Opioids are prescription drugs which are prescribed by the doctor as pain killer. They also affect the areas of the brain that control emotions, which can further decrease the effects of painful stimuli. They have been used for years to cure pain, cough, and diarrhea. The most common current use of opioids is the treatment of acute pain. However, since the 1990s they have increasingly been used to treat chronic pain despite little evidence of their efficacy when used long-term. In fact, in some patient’s opioid treatment worsens pain or increases sensitivity to pain, a phenomenon known as hyperalgesia.
Opioids prescription drug include hydrocodone (e.g. Vicodin ® ), oxycodone (eg OxyContin ® or Percocet ® ), oxymorphone (eg Opana ® ), morphine (eg, Kadian ® or Avinza ® ), codeine and fentanyl , among others. Hydrocodone products are the most commonly prescribed in the United States for a variety of symptoms, including pain related to dental procedures and injuries. Oxycodone and oxymorphone are also prescribed to relieve moderate to severe pain. Morphine is often used before and after surgery to relieve severe pain, and codeine is usually prescribed for milder pain.
What effects do opioids have on the brain and body?
Opioids bind to and activate opioid receptor proteins. These receptors are found in neurons, the spinal cord, the gastrointestinal tract, and other organs in the body. When these drugs bind to their receptors, they inhibit the transmission of pain signals. Opioids can also cause lethargy, mental confusion, nausea, constipation, and respiratory depression, and because these drugs also act on regions of the brain that are involved in the reward system, they can induce euphoria, particularly when taken in higher doses than directed. or they are administered differently than originally intended. For example, OxyContin ®is an oral medication used to treat moderate to severe pain through the slow and steady release of the opioid. Some people who abuse OxyContin ® intensify the experience by snorting or injecting the medicine. This is a very dangerous practice that greatly increases the risk of serious medical complications, including overdose.
Overdose is another major hazard from opioids because these compounds also interact with parts of the brain stem that control breathing. Taking too much of an opioid can suppress a person’s breathing to the point of suffocation. An overdose can be reversed (thus preventing death) by rapidly administering the compound naloxone (see ” Reversing an Opioid Overdose with Naloxone “).
An important factor is that, in addition to relieving pain, opioids also activate the reward regions of the brain, causing a state of euphoria or “high.” This euphoria is what creates the possibility of abuse or a drug use disorder. From a chemical point of view, these drugs are very similar to heroin, which was originally synthesized as a drug from morphine in the late 1800s. These properties make these medications increase the risk of creating a drug use disorder, even in patients who take them as prescribed by the doctor.