Prescription Pain Medications (Opioids)

Opioids attach to specific proteins, called opioid receptors, on nerve cells in the brain, spinal cord, gut, and other organs. When these drugs attach to their receptors, they block pain messages sent from the body through the spinal cord to the brain. They can also reduce or stop other essential functions like breathing.

Opioid receptors are also located in the brain’s reward center, where they cause a large release of the neurotransmitter dopamine. This causes a strong feeling of relaxation and euphoria (extreme good feelings). Repeated surges of dopamine in the reward center 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.

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 have been increasing since the early 1990s, largely due to the increase in misuse of prescription opioid pain relievers. Nearly 23,000 people died from an overdose of a prescription pain medication in 2015, with alarming increases among young people ages 15 to 24.¹ Learn more about drug overdoses in youth.

The risk of overdose and death increase if you combine opioids with alcohol or other medications that also slow breathing, such as Benzodiazepines (e.g. Xanax).

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

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 is given in time.

Naloxone is available as an easy-to-use nasal spray or autoinjector. It is 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 in the event of an overdose, it can be given right away without waiting for emergency personnel (who may not arrive in time). Read more about how Naloxone Saves Lives.

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.

Opioid withdrawal can cause:

• restlessness
• muscle and bone pain
• sleep problems
• diarrhea
• vomiting (throwing up)
• cold flashes with goosebumps (“cold turkey”)
• involuntary leg movements

Carefully following the doctor’s instructions for taking a medication can make it less likely that someone will develop dependence or addiction, because the medication is prescribed in amounts and forms that are considered appropriate for that person.

Doctors should always weigh the risks of opioid dependence and addiction against the benefits of the medication, and 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. 

If you, or a friend, are in crisis and need to speak with someone now: 

• Call 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 need information on drug treatment and where you can find it, the Substance Abuse and Mental Health Services Administration can help.

• Call Substance Abuse Treatment Facility Locator at 1-800-662-HELP
• Visit the locator online at www.findtreatment.samhsa.gov

For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.