©iStock.com/smartstockAlso known as: Happy Pills, Hillbilly Heroin, OC, Oxy, Percs, or Vikes
Prescription opioids are medications that are chemically similar to endorphins – opioids that our body makes naturally to relieve pain. They are also similar to the illegal drug heroin. In nature, opioids are found in the seed pod of the opium poppy plant. Prescription opioids usually come in pill or liquid form, and are given to treat severe pain—for example, pain from dental surgery (read more about drug use and your mouth), serious sports injuries, or cancer. If you are in the hospital, they can be given through an IV (needle and tube) in your arm. Opioids are sometimes prescribed to treat pain that lasts a long time (chronic pain), but it is unclear if they are effective for long term pain.
When opioids are taken as prescribed by a medical professional for a short time, they can be relatively safe and can reduce pain effectively. However, taking prescription opioids, puts you at risk for dependence and addiction. Dependence means you feel withdrawal symptoms when you stop taking the drug. Continued use can lead to addiction, where you continue to seek out the drug and use it despite negative consequences. These risks increase when the medications are misused. Prescription medications are some of the most commonly misused drugs by teens, after tobacco, alcohol, and marijuana.
Opioid medications can be natural, created in labs from natural opioids, or synthetic (human-made). Common opioids and their medical uses are listed below.
| Opioid Types | Conditions They Treat |
|---|---|
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Fentanyl has been in the news recently. It is a powerful synthetic (human-made) opioid that is 50 to 100 times stronger than morphine, and is prescribed for extreme pain. It is extremely dangerous if misused, and is sometimes added to illicit drugs sold by drug dealers. Find out more about Fentanyl.
How Prescription Opioids Are Misused
People misuse prescription opioid medications by taking them in a way that is not intended, such as:
- Taking someone else’s prescription, even if it is for a medical reason like relieving pain.
- Taking an opioid medication in a way other than prescribed—for instance, taking more than the prescribed dose or taking it more often, or crushing pills into powder to snort or inject the drug.
- Taking the opioid prescription to get "high."
- Mixing it with alcohol or certain other drugs. Your pharmacist can tell you what other drugs are safe to use with prescription pain relievers.
When opioids enter the brain, they attach to molecules on cells known as opioid receptors. These receptors are located in many areas of the brain and body, especially areas involved in feelings of pain and pleasure, as well as a part of the brain that regulates breathing.
Opioids affect the brain's "reward circuit," causing euphoria (the “high”) and flooding the brain with the chemical messenger dopamine. Surges of dopamine in the reward circuit encourage you to continue pleasurable but unhealthy behaviors like taking drugs, leading you to repeat the behavior again and again. Repeated surges from drug-taking can lead to addiction.
Learn more about how the brain works and what happens when a person misuses drugs. And, check out how the brain responds to natural rewards and to drugs.
Short-Term Effects
In addition to pain relief, other effects of opioids include:
- sleepiness
- confusion
- nausea (feeling sick to the stomach)
- constipation
- slowed or stopped breathing
Mixing prescription opioid medications with alcohol can cause a dangerous slowing of the heart rate and breathing. This can lead to a coma or death.
Long-Term Effects
People who use prescription opioid medicines for a long period of time increase their risk of addiction and overdose.
Yes, you can overdose and die from prescription opioid misuse. In fact, taking just one large dose could cause the body to stop breathing.
Deaths from overdoses of prescription drugs increased from the early 1990s to 2017, largely due to the increase in misuse of prescription opioid pain relievers. Between 2017 and 2018 (the latest year for which data is available), these overdoses decreased by 13.5 percent. However, nearly 15,000 people died from an overdose of a prescription pain medication in 2018. The risk of overdose and death increases if you combine opioids with alcohol or other medications that also slow breathing, such as benzodiazepines (e.g. Xanax®). Among all age groups, males are more likely to overdose from prescription pain medicines than females are.1
Learn more about drug overdoses in youth.
Signs of Overdose
Signs of a possible prescription opioid overdose are:
- slow breathing
- blue lips and fingernails
- cold damp skin
- shaking
- vomiting or gurgling noise
- looking like you have passed out---or with a nodding head going in and out of consciousness
People who are showing symptoms of overdose need urgent medical help (call 911 immediately). A drug called naloxone can be given to reverse the effects of an opioid overdose and prevent death—but only if it's given in time.
Naloxone is available as an easy-to-use nasal spray called Nasal Narcan® or autoinjector with the brand name Ezvio®. It's often carried by emergency first responders, including police officers and emergency medical services. In some states, doctors can now prescribe naloxone in advance to people who use prescription opioids or to their family members, so that if an overdose happens, naloxone can be given right away without waiting for emergency personnel (who may not arrive in time).
Read more about how naloxone saves lives.
Prescription opioids are closely related to heroin chemically, and their effects can be very similar, especially when misused. Nearly 80 percent of people addicted to heroin started first with prescription opioids. Heroin can be cheaper to get, so about 4% of people who misuse prescription pain medications switch to heroin. This adds up to hundreds of thousands of heroin users, because millions of people are misusing prescription opioids.2
2 Compton WM, Jones, CM, Baldwin GT. Relationship between nonmedical prescription-opioid use and heroin use. England Journal of Medicine, 2016, 374:154-163.
Yes, prescription opioids can be addictive. People who misuse prescription opioids are at greater risk of becoming addicted to opioids than people who take them as prescribed by a doctor. They often continue to take the drug simply to avoid painful withdrawal symptoms.
Opioid withdrawal can cause:
- restlessness
- muscle and bone pain
- sleep problems
- diarrhea
- vomiting (throwing up)
- cold flashes with goosebumps (“cold turkey”)
- leg movements
Doctors, dentists and other health care providers who prescribe opioids know how to weigh the risks of opioid dependence and addiction against the benefits of the medication. Patients should communicate any issues or concerns to their doctor as soon as they arise. The earlier a problem is identified, the better the chances are for long term recovery. Learn more about dentists and prescription opioid medications.
Misuse of prescription opioid medications among teens has dropped significantly since 2002, when it was first measured. In fact, past-year misuse of Vicodin® and OxyContin® among 12th graders is at a record low, dropping from 9.6 percent in 2002 to 1.1 percent in 2019 for Vicodin®, and from 4 percent in 2002 to 1.7 percent in 2019 for OxyContin®.
The chart below shows the latest percentage of teens who misuse prescription opioid pain medicines.
Swipe left or right to scroll.
| Drug | Time Period | 8th Graders | 10th Graders | 12th Graders |
|---|---|---|---|---|
| Vicodin | Past Year | 0.90 | 1.10 | [1.10] |
| OxyContin | Past Year | 1.20 | 2.00 | 1.70 |
* Data in brackets indicate statistically significant change from the previous year.
If you, or a friend, are in crisis and need to speak with someone now:
- Call the National Suicide Prevention Lifeline at 1-800-273-TALK (they don't just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by)
If you want to help a friend, you can:
- Share resources from this site, including this page.
- Point your friend to NIDA's Step by Step Guide for Teens and Young Adults.
- Encourage your friend to speak with a trusted adult.
If a friend is using drugs, you might have to step away from the friendship for a while. It is important to protect your own mental health and not put yourself in situations where drugs are being used.
For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.
NIDA Resources:
Check out the newly revised Opioids & Other Prescription Drugs Event Toolkit- Opioid Facts for Teens
- Mind Matters: The Brain's Response to Opioids
- Commonly Abused Prescription Drugs Chart
- Drug Use and Your Mouth
- DrugFacts: Prescription and Over-the-Counter Medications
- DrugFacts: High School and Youth Trends
Other Government Resources:
- Opioids and Adolescents [Office of Adolescent Health]
- Pick Your Poison. Intoxicating Pleasures & Medical Prescriptions: Opium [National Library of Medicine]
- Prescription Pain Medications: What You Need to Know [Scholastic, Inc.]
- Slang Terms and Code Words: A Reference for Law Enforcement Personnel (PDF, 1MB) [Drug Enforcement Agency]
Educator Resources:
- Monitoring the Future
- National Survey on Drug Use and Health [Substance Abuse and Mental Health Services Administration]
- United States Adolescent Substance Abuse Facts (National and State Data) [Office of Adolescent Health]
- Youth Risk Behavior Surveillance System [Centers for Disease Control and Prevention]
Videos
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How Naloxone Saves Lives in Opioid Overdose
Naloxone saves lives. This video reviews when naloxone is used, how it is administered, and the way it works.
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Animated Infographic: Monitoring the Future 2018 Survey Results
Monitoring the Future (MTF) is an annual survey of 8th, 10th, and 12th graders measuring drug, alcohol, and cigarette use.
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Dr. Compton Discusses Half of Opioid-Related Overdose Deaths Involve Fentanyl
NIDA's researcher discusses fentanyl overdose deaths in the U.S.
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Animated Infographic: Monitoring the Future 2017 Survey Results
Monitoring the Future (MTF) is an annual survey of 8th, 10th, and 12th graders.
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This Is NIDA: Opioids
The National Institute on Drug Abuse's research-based, informative video series "This Is NIDA," addresses the topic of OPIOIDS.
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Choose Your Path - BFF or the Ex: Tell a Friend at School
You tell a friend about the stress you're feeling after Mario asked you out, and she gives you some pills that a doctor prescribed for her boyfriend. Since a doctor prescribed them, they should be fine, right? You have a bad reaction and the school nurse calls an ambulance.
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Information on Prescription Drug Video NIDA: How many pain meds should you take?
Addiction, compulsive drug use, and prescription drug abuse are explored in detail.
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NIDA Painkillers: Get Back in the Game---Use Painkillers Safely.
NIDA scientists play softball with young friends and talk about the safe use of prescription painkillers.
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Animated Infographic: Monitoring the Future 2015 Survey Results
The annual survey measures teen drug, alcohol, and tobacco use and attitudes.
Blog Posts
Opioid Withdrawal in Babies Is Increasing
Approximately every 15 minutes, a baby is born suffering from opioid withdrawal. Read More »
Treating Opioid Use Disorder in the Emergency Room
Opioid use disorder is a complex problem. Emergency room doctors can save the life of someone with OUD by reversing an opioid overdose and addressing the longer-term problem of addiction. Read More »
Opioids: Just the Facts
What are the risks of misusing opioids? Learn the answer and more about opioids in NIDA’s new guide “Opioid Facts for Teens.” Read More »
Publications
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Mind Matters: The Body's Response to Opioids
Mind Matters is a series that explores the ways that different drugs affect your brain, body, and life. In this issue we are going to talk about opioids.
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DrugFacts: Prescription and Over-the-Counter Medications
Provides an overview of commonly abused over-the-counter (OTC) medications and prescription drugs—opioids, central nervous system depressants, and stimulants—and explains effects on the brain and reported use.
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Opioids: Facts Parents Need to Know
Brochure provides parents with facts about opioids and their potential harmful effects.
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Opioid Facts for Teens
Provides facts for teens about opioids, including prescription pain medicines and heroin.
Infographics
Drug and Alcohol Use in College-Age Adults in 2018
Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome
Drug and Alcohol Use in College-Age Adults in 2017
Fentanyl and Other Synthetic Opioids Drug Overdose Deaths
Abuse of Prescription (Rx) Drugs Affects Young Adults Most
Substance Use in Women and Men
Teens Mix Prescription Opioids with Other Substances
Prescription Drug Abuse: Young People at Risk
Lesson Finder: Prescription Opioids
Lessons and classroom activities on prescription pain medicine misuse use and its effects.
Cite this article
The National Institute on Drug Abuse Blog Team. (). Prescription Pain Medications (Opioids). Retrieved from https://teens.drugabuse.gov/drug-facts/prescription-pain-medications-opioids on
Real Questions from Real Teens
Sometimes it feels like you're the only one who doesn't know—but your friends often have the same questions as you. See what other teens are asking about drugs and drug abuse.
