What Are Prescription Opioids?

Prescription Opioids are legal Opioid pain relievers, (OPRs), that can be given to patients suffering from mild to severe, ongoing pain. With a wide variation in strengths, from Codeine to Oxycodone, they’ve become the gold standard of pain relief since the 1990s. However, their addictive potential has caused much harm and duress to individuals and their families. It is these Prescription Opioids that are at the root of our nation’s current Opioid Epidemic and the growing abuse of Heroin.

Opioids have been used for their pain-relieving effects for hundreds of years, starting with Opium. Their effectiveness is due to their similarity in structure to our bodies’ naturally produced endorphins. Because of this, they bind to the body’s natural Opioid receptors in the brain, spinal cord, and other organs. Binding to these receptors, originally meant for our endorphins, causes large amounts of dopamine to be released through the body. This is what dulls pain, causes euphoria, and makes the drugs so addictive. This discovery started a chain of events that eventually led to the invention of Prescription Opioids.

Common Prescription Opioids

In the US, there is a long list of OPRs that can be prescribed for any amount of physical pain. From a common cold to terminal illness, pharmaceutical companies have developed a wide range of natural and synthetic Prescription Opioids. At one point, Codeine was even available without a prescription. However, as of 2018, with our nation facing the worst Opioid crisis it has ever seen, stricter regulations have fallen down to protect people from the addictive effects of these prescription drugs. Pain killers like:

Demerol
Used to treat moderate to severe pain, Demerol is an extremely potent Opioid that is taken in large doses. Typically used to treat people who are in intense pain or post-surgery.
Tramadol
Tramadol is a relatively weak Opioid in comparison to the others that are available. It is the only prescribed Opioid on the market that is a Schedule IV by the DEA. Its greatest risk is that it is more common to be prescribed in the long term, meaning that it provides a greater window for people to become addicted.
Codeine
Once available in over-the-counter cough syrup, Codeine was prescribed less for pain, and more for its ability as a cough suppressant. Today, it is considered the “gold standard” of cough suppressant. With the Opioid Epidemic, however, use of Codeine has become a lot stricter.
Morphine
Morphine is the original Opioid used in pain relief. It is naturally occurring and abundant in the opium poppy. It is the basis of what all other opioids are formed off of. While it was once the most common painkiller found in hospitals, it has now been replaced in popularity by synthetic opiates that can be both weaker and stronger depending on the need.
Hydrocodone
Hydrocodone is roughly equivalent in strength to Morphine. Commonly prescribed after dental surgeries, it is considered as a painkiller for people suffering from severe pain.
Oxycodone
Used to treat severe pain, Oxycodone has become one of the most abused prescription drugs in the nation. It has been pushed and overprescribed across the country, particularly from Purdue Pharma, creator of OxyContin.
Dilaudid
Dilaudid was designed to help patients deal with severe pain. Its potency is greater than Oxycodone, which makes it highly addictive. It even provides a greater sense of euphoria than other commonly abused Opioids.
Methadone
Methadone is a potent Prescription Opioid used to treat Heroin addiction. Its potency makes it a viable option for someone who is experiencing the symptoms of withdrawal and cravings. While this Prescription Opioid sounds good, it is addictive in its own right, and people who are suffering withdrawal from one drug are more likely to become addicted to Methadone. That is why it must only ever be taken under a doctor’s supervision.
Buprenorphine
Like Methadone, Buprenorphine is an Opioid used for easing symptoms of withdrawal. It is most commonly prescribed in combination with Naloxone in the form of Suboxone. This produces less addictive effects and blocks a person from feeling the effects of euphoria if they relapse.
Fentanyl
Fentanyl is currently the strongest, legal Prescription Opioid in the US. It is only ever prescribed in low doses as a transdermal patch or lozenge. This patch can deliver traces of Fentanyl over time and keep someone from taking too much. That being said, clandestine labs across the world are producing synthetic Fentanyl that is being sold in the US. This is often the cause of overdoses seen on the news.

According to the CDC, Prescription Opioids were responsible for over 40% of all Opioid overdose deaths in the US in 2016. Technically, yes, that is the minority. However, there is more data from the National Institute on Drug Abuse that suggest 80% of Heroin users started with a Prescription Opioid. Many see Heroin as the issue, but that is only a result of people unable to have access to prescription drugs after their prescription runs out.

The (Prescription) Opioid Epidemic

Today, the Opioid Epidemic that our nation finds itself in isn’t due to the popularity of Heroin, but the large push from Opioid manufacturers. Companies, like Purdue Pharma the creator of OxyContin, are being sued by the majority of states for pushing out their opioids without giving the prescribing doctors a full picture of how addictive the Opioids are.

This may not seem like a cause for concern. Doctors train for years before actually prescribing anything. They should know what people need and the potential ramifications. However, they only know as much as what has been reported by manufacturers, and that is where much of our current epidemic comes from. From 2002 to 2010, a single doctor prescribed over 335,000 Prescription Opioids. That comes out to 130 prescriptions a day, 365 days a year. That is approximately that same number of people who died every day from 2016 to 2017 from Opioid-related overdoses. Her clinic was raided for overprescribing in 2010, yet she hasn’t admitted to anything and stands by her actions.

How Addictive Are Prescription Opioids?

Studies by the CDC show that after 5 days of regular use, the risk of addiction to a Prescription Opioid skyrockets. What’s more, is that the efficiency of the medication will decrease over time as your body builds a tolerance to it. This is often the reason people begin using more, as they are trying to fight the pain they are feeling, and eventually grow dependent on it.

Again, 80% of people who are addicted to Heroin started out with a Prescription Opioid. However, due to the scarcity of real prescription pills on the street, and how much they cost, people who are up against a wall will turn to Heroin. Not only is it more available and cheaper, but it is also more potent. This hooks people from the moment they take it, and many are unable to turn back to their old addiction.

Talking to Your Doctor About Prescription Opioids

Always remember that your doctor works for you. Their time is your time. If you are in pain, and your doctor prescribes an Opioid, you should feel comfortable asking them questions, talking about your concerns, and asking for an alternative treatment. The key is honest, open communication. In some cases, an Opioid may be the only way to manage your pain, but there are ways to be better prepared. Try asking your doctor these questions:

How long will I have to take this prescription?

What alternatives are there to taking an Opioid in my situation?

What can happen, even if I take my medication as prescribed?

What does an Opioid overdose look like?

How do I know if I’m becoming dependent on my prescription?

What other substances, foods, and drinks should I stay away from on this prescription?

Recovering from Prescription Opioid Addiction

The key to navigating a potential dependence is to speak openly. There is so much stigma surrounding addiction, that people who begin to suffer from it are too scared to come forward. However, there is nothing to be ashamed of. Dependence and addiction are not the results of weakness, they happen as a biological response to taking any drug or medication for a long amount of time. Being honest with friends and family members is often the biggest key to stopping addiction before it takes.