Opioids

What are opioids?

(OH-pee-oydz)

Understanding opioids and the opioid crisis can be confusing. Our glossary explains opioid use disorders (OUD) and treatment options.

Opioids definition

Opioids include prescription pain medications, synthetic drugs, and illegal substances derived from (or similar to) opium, which is a natural narcotic derived from poppy plants. While opioids are designed to treat moderate to severe pain, all variations have dangerously addictive properties.

Historical context

Opioids have been around for thousands of years, with opium use dating back to several ancient civilizations. Modern pharmaceutical opioids were developed in the 19th and 20th centuries; some were even purchasable over the counter (OTC)¹.

Opioids were eventually adopted for widespread medical use. Unfortunately, this was without understanding the risk of dependence. In turn, these “miracle drugs” were overprescribed, leading to the opioid epidemic we are currently combating².

How opioids work

Interaction with the brain and nervous system

Opioids bind to specific receptors in the brain, spinal cord, and other organs. These receptors are part of the body’s natural pain-relief system. When activated, they block pain signals from traveling to the brain. At the same time, they trigger the release of dopamine and endorphins in the brain’s reward center.

Effects on pain and euphoria

By stimulating the reward centers in the brain, opioids produce feelings of euphoria. This effect incentivizes continued use, which rewires the brain’s reward system as it adapts to the presence of opioids. Over time, the brain requires higher doses more frequently to achieve the same effects, leading to increased tolerance and dependence. Eventually, people with opioid use disorder ( OUD) aren’t taking opioids to feel high; it’s just to avoid painful withdrawal symptoms³.

Types of opioids

Prescription opioids (e.g., oxycodone, hydrocodone, morphine)

Doctors can legally prescribe many opioid medications, like oxycodone, hydrocodone, morphine, hydromorphone (derived from morphine), and codeine. They’re most often given temporarily for pain management following a significant injury or surgery. However, individuals with chronic conditions can receive ongoing prescriptions for these medications.

Synthetic opioids (e.g., fentanyl)

Synthetic opioids like fentanyl are manufactured in laboratories to be significantly more potent than natural opioids. On the face of it, this is a good thing, with medical-grade fentanyl helping patients in severe pain. Unfortunately, illicitly developed fentanyl has flooded the illegal drug market in recent years, contributing heavily to the opioid crisis.

Illegal opioids (e.g., heroin)

Heroin is an illegal opioid created by modifying morphine to make it more potent and faster-acting. Many people replace opioids with heroin after developing a dependence on prescription medications because it’s often more accessible and less expensive.

Risks and dangers of opioid use

Tolerance, dependence + addiction

Regular opioid use increases the user’s tolerance, so higher doses are needed to achieve the same effect. Physical dependence develops as the body adjusts to the presence of the drug. At this point, individuals are reliant on opioids and require professional treatment.

Risk of overdose

Opioids slow down respiration, resulting in an overdose where breathing becomes dangerously slow. In the worst-case scenario, breathing stops entirely. Overdose risk increases dramatically when opioids are taken extensively or in large doses. Using alcohol while taking opioids can also have life-threatening consequences⁴.

Fortunately, doctors, emergency responders, and individuals who are not in the healthcare industry can reverse opioid overdoses using naloxone, an opioid antagonist that reverses 93% of overdoses⁵. However, naloxone needs to be administered quickly, making opioid overdoses an extremely time-sensitive situation.

Additionally, many street drugs are now cut or laced with potent synthetic opioids, most notably fentanyl and nitazenes. These powerful synthetic opioids have a high probability of causing overdose and can be consumed without the user even being aware of its presence. Street drugs cut with non-opioids like xylazine and medetomidine also pose safety risks.

An unpredictable and unsafe drug supply contributes to the above concerns.

The role of opioids in the addiction crisis

Statistics + scope of the epidemic

The opioid crisis has claimed 645,000 lives in the United States since 2017⁶. Despite increasing public awareness, overdose deaths continue to rise, with synthetic opioids driving much of the increase. This epidemic affects people across all demographics and geographic regions⁷.

Government + medical response

Federal and state governments implement various strategies in response to the opioid epidemic, including:

Prescription monitoring programs
Expanded access to treatment
Distribution of overdose-reversal medications.

The medical community has also adopted new prescribing guidelines and increased focus on alternative pain management solutions.

Learn More About Opioids

Links to our related blog posts

For additional resources, explore our posts:

Links to related glossary terms

Buprenorphine: A partial opioid agonist used in medication-assisted treatment (MAT). It reduces cravings and withdrawal symptoms while carrying a lower overdose risk.
Fentanyl: A synthetic opioid up to 100 times more potent than morphine and 50 times more powerful than heroin⁸. It’s supposed to be used in medical settings and only for severe pain. Unfortunately, illegal suppliers have manufactured their own highly potent fentanyl in recent years.
Medication-assisted treatment: Evidence-based treatment combining FDA-approved medications with counseling and behavioral therapies for opioid use disorder.
Naloxone: An opioid antagonist that rapidly reverses opioid overdose by blocking opioid receptors and restoring normal breathing.‍
Opioid addiction treatment: Comprehensive care, including medical detox, MAT, counseling, and ongoing support for long-term recovery.

Sources:

From cough medicine to deadly addiction, a century of heroin and drug-abuse policy. Yale Medicine Magazine. Retrieved June 26, 2025, from https://medicine.yale.edu/news/yale-medicine-magazine/article/from-cough-medicine-to-deadly-addiction-a-century/
Singh, R. and Pushkin, G. (August 1, 2019). How Should Medical Education Better Prepare Physicians for Opioid Prescribing? AMA Journal of Ethics. Retrieved June 26, 2025, from https://journalofethics.ama-assn.org/article/how-should-medical-education-better-prepare-physicians-opioid-prescribing/2019-08#
Opioid Use Disorder. Hopkins Medicine. Retrieved June 26, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/opioid-use-disorder
(31 January 2025). Drinking Alcohol While Using Other Drugs Can Be Deadly. Centers for Disease Control and Prevention. Retrieved July 16, 2025, from https://www.cdc.gov/alcohol/about-alcohol-use/other-drug-use.html
Kounang, N. (October 30, 2017). Naloxone reverses 93% of overdoses, but many recipients don’t survive a year. CNN Health. Retrieved June 26, 2025, from https://www.cnn.com/2017/10/30/health/naloxone-reversal-success-study
Focus on Broadband and Opioids. Federal Communications Commission. Retrieved June 26, 2025, from https://www.fcc.gov/reports-research/maps/connect2health/focus-on-opioids.html
Lippold K.M., Jones C.M., Olsen E.O., et al. (November 1, 2019). Racial/Ethnic and Age Group Differences in Opioid and Synthetic Opioid–Involved Overdose Deaths Among Adults Aged ≥18 Years in Metropolitan Areas — United States, 2015–2017. Centers for Disease Control and Prevention. Retrieved June 26, 2025, from https://www.cdc.gov/mmwr/volumes/68/wr/mm6843a3.htm‍
(April 2, 2024). Fentanyl Facts. Centers for Disease Control and Prevention. Retrieved on June 26, 2025, from https://www.cdc.gov/stop-overdose/caring/fentanyl-facts.html

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