Mental Health Services Administration. Methadone is also used to treat pain, including the pain of withdrawal from other opioids such as heroin. It is taken once a day as a pill, a liquid or a wafer under a doctor’s supervision and at a dosage that is tailored to the needs of the patient. Many patients need to go to a clinic to take their dose of methadone if they are using it to quit another opioid. When they are seen to be reliable and stable, they can take the drug home with them.
Like other opioids, a person can become addicted to methadone, so it is crucial that they take it exactly as their doctor prescribed. This is especially true of patients who can take the drug home with them.
There are many other types of opioids, including hydromorphone, hydrocodone, oxymorphone and codeine. They are powerful, pain-killing drugs that have made the lives of many patients bearable, but the risk of abusing and even dying from these drugs is considerable if they are misused. If you feel you have a problem with opioids, don’t hesitate to call us today. Our counselors are available 24 hours a day, seven days a week. Call us at 123-456-7890.