Facts About Opioids — Hydrocodone, Oxycodone, Codeine & Others
Four versions of Percocet, a brand name for an oxycodone hydrochloride mixture with acetaminophen.
Credit: National Library of Medicine

Opioids are powerful painkillers give relief to those in acute pain. They can be dangerous with misuse, though, and should only be taken under the advisement of a medical professional. 

Opioids are derived from the opium poppy or from synthetic versions or it. They are usually prescribed to help with acute pain when over-the-counter pain relievers aren't strong enough. They reduce the intensity of pain signals that travel along the nerves to the brain area that controls emotion. 

There are many types of opioids. Some of the more common types of opioids are hydrocodone (marketed as Vicodin), oxycodone (OxyContin, Percocet), morphine (Kadian, Avinza) and codeine. 

Hydrocodone and morphine are often prescribed for high pain occurrences. According to the National Institute on Drug Abuse, hydrocodone drugs are the most common opioids. Hydrocodone is often prescribed for a wide range of conditions, such as dental and injury-related pain. Morphine is commonly given to patients before and after surgical procedures to reduce pain. 

Codeine is usually prescribed for mild pain. It and other opioids, such as diphenoxylate (Lomotil), are prescribed to relieve coughs and severe diarrhea.

Heroin is an illegal opioid that is not used as a medication. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), many young people misuse prescription opioids before starting to use heroin.

Side effects of opioids depend on the type of drug being prescribed. Some opioids also cause withdrawal symptoms, so stopping the use of an opioid prescription should be overseen by a medical professional.

"These drugs use the same raw material as heroin and, even if an individual is not 'addicted' to them, the withdrawal symptoms upon stopping usage can drive the person back to using the pain killer for relief," said Dr. Indra Cidambi, medical director and founder of the Center for Network Therapy in New Jersey. 

Patients should ask their doctors these questions before taking opioids:

  • How addictive is the medication? 
  • What are other options? 
  • Is the dosage prescribed the minimal needed? 
  • How long does the physician want the individual to be on the drug? 
  • When and how does the physician plan to wean the individual off of the pain medication? 
  • What is the plan if pain persists after the pre-determined period?
  • What are some signs that the patient may be getting dependent on the medication? 
  • What should be done to help with any withdrawal symptoms?

"You should also ask about the potential side effects of the medication, including not being able to drive, constipation, sedation, dizziness and how it will affect your everyday living," said Dr. Damon Raskin, a board certified addiction specialist and the medical consultant of Cliffside Malibu Treatment Center.

Opioids are extremely addictive and can be deadly. According to the Centers for Disease Control and Prevention (CDC), 44 people in the United States die each day from overdose of prescription painkillers. The most common drugs used in overdoses are opioids. 

Many people can take prescription opioids safely and can stop taking them without difficulty. Other people find that opioids make them feel good emotionally as well as physically, and that makes them prone to use opioids for other purposes besides the prescribed indication, such as getting high, calming down after a stressful day or helping them get to sleep at night. According to the National Institutes of Health, an addiction disorder only occurs in around 5 percent of people who take opioids as directed over the period of a year. 

There are some factors that make addiction more likely. "Anyone who has a family history of any type of addiction, or their own personal history of addiction to substances, process addictions or eating disorders should be wary of taking opioids," said Dr. Kim Dennis, a board-certified psychiatrist, addictions specialist, CEO and medical director of Timberline Knolls, a residential treatment center for women and adolescent girls struggling with addiction, eating disorders and other co-occurring disorders, such as trauma.

Dr. Michael Weaver, who specializes in addiction as medical director of the UTHealth Center for Neurobehavioral Research on Addiction and works as a professor of psychiatry at McGovern Medical School at The University of Texas Health Science Center at Houston, recommended that those concerned about the possibility of becoming addicted to opioids should ask their prescribing physician if there is an alternative pain medication that is not an opioid, such as a prescription-strength anti-inflammatory drug (something like the ibuprofen in Motrin). After surgery, an epidural or use of a nerve block or a local anesthetic during the surgery can help reduce pain and reduce the need for opioid analgesics. 

The 2013 and 2014 National Survey on Drug Use and Health (NSDUH) found that 50.5 percent of people who misused prescription painkillers got them from a friend or relative for free. "If you are concerned that someone in your family might take some of your opioid analgesic medication, there are abuse-deterrent formulations of popular opioid painkillers available that make it hard to abuse those pills. The physician or a nurse should also be checking on the patient regularly to see whether problems may be starting to develop," said Weaver.

Opioid addiction is treatable and there are medications and non-medication therapies available. The federal government has a Treatment Finder website to help patients and physicians connect people with treatment programs. 

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