Understanding Opioids | How They Work & What They're Used For

If you’ve ever had surgery or experienced an accident, you’ve probably used a prescription opioid pain reliever like OxyContin, Vicodin, or Percocet for a short period of time.

But while opioid drugs play a critically important role in modern medical care, they’re widely abused and highly addictive.

Opioid/Opiate Background

Opiates are natural compounds extracted from the opium poppy, which are able to bind to opioid receptors in the brain to reduce feelings of pain or trigger strong sensations of euphoria.

Opium, a natural substance containing a mix of several natural opiate compounds, has been used by human cultures since ancient times. In the modern period, opioids have been used as a springboard in the creation of a variety of semi- and fully synthetic opioids.

While these drugs are all related to opium on a chemical level and work in the same general manner, they vary greatly in terms of potency, length of effect, and medical use.

Common Opioids

Opioids are considered controlled substances and should only be used with a prescription from a licensed healthcare provider.

Common opioids, ranked by increasing potency, include:

• codeine
• meperidine
• tramadol
• morphine
• hydrocodone
• oxycodone
• methadone
• heroin (illegal in the United States)
• hydromorphone
• oxymorphone
• buprenorphine
• fentanyl

How Opioids Work

When you take an opioid, it spreads across your body and binds to opioid receptors located on nerve cells throughout your nervous system, including your spinal column and brain.

These opioid receptors usually interact with your own endogenous opioids (endorphins), which provide normal, healthy feelings of pleasure and wellness.

Opioid drugs, however, are far stronger than endogenous opioids and can completely block pain messages that would otherwise be sent along your neurons from your spinal cord to your brain.

They also slow down your neurotransmitter activity as a whole, which can lead to side-effects including:

• dizziness
• nausea
• vomiting
• constipation
• reduced heart rate
• reduced libido
• low blood pressure
• slowed breathing
• cloudy thoughts

Opioid Uses

In therapeutic use, opioid medications are used primarily as analgesics (pain medications) with secondary effects including anesthesia (reducing awareness and sensation), sedation (lethargy or drowsiness), and anxiolysis (anxiety relief).

More specifically, opioids are prescribed for severe pain management during surgery and during post-surgical recovery, as well as the treatment of chronic pain and mild, moderate, or severe pain following an injury.

Certain opioids may also be used for cough suppression, to treat diarrhea, or to treat opioid use disorder (addiction) through medication-assisted treatment (MAT).

Opioid Abuse & Addiction

When abused in higher doses without a medical necessity, opioids can trigger a rush of dopamine in the brain and a euphoric high, as well as an increased risk of opioid addiction and overdose.

Opioid Dependence

The longer you take a particular opioid, the more likely your body is to adjust your internal chemistry to minimize the drug’s effects. This results in tolerance, as the same dose of the same drug will naturally have less and less effect over time.

While dependence can and does develop with therapeutic use, it tends to form much faster when drugs are being abused in order to get high.

Opioid Withdrawal

After dependence forms, any attempt to cut back or stop taking the drug will lead to withdrawal symptoms as your body’s new internal balance is once again thrown off-balance.

Opioid withdrawal symptoms can include:

• agitation
• anxiety
• muscle aches
• insomnia
• runny nose
• sweating
• yawning
• cramping
• diarrhea
• dilated pupils
• goosebumps
• nausea and vomiting
• drug cravings

Opioid Use Disorder

While dependence and addiction are related, they are not the same. Opioid addiction, formally referred to as opioid use disorder, occurs when your use of opioids spirals out of control and the drug use that once felt pleasurable now feels like something you can’t live without.

Signs and symptoms of opioid use disorder can include:

• drug cravings and compulsions
• drug-seeking behavior
• increasing dosage or frequency of use
• personality and behavioral changes
• decline in personal hygiene and nutrition
• social withdrawal and isolation
• relational and financial difficulties

Opioid Overdose

At high doses, the effects of opioids on the body can be life-threatening, as opioids are able to slow physical and mental activity to the point that life-saving functions, like breathing, begin to fail.

Signs and symptoms of opioid overdoses can include:

• pinpoint pupils
• unresponsiveness or loss of consciousness
• slowed, shallow, or stopped breathing
• gasping, snoring, or gurgling sounds
• cold clammy skin
• blue-colored lips or fingernails

If you suspect an overdose has occurred, call emergency services as quickly as possible. Opioid overdoses can be reversed with the antidote naloxone if it is administered quickly enough.

If you or a close family member lives with prescription drug addiction or opioid use disorder, contact Northeast Addictions Treatment Center to learn how we can help.