Opioids are a class of medicine that help with pain management. When used correctly, they can provide pain relief for medical issues such as surgery, cancer treatments and childbirth. But opioids are also very addictive and often misused. With the opioid epidemic impacting communities across the country, it’s important to stay informed so we create change.
Below, we’ll explain what opioids are, how to spot the signs of addiction and how to prevent an overdose.
What are opioids?
Opioids define a class of drugs that are similar to opium, a drug naturally found in a poppy plant. You may also hear them referred to as narcotics to distinguish them from over-the-counter painkillers. Some opioid drugs are derived from the opium in poppies, while others are synthetic versions of the substance.
When opioids are used correctly as prescribed by a doctor, they can provide relief for moderate to severe pain. But when they are misused or overused, opioids can make pain worse over time and become addictive.
Medical uses of opioids
Prescription opioids, like OxyContin and Vicodin, are often prescribed to treat moderate to severe pain. But they also have other medical uses, including anesthesia, suppressing diarrhea or cough, replacement therapy for opioid use disorder or opioid withdrawal, and reversing an opioid overdose.
How long do opioids stay in your system?
The length of time that an opioid can be detected in your system depends on a few factors, including the frequency of drug use and the type of opioid. Short-lasting opiates like codeine can stay in your system for a few days, but long-lasting opioids like methadone can stay in your system for up to a week.
It also depends on what test is being used to detect the presence of opioids. After last use, opioids can be detected in saliva between 24-48 hours, in blood for around a day, urine for up to three days, and in your hair for up to 90 days.
Types of opioids
There are a few types of opioids, including synthetic opioids, prescription pain relievers and illegal drugs.
Prescription opioids are often prescribed to treat moderate to severe pain and are safe to use for a short time when prescribed by a doctor. But they can be misused and have serious risks and side effects like addiction. Some of the most common prescription opioids are:
Many prescription opioids are synthetic opioids. Synthetic opioids are created in a laboratory but target the brain in the same areas as natural opioids. Fentanyl is the most well-known synthetic opioid, and it is many times more powerful than other opioids. It is used to treat severe pain for those in advanced cancer stages. Other synthetic opioids include:
Fentanyl and other synthetic opioids that are being illegally made and distributed as a street drug have also been on the rise across the United States and are driving the opioid epidemic.
Heroin, counterfeit prescription opioids and other recreational drugs laced with fentanyl are all illegal opioids. They are some of the most dangerous drugs because you aren’t always sure what you’re getting, which can lead to overdose and death.
The opioid epidemic
The United States is in the midst of an opioid overdose epidemic. Since 1999, hundreds of thousands of people have died from an overdose involving opioids. But the problem has gotten significantly worse in the last few years with the number of opioid-related deaths increasing by nearly 30%. And in the state of Minnesota alone, overdose deaths involving opioids have increased by 35% since 2020.
Park Nicollet and HealthPartners are working to reduce the misuse of opioids by asking our clinicians to prescribe fewer painkillers, giving presentations on the topic to our peers in other health care systems, and even influencing the state medical licensing board to change its stance on opioids. We’re proud to lead the way in helping our patients and the community find the safest, most effective pain relief.
Opioid addiction and dependence
Anyone who takes opioids can be at risk for addiction or opioid dependence. Knowing how opioids work can help us better understand opioid addiction.
Opioids are highly addictive because they activate powerful reward centers in your brain that trigger the release of endorphins. These endorphins can decrease your perception of pain and increase feelings of pleasure. When an opioid dose wears off, many people want to recapture that feeling as soon as possible, which is often the first sign of a potential opioid addiction.
How does opioid addiction happen?
It is impossible to know who will be vulnerable to opioid addiction. Genetic, psychological and environmental factors can all play a role in addiction. Some known risk factors of opioid addiction include:
- Young age
- Living in poverty
- Loss of a job or other stressful circumstances
- Severe depression, anxiety or other mental health concerns
- History of drug, alcohol or tobacco abuse
- History of criminal activity or legal problems
- Contact with high-risk people or environments
- Risk-taking or thrill-seeking behavior
Signs of an opioid addiction can present themselves in different ways depending on the person. If you or a loved one has experienced at least two of the following in the last year, it could be a sign of opioid addiction.
- Needing more medication to produce the desired effect
- Craving opioids
- Unable to fulfill obligations at work, school or home
- Interpersonal problems with family, friends or coworkers because of opioid use
- Not participating in activities you once enjoyed because of opioid use
- Experiencing withdrawal symptoms or taking opioids to avoid withdrawal
Opioid use disorder
You may hear opioid use disorder referred to as opioid abuse, opioid dependence or opioid addiction. Like other substance use disorders, opioid use disorder is a chronic lifelong condition. Someone living with opioid use disorder may need different levels of treatment at different times.
For treatment to be effective, opioid use disorder often requires continuing care including:
- Individualized treatment plans
- Access to medications
- Behavioral interventions from trained professionals
- Long-term outpatient treatment and counseling
- Recovery support services, peer groups and other aid
When opioid users stop using abruptly, they can experience severe opioid withdrawal symptoms, including pain, chills, cramps, diarrhea, dilated pupils, restlessness, anxiety, nausea, vomiting, insomnia and very intense cravings. Because opioid withdrawal symptoms are so severe it can be extremely hard for users to quit without support or medication-assisted treatment.
An opioid overdose can be identified by pinpoint pupils, unconsciousness and difficulty breathing. You are at a higher risk of an opioid overdose if you:
- Have opioid use disorder
- Inject opioids
- Start taking opioids again after a prolonged recovery period
- Use opioids with other drugs or alcohol
- Have HIV, liver disease, lung disease or mental health conditions
Preventing an opioid overdose
Naloxone (Narcan or Evzio) is a potentially life-saving medication used to quickly reverse an opioid overdose. It can be administered through injection or as a nasal spray, and is used to block the effects opioids. It can also help someone having an opioid overdose return to normal breathing if it has slowed or stopped as a result of the overdose.
Opioid addiction treatment
Meeting with your primary care doctor is also a good place to start with getting help. They can refer you to the proper care, which could include getting help from an addiction medicine specialist, an addiction recovery program, or by visiting one of HealthPartners pain management clinics in the Twin Cities metro. Chronic pain management without opioids is more than possible.
If you need immediate help, the Crisis Text Line offers free, 24/7 texting services with a compassionate counselor. Text HOME to 741741.
Or call the National Helpline 1-800-662-HELP (4375) for 24/7 confidential help and guidance.
You can also find a treatment facility near you through the Substance Abuse and Mental Health Services Administration.