are either derived from the Asian poppy plant or made into synthetic
chemicals that are designed to chemically resemble opium or derivatives
of opium. They all share a similar mechanism of action.
drugs bind to the neural receptor sites in the brain that are
specialized for neurotransmitters involved in reducing the subjective
experience of pain, stress, and exertion. Opioid drugs are chemically
similar to these neurotransmitters (enkephalins and endorphins), so they
are primarily used to reduce the experience of pain.
Opioids also have the side effect of producing euphoria, relaxation, and feelings of overall well-being. This mechanism of action results in these substances being used for recreational purposes. Ultimately, they carry a very significant potential for abuse.
Originally, the labels opioid, opiate, and narcotic were designed to differentiate between three effects of drugs that had similar mechanisms of action.
The term opioid was initially used for any drug that was believed to attach to the opiate receptors in the brain. The term opiate was first used to refer to medications that were directly developed from opium. The term narcotic was initially used to describe any medication that produced drowsiness or sleepiness, though law enforcement agencies often refer to any illicit or controlled substance as a narcotic.
These specific definitions are no longer utilized. The three terms essentially refer to the same class of drugs.
drugs are classified as opioids, and the classification is based on the
mechanism of action discussed above. Different opioids are developed to
address different situations. Because of individual differences in body
chemistry, some individuals may have a better response to one opioid
compared to another.
a large array of opioids allows physicians to treat many levels of
pain, to use opiates to treat other issues such as chronic coughing, and
to offer variability in the treatment of pain for people who have very
intense pain and people who have milder levels of chronic pain.
All opioid drugs are listed as controlled substances by the U.S. Drug Enforcement Administration (DEA). They all require a physician’s prescription to legally obtain and use them.
The clinical term substance use disorder is used to define either drug abuse or addiction to drugs. Any abuse of a substance refers to a chronic pattern of using it in a manner that is not consistent with its purpose or using illicit drugs for recreational purposes.
Medical use refers to the application of medications for their recognized purpose. The use of controlled substances medicinally is defined as using the medication under the supervision of a physician.
Even though people who use opioid medications under the supervision of a physician for lengthy periods will experience some of the effects listed here, chronic abuse is more likely to produce more severe and longer-lasting effects.
Chronic use of opioids will have many effects on the brain and spinal cord (CNS: the central nervous system). Some of the most prevalent effects include alterations in the reward pathways of the brain, which occur with repeated use of nearly any drug, including opioids.
The reward pathways of the brain primarily use the neurotransmitter dopamine. Over time, structural changes to these areas of the brain occur with repeated use.
Long-term use of opioids is associated with several other changes to the CNS.
Long-term opioid use and abuse have many other potential physical effects.
Chronic opioid abuse leads to damage that will affect other areas of life.
Research has suggested that individuals who have chronic opioid use disorders:
Opioids are notorious for producing physical dependence in people who use them for more than a few weeks. Physical dependence on an opioid is not considered to be a serious issue when the person is using the medication under the supervision of a physician.
Patients take the drug regularly in prescribed doses, and any physical dependence is typically not serious or problematic.
Abusers of drugs take them in far higher amounts than individuals who use them medicinally, and they often use them in a fashion that leads to even greater tolerance, such as injecting. For abusers of opioids, physical dependence becomes a motivating factor to use the drug more often because the withdrawal symptoms are typically highly distressing.
They use to avoid withdrawal symptoms, and this behavior fuels the cycle of addiction. Opioid abuse becomes a type of lifestyle, such that the person needs the opioid just to get through the day.
The brain’s ability to repair itself (neuroplasticity) is remarkable but limited. Most individuals will experience some reversal of the effects of opioid use, but the actual reversal of any physical and neurological effects of drug use is dependent on many factors.
Older individuals will experience less of a reversal than younger ones in most cases.
Some systems repair more easily than others. For instance, liver damage may not be reversible after a certain point.
People who used the drug for longer or in higher doses will experience less reversal.
bottom line is that anyone at any level of abuse will experience some
resolution of the effects, but numerous factors will determine how much
of the damage is reversible. To experience any potential reversal, one
must stop all opioid abuse.
in a formal substance use disorder recovery program can go a long way
in reversing the effects of opioid drug abuse. Individuals who adhere to
their treatment plans have the best chance to get the full potential of
Anyone who believes they have a problem with opioid abuse should discuss their situation with a licensed addiction treatment professional.
(N.D.) Drug Scheduling. Drug Enforcement Administration. Retrieved from https://www.dea.gov/drug-scheduling
Ichan School of Medicine at Mount Sinai. Retrieved from https://neuroscience.mssm.edu/nestler/nidappg/brain_reward_pathways.html