Opioid and Pain Reliever Facts

View PDF (1 MB)

"Facts on Opioids" is part of a series of fact sheets from the National Institute on Drug Abuse (NIDA) that are designed to inform students, parents, educators, and mentors about the harmful effects of prescription drug abuse.

• What are opioids?
• How are opioids abused?
• How do opioids affect the brain?
• What negative effects can be associated with opioids?
• What happens when you stop taking opioids?
• Are there treatments for opioid addiction?
• What can I do?

What are opioids?

Opioids are commonly prescribed to relieve pain. They are often prescribed by doctors after surgery or to help patients with severe acute or chronic pain. Studies have shown that if taken exactly as prescribed by a medical professional, opioids are safe, can manage pain effectively, and rarely cause addiction. The problem occurs when they are abused.

Common opioids and their uses are listed below.

How are opioids abused?

Opioids usually come in pill form. People who abuse opioids sometimes crush the pills into powder and snort or inject the drug, causing the drug to enter the bloodstream and brain very quickly. Taking opioids in this way increases risk of both addiction and overdose.

How do opioids affect the brain?

Opioids attach to specific proteins called opioid receptors, which are found in the brain, spinal cord, gastrointestinal tract, and other organs. When opioid drugs attach to these receptors in certain brain regions, they can diminish the perception of pain.

Opioids can also cause a person to feel relaxed and euphoric by affecting areas of the brain that deal with what we perceive as pleasure. These feelings can be intensified when opioids are abused using routes of administration other than what is recommended. Repeated abuse of opioids can lead to addiction—compulsive drug seeking and abuse despite its known harmful consequences.

What negative effects can be associated with opioids?

Opioids can produce drowsiness, cause constipation, and, depending on the amount taken, affect a person's ability to breathe properly. In fact, taking just one large dose could cause severe breathing complications or death.

These medications are not safe to use with other substances unless under a physician's supervision. In general, they should not be used with alcohol or other medications that may slow breathing, such as antihistamines, barbiturates, or benzodiazepines, because their combined effects could lead to life-threatening respiratory complications.

What happens when you stop taking opioids?

People who are prescribed opioids by their doctor for a period of several weeks or more may develop a physical dependence on the drug; that is, the body adapts to the presence of the drug. Dependence is not the same as addiction, which is when people compulsively seek out the drug even though they know it can be harmful. When someone is dependent on a drug and they stop using or abusing it, they may experience withdrawal symptoms. Thus, individuals prescribed opioid medications should not only be taking them under appropriate medical supervision, but should also be medically supervised when stopping use, to reduce or prevent withdrawal symptoms.

Symptoms of opioid withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goosebumps ("cold turkey"), and involuntary leg movements.

Are there treatments for opioid addiction?

People who abuse or are addicted to prescription opioid medications can be treated. They may need to undergo medically supervised detoxification to help reduce withdrawal symptoms—but that is just the first step. What we know about treating addiction to opioid medications comes from research on treating addiction to heroin—an illegal opioid—where behavioral treatments combined with medications have been shown to be most effective. Medications currently being used include:

• Methadone, a manmade opioid that eliminates withdrawal symptoms and relieves craving, has been used for more than 40 years to successfully treat people addicted to heroin.
• Buprenorphine, another manmade opioid, is a more recently approved medication for treating addiction to heroin and other opioid drugs, and can be prescribed in a physician's office.
• Naltrexone is an opioid receptor blocker that can help prevent relapse. Only someone who has already stopped using opioids can take it, though, since it can produce severe withdrawal symptoms in a person continuing to abuse opioids. Recently, a long-acting version was approved to treat opioid addiction. This version lasts for weeks at a time so people don’t have to take medications regularly.
• Naloxone is a short-acting opioid receptor blocker that counteracts the effects of opioids and can be used to treat overdoses.

What can I do?

When someone has a drug problem, it's not always easy to know what to do. If someone you know is abusing prescription drugs, encourage him or her to talk to a parent, school guidance counselor, or other trusted adult. There are also anonymous resources, such as the National Suicide Prevention Lifeline (1-800-273-TALK) and the Treatment Referral Helpline (1-800-662-HELP).

The National Suicide Prevention Lifeline (1-800-273-TALK) is a crisis hotline that can help with a lot of issues, not just suicide. For example, anyone who feels sad, hopeless, or suicidal; family and friends who are concerned about a loved one; or anyone interested in mental health treatment referrals can call this Lifeline. Callers are connected with a professional nearby who will talk with them about what they're feeling or about concerns for family and friends.

In addition, the Treatment Referral Helpline (1-800-662-HELP)—offered by the Substance Abuse and Mental Health Services Administration—refers callers to treatment facilities, support groups, and other local organizations that can provide help for their specific needs. You can also locate treatment centers in your state by going to www.findtreatment.samhsa.gov.