Opioid Drugs

July 21, 2017 | Cameron, Russell E., MD


Shown are examples of several opioids that can be prescribed from a pharmacy.

Opioid drugs are mentioned in the news a lot and not in a good way. Many times, the stories are about addictions and even deaths attributed to the abuse of opioids.
 
The name opioid can be used to refer to various types of drugs which can be confusing – especially if you are prescribed an opioid by a healthcare provider that you trust.

 
What are opioids?

“Opioids” is the name of a class of drugs used to reduce pain, according to Dr. Russell Cameron, chief informatics officer and interim chief medical officer at Penn Highlands Healthcare and chief medical officer of Penn Highlands DuBois.
 
There are three types of opioids that have been in the media spotlight lately. They are prescription opioids, fentanyl and its relatives, such as carfentanyl, and heroin.

 
Prescription opioids

Prescription opioids are prescribed by providers to treat moderate to severe pain – especially after a medical procedure or injury.  Some common medications that are in this category are oxycodone or OxyContin, hydrocodone or Vicodin, codeine and methadone.
 
When used properly, prescription opioids relieve pain so a person can rest or function in daily life.  Sometimes, they are used at end-of-life for patients who are suffering.
 
These medications are intended for short-term use, but they have been prescribed for some to control their chronic pain. For those who take prescription opioids for a long-period of time, their bodies can build up a tolerance, and the amount needed to achieve the same pain relief may need to be increased.  It can also cause a physical dependence when used for a period of time.  
 
Before taking opioid medications for chronic pain, patients and physicians should discuss pain treatment options that do not require prescription drugs. Patients should also tell their physicians about past and current drug and alcohol use, and discuss all the risks and benefits of the prescriptions.
 
Side effects of opioid use include constipation, nausea, vomiting, dry mouth, sleepiness, dizziness, confusion, depression, low-energy, itching and sweating, according to the Centers for Disease Control.
 
In Pennsylvania, the state Office of the Attorney General with help of the state Department of Health has created the Prescription Drug Monitoring Program, or PDMP. All healthcare providers in Pennsylvania, including Penn Highlands Healthcare, are mandated to use the PDMP to input information via a computer program on all prescriptions issued for controlled substances, including opioids. Penn Highlands also follows the CDC’s guidelines and monitors patients with extra assessments, more frequent office visits and urine testing.

 
Fentanyl

Another type of opioid is fentanyl. Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. 
More powerful than other opioids, it is approved for treating severe pain for some cancer patients.  It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse.
 
Carfentanil is similar in make-up to Fentanyl, but is 100 times more potent and is sometimes used to tranquilize elephants.  
 
Both can be made illegally which leads to addictions. “Synthetic opioid death rates (other than methadone) increased across all demographics, regions and numerous states,” the CDC said.
 
Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl and carfentanyl, can cause breathing to stop completely, which can lead to death. The high potency greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl or a similar drug. Fentanyl and carfentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers. It is also colorless and odorless, so those who ingest it may never know it’s there.

 
Heroin

Heroin is an illegal drug, and it is considered an opioid, too. It is made from morphine, a natural substance taken from the seed pod of the Asian opium poppy plant. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. It is usually injected but it is also smoked and snorted, too.
 
Heroin is highly addictive. It has a high risk of overdose and death for uses.  Side effects of long-term use include collapsed veins, infection of the heart lining and valves, abscesses, constipation and stomach cramping, liver or kidney disease, lung complications and various types of pneumonia.
 
Those who abuse prescription opioid drugs are more likely to turn to heroin because of cost and no legal paper trails. Nearly 80 percent of Americans using heroin reported misusing prescription opioids prior to using heroin.  But only a small fraction of people who misuse pain relievers ever switch to heroin. According to a national survey, less than 4 percent of people who had misused prescription pain medicines started using heroin within five years, the National Institute on Drug Abuse said.

 
Education

The best prevention to drug abuse is education – for everyone.  No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental and developmental factors influences risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction.  
 
Drug addiction is complex and drugs change the brain making quitting hard. But drug addiction is treatable and can be successfully managed. Teachers, parents and healthcare providers have crucial roles in educating young people and preventing drug use and addiction.
 
For help in finding drug treatment programs, Penn Highlands encourages anyone who is having a problem to seek help by calling the state helpline at 1-800-662-4357.


Experts

Doctor Photo

Cameron, Russell E., MD

Specialties

Emergency Medicine

Locations

Emergency Department - Brookville

Emergency Department - DuBois

Emergency Department- Elk