What Are Opioids? Understanding Their Effects, Risks, and Addiction

The pain racks through your body. It’s been two months since your car accident at the hands of a drunk driver, forcing you into the O.R where they had to perform surgery on your neck to replace the damaged disc.

The pain never seems to stop, and your Vicodin script is the only thing keeping you sane. You pop a pill, and for the next few hours you don’t have to worry about your neck.

Millions of Americans deal with a similar scenario where they’re using opioids to manage pain. These drugs are incredibly effective at blocking pain signals to the brain by attaching to opioid receptors in the brain, creating an analgesic response that dampens all types of pain.

Without hydrocodone, oxymorphone, and other opioids, there would be a lot more suffering in the world.

But despite the medical need for these drugs, they have a much, much darker side.

Misuse and abuse of these drugs is rife in communities across the United States and almost everyone you know probably has a story of addiction to prescription opioids—or knows someone who’s struggled with opioid-related SUD.

With street drugs like fentanyl being readily available in open-air drugs markets in sanctuary states, and in black markets across the country, more people find themselves lost in the despair of opioid addiction.

Opioids 101 – Understanding the Origins of the Opioid Crisis

But what are opioids exactly? These Schedule II narcotics are tightly controlled by the FDA and DEA—at least at a medical level. While regulators monitor the prescribing of opioid medications, there’s still plenty of room for error and corrupt doctors to overprescribe these medications.

While “Pain Clinics” were everywhere in Florida a few years ago, the crackdown on these businesses, which were practically legal drug dealers, took a lot of sources away from people misusing and abusing these meds. As a result, people who couldn’t afford a script or who weren’t eligible for a refill because they had finished their prescription to soon, found themselves sourcing black market drugs.

The crackdown took away these sources of pharma-grade pills, forcing patients to find street dealers for illicit black-market pills. Around 2015, fentanyl came onto the scene, imported from China, flooding the streets with this synthetic opioid. It was super affordable compared to opioids like heroin, and way more potent.

We all know the rest of the story. Fentanyl slowly crept into the black-market drug supply, landing up in everything from heroin to cocaine, to counterfeit prescription meds. What followed was the biggest public health crisis ever facing Americans, with opioid overdose becoming the number one cause of death in Americans aged 18 to 45.

Understanding Opioids – What are They?

Opioids are synthetic versions of opiates, which are naturally derived from poppies grown in Asian regions like Afghanistan and Myanmar. Codeine and morphine are examples of opiate medications commonly used in medical treatments. Opiates, like opioids, have tremendous potential for misuse and abuse, and eventual action to these drugs.

A good example is codeine-based cough mixture, commonly called “Lean” or “Drank.” This red or purple cough syrup became a popular drug in the 2010s due to its infiltration into the hip hop community, and its abuse by Artists like Lil Wayne.

Next we have semi-synthetic opioids like heroin or oxycodone which are opiates chemically modified during the manufacturing process. We all know the story of the Oxycontin addiction epidemic in the early 2000s leading into the 2010s before fentanyl arrived in America on large scale.

Then we have fully synthetic opioids like methadone, fentanyl, and its analogs. These drugs are manufactured from chemical precursors and don’t contain any natural opiates. However, they have the same mechanism of action in the body, binding to opioid receptors to blunt the pain response.

Understanding the Difference Between Medical vs. Illicit Opioids

We’ve already touched on this slightly when we discussed the progression of the opioid crisis in America but let’s unpack it in greater detail in this section. 

OxyContin was the first opioid painkiller brand to experience massive commercial success, partly thanks to the massive marketing campaign Purdue Pharma—the drugs manufacturer—and partly due to corrupt medical officials and doctors overprescribing these drugs.

But oxycodone wasn’t the only drug responsible for driving the opioid crisis. Brand name drugs like Vicodin (hydrocodone) and Percocet (also oxycodone) also made huge inroads into communities across America, causing addiction in millions of households.

Medical-grade opioids used for filling prescriptions can cause abuse and addiction, but they do have one upside—you know what you’re getting. There’s no chance of cross-contamination in the manufacturing process because these drug companies adhere to ISO manufacturing processes and regulations that tightly control the production and distribution of these drugs.

While prescription meds were the primary driver of the opioid crisis, the rise of counterfeit synthetics imported into the US from Mexico and China slowly replaced the market share of prescription drugs in the black market.

This happened slowly from around 2012 through to 2015, and by 2017 it was causing nearly 50,000 overdose deaths a year. The data from 2022 shows that the situation isn’t improving, with more than 84,000 opioid-related overdose deaths. 

In 2024, it seems that this trend is starting to scale back. Data from 2023 shows a decline in the mortality rate, with opioid overdose deaths scaling back to the 81,000 mark—but that’s still a huge amount of people perishing every year from these highly dangerous substances.

How Do Opioids Affect Our Physiology?

So now that we know what opioids are and how they became a problematic addiction public health crisis, it’s time to move on to get a better understanding of how they work in the body, the effects they have when used, misused, and abused, and the health risks involved with addiction to these toxic substances.

The most commonly abused opioids in the US are in tablet form. While prescription medications used to dominate this area, the flood of counterfeit pills from Mexico have saturated the market to an extent that they are now the leading supply.

Unfortunately, these counterfeits rarely include the Xanax or Valium they promise. Instead, they’re contaminated with fentanyl. Unsuspecting users thinking they’re scoring some Alprazolam are actually receiving fentanyl-laced pills, causing a massive uptick in overdoses across the US, especially in California.

Fentanyl is also available in pill form, but users will grind or grate these pills into powder and either snort it or inject it intravenously. When users can’t find sources of opiates like heroin, they may turn to fentanyl for relief. Unfortunately, fentanyl is 50 times more potent than heroin and 100 times stronger than morphine in its actions on the brain and nervous system.

When a user consumes an opioid-based drug, whether it’s in pill, powder, or injectable format, they feel the onset of the medications analgesic effects, with a wave of relaxation and euphoria sweeping over them. As the drug reaches peak serum levels in the blood it sedates the mind leading to feelings of pleasure and.

Opioids bind to opioid receptors in the spinal cord and brain where they provide relief from pain for four to six hours before the patient needs another dose. These drugs release the chemical neurotransmitter dopamine in the brain, which is the chemical responsible for causing the addictive, compulsive behavior of the addict as they chase their next high.

Unfortunately, the body builds a tolerance to the dose, and the user will continually up their dose as their addiction progresses. A newbie addict using the same dose as a seasoned user would likely experience an overdose because their body can’t handle the high dose.

Since black market fentanyl isn’t regulated at a manufacturing level, there’s no consistency between batches produced by the Mexican cartels, and some batches might be stronger than others, resulting in overdose even if the addict uses the same dose they normally use.

The Harrowing Risks of Opioid Abuse and Addiction

Opioid addiction ruins countless lives every day, and a trip through Kensington Road in Philadelphia or Skid Row in LA reveals the extent of the problem and how these drugs are tearing apart communities across the United States. People lost in the desperate cycle of despair caused by addiction to opioids are everywhere in these areas, with addicts swaying in a drugged stupor on every street corner.

No one starts off using opioids with the intention of becoming an addict. So, how is it that so many people end up addicted to these drugs? The answer lies in the compounds “half-=life.” The half life of the drug is the time it takes for half of the dose to clear your body. This is typically when the patient using the opioid medication will need to look at taking their next dose.

When opioids, specifically OxyContin, arrived on the market in the late 1990s and early 2000s, doctors were instructed that the medication had up to an 8-hour half life, when in reality the half life of these medications was anywhere from three to seven hours.

The issue with this misinterpretation of efficacy results in the patient using more medication than they should during the day to fight off pain symptoms. So, instead of taking three to four pills a day, the patient would be taking six or more.

We already talked about how opioids cause the body to develop a tolerance against the medication. This effect of diminishing returns combined with the addictive properties of the drug meant patients needed to resort to black market sources to top up their script early when their doctor wouldn’t write them another prescription.

So, it’s just a matter of time before the patient makes their transition from patient to addict. As the patient continues their now “abuse” of the medication, they find themselves being drawn deeper and deeper into the addiction cycle to a point where they become powerless to control it and end up chasing their next high, doing anything they need to in order to source their next dose.

As use increases, so does overdose risk, either from taking too much—inadvertently or intentionally—or from receiving laced pills or other street drugs. Opioid drugs bind to the opioid receptors and as they do they suppress the nervous system, leading to shallow breathing and a life-threatening condition called respiratory depression, where the patient eventually stops breathing and passes away.

The only way to bring the patient back is by giving them a dose of Naloxone, known by its brand name “Narcan.” This medication reverses the effect and brings the person back, provided they get it in time.

Wrapping Up – Inpatient Treatment Programs for Opioid Dependence

Opioid addiction is impossible to quit on your own. The withdrawal symptoms are too much for any human to bear, and you’ll probably just end up relapsing if you try to break the addiction cycle and recover at home. If you’re addicted to opioids, you need professional help.

An inpatient recovery program is your best chance at getting clean. You’ll check into a facility and remain under the care of medical professionals until you get clean and feel ready to return to society.

When you enter the inpatient program you go though a medical detox to stop you from feeling the full effects of the withdrawal. It doesn’t take away all of the addiction symptoms but it makes it much more easier to manage.

Your inpatient program involves intensive daily therapy sessions and you’ll work with a licensed therapist in individual and group settings, using evidence-based therapies to help you develop coping strategies. Inpatient programs provide a holistic recovery, meaning they focus on getting you clean, giving you counseling, and improving your health. You’ll learn how to eat right to support your recovery, how to exercise, and how to implement coping strategies like mindfulness when you experience triggers that tempt you to relapse.

An inpatient program is the only successful way to escape the grip of opioid addiction and return to a sober lifestyle. If you need help, or you have a loved one struggling with opioid addiction, reach out to our team and we’ll discuss how we can help.