What is Opioid and opiate ? Use and Side effects ? | Forum

What are opioids?

Opioids (sometimes called narcotics) are a class of drugs that are chemicals — natural or synthetic — that interact with nerve cells that have the potential to reduce pain. Healthcare providers typically prescribe opioids to manage moderate to severe pain.

However, opioids can become addictive because they not only dull pain but produce a sense of euphoria. This, combined with tolerance build (needing to increase doses to produce the same effect) can lead to opioid use disorder. Because of this, providers have modified their prescribing practices to reduce the length and strength of opioids to try to prevent addiction.

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What is the difference between opiates and opioids?

Opiates are derived from the naturally-occurring poppy plant (Papaver somniferum) that creates the active ingredient in the drugs. Common opiates include opium, heroin morphine and codeine.

An opioid is a substance that can be derived from the from the poppy plant, be synthetic or be semi-synthetic, meaning the active ingredients are created chemically in a lab. Common opioids include morphine, oxycodone, OxyContin, hydrocodone, fentanyl and others.

All opiates are opioids, but not all opioids are opiates. However, opioids and opiates have the same effects on your body because they have similar molecules, and they both have high addiction potential.

What are opioids approved for?

Prescription opioids are approved for managing moderate to severe pain. This can include:

• Some types of acute pain (sudden and short-term).
• Cancer-related pain.
• Post-surgical pain.
• Vascular pain, such as acute sickle-cell crisis.

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The U.S. Food and Drug Administration (FDA) has also approved the use of some opioids to treat intense coughing and chronic diarrhea. Loperamide is an opioid healthcare providers use to treat diarrhea and irritable bowel syndrome (IBS). Opioids such as codeine and dextromethorphan are useful as cough suppressants.

How do opioids work?

"Opioid" is an umbrella term that represents all compounds that bind to opioid receptors. Opioid receptors are found throughout your central and peripheral nervous systems, as well as your gastrointestinal (GI) tract. These receptors regulate many body functions, including:

• Pain.
• Mood.
• Stress.
• Reward.
• Gastrointestinal functions.
• Breathing (respiration).

Once activated, opioid receptors initiate a cascade of chemical reactions that ultimately modulate the transmission of pain signals. Opioids also cause neurons that produce dopamine, the neurotransmitter that plays a role in how we feel pleasure, to fire more frequently. This creates feelings of euphoria (intense happiness).

Some opioids are used to stop diarrhea by slowing gastric motility — the process by which food travels through your digestive tract via a series of muscular contractions. This allows more time for absorption of the food in your system.

What are the types of opioids?

There are over one hundred different types of prescription opioids. The most commonly prescribed opioids and some of the most common brand names include:

• Hydrocodone (Vicodin®).
• Oxycodone (OxyContin®, Percocet®).
• Oxymorphone (Opana®).
• Morphine (Kadian®, Avinza®).
• Codeine.
• Fentanyl.
• Hydromorphone.
• Tapentadol.

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• Methadone.

Heroin is a morphine derivative drug that’s exclusively used for recreational purposes and is illegal.

What should I tell my healthcare provider before taking opioids?

In a discussion with your healthcare provider about whether you need to take opioids, you should discuss the following topics:

• Whether there are other medicines or therapies that might treat your pain.
• The risks and benefits of taking opioids.
• Your medical history.
• If you or anyone in your family has a history of substance use or addiction to drugs or alcohol.
• Any other medicines and supplements you’re taking, which may interact with the opioid.
• How much alcohol you drink.
• If you’repregnant or planning to become pregnant.
• If you use marijuana/cannabis (prescription or otherwise).
• If you use any street drugs.

You also need to tell your provider about any medical conditions you have. Opioids can worsen the effects of certain conditions and vice versa. For example:

• People with lung conditions and breathing issues may not be able to manage the respiratory depression caused by opioids.
• If people with liver or kidney issues take opioids, they may have poor excretion and metabolism, which may result in the accumulation of harmful byproducts.
• People with certain adrenal gland and thyroid issues may be more sensitive to opioids.

Why are opioids addictive?

The main reason opioids have a high addiction potential is because they not only relieve pain but create a sense of euphoria (intense happiness), which many people find pleasurable.

People who use opioids regularly soon develop tolerance to these effects. They may then use more and more of the drug in an attempt to get the original intensity of pain relief and euphoria. Chronic use or misuse of opioids can lead to psychological and physical dependence.

People are psychologically dependent when a drug is so central to their thoughts, emotions and activities that the need to continue its use becomes a craving or compulsion despite negative consequences.

With physical dependence, your body has adapted to the presence of the drug, and withdrawal symptoms happen if you suddenly stop taking the drug or you take a reduced dosage.

People who are physically dependent on opioids experience withdrawal symptoms when they stop taking the drug. These symptoms are often unpleasant, so they may be more likely to take more of the drug to stop the withdrawal symptoms.

Does everyone who is prescribed an opioid become addicted?

No, not everyone taking a prescription opioid becomes addicted to them. When prescription instructions are carefully followed, the chances of becoming addicted are decreased.

Opioids are useful for treating acute pain through short-term use. However, when a prescription drug is used outside of the instructions or for chronic pain, the risk of developing opioid use disorder increases.