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What is an Opioid?

An Opioid is a chemical substance that has a morphine like action in the body. Opioid's can be classified as natrual, semi-synthetic, and fully-synthetic.

Natural opioid's include morphine, codeine, thebaine, and oripavine. Semi-sythetic opioids include hydromorphone, hydrocodone, oxycodone, and heroin. Fully-synthetic opioids include fentanyl, pethidine, methadone, and propoxyphene.

Opioid's bind to specific opioid receptors in the central nervous system and in other tissues.

Medical Usage

Opioids are medications that are derived from opium, which is collected from the seed pods of opium poppies. Many synthetic, or man-made, opioids are also available, as are semi-synthetics, which are made by changing the chemical structure of opium.

Opioid medications, also known as narcotics, are most commonly used to treat moderate to severe pain. Some less-potent forms are also used to treat conditions like coughing or diarrhea. They can come in a variety of forms, from tablets and capsules to patches, injectables and suppositories. Some commonly prescribed medications that fall into this category include:

  • Morphine, also known as MS Contin or Kadian
  • Oxycodone, found in Percocet and Percodan and Oxycontin
  • Codeine, found in Tylenol #3 and many prescription cough syrups
  • Hydromorphone, known as Dilaudid
  • Fentanyl, also known as Duragesic in its patch form and Actiq as a transmucosal lozenge
  • Hydrocodone, found in Vicodin and Lortab
  • Methadone, a potent pain killer that is also used to treat heroin addiction
  • Meperidine, also known as Demerol

Opioids at Work

Opioids work in the body by attaching to the opioid receptors. These receptors are found in the gastrointestinal tract, along the spinal cord and in the brain. The body stops perceiving pain when these receptors are blocked.

Another effect of opioids is the feeling of euphoria that is often associated with them. Many people abuse opioid medications specifically to get this feeling and opioid addiction is a severe problem. It is estimated that approximately 9 percent of people have used opioid medications for a purpose other than the intended one.

Many people who abuse opioids are unaware of the dangers these medications can pose. Opioids are nervous system depressants. This means that they slow down many of the body's normal functions, including breathing. This can be extremely dangerous, especially when the medication is used in people who already have decreased respiratory function, or when mixed with other medications or alcohol. The symptoms of an opioid overdose include breathing that is slow and shallow, skin that has a bluish tone, coma or even death. Pregnant women who use opioid medications run the risk of delivering the baby prematurely or giving birth to an addicted infant who must go through the painful and dangerous process of withdrawal.

Opioid Side Effects

Opioids have many other side effects, other than the feeling of euphoria. They are often known to cause constipation and people who take long-acting or timed-release forms of the medications, such as Oxycontin, MS Contin and fentanyl patches are often prescribed a stool softener alongside to keep this side effect from creating a problem. Other common side effects are a loss of sex drive, irregularities in the menstrual cycle and mood swings.

Opioid Withdrawls

Opioid medications taken over a long period of time or for a chronic condition also have the effect of making the body become dependent on them. When this happens, even if it does not lead to addiction, the body experiences withdrawal symptoms. These symptoms can be severe and dangerous. Some of the symptoms found during withdrawal from opioids include:

  • Edginess and anxiety
  • Weepiness
  • Diarrhea
  • Cramping
  • Cravings
  • Insomnia
  • Muscle aches
  • Flu-like symptoms
  • Nausea and vomiting

It generally takes regular use over time before a person becomes physically dependent on the medication, but there is no set time. It's completely dependent on the individual and several other factors, such as which medication is being taken, the strength of the medication, how accustomed the patient is to taking opioid medications and the route of administration.

As the body becomes more accustomed to the drug, the patient will find that more and more medication is required to help achieve the same effect. It can be a fine line for the doctor and patient to walk, as they try to use enough medication to effectively control the pain, while keeping physical dependence to a minimum. There is no reason, however, for a patient to suffer unduly. Part of a doctor's job is to keep pain under control. If this means higher doses of opioid drugs, this should be done and the physical dependence aspect can be dealt with later.

A doctor who has prescribed opioids to treat a temporary condition, for example pain following surgery, will help the patient slowly wean down from the medication to prevent these withdrawal symptoms from becoming troublesome. Often, other medications, such as clonidine -- a medication normally used to treat blood pressure -- are used to help the patient manage symptoms.

Sources:

http://www.nida.nih.gov/researchreports/prescription/prescription2.html

http://www.camh.net/About_Addiction_Mental_Health/Drug_and_Addiction_Information/opioids_dyk.html

http://www.nlm.nih.gov/medlineplus/ency/article/000949.htm

Learn More About Opioid's:

Wikipedia

FamilyDoctor.org

American Association for the Treatment of Opioid Dependence