Exploring risks & benefits of opioids

• Opioids are a class of drugs that are either derived from the opium poppy plant or created synthetically in laboratories to mimic the effects of natural opioids. 

• Our bodies make their own opioids that play an important role in regulating many of our organs and bodily functions, and helping us manage social stress and build strong relationships.

• Prescription opioids bind to and activate opioid receptors located in the brain, spinal cord, and other organs involved in pain and pleasure. When this occurs, they block pain signals from reaching the brain and can make the brain release dopamine, creating feelings of safety and euphoria.

• Prescription opioid medications include: Codeine, Tramadol. Hydrocodone (e.g., Vicodin®), Morphine, Oxycodone (e.g., OxyContin®, Percocet®), Fentanyl, Hydromorphone, Oxymorphone, Methadone, and Buprenorphine.

• People sometimes get opioids without a prescription, like heroin or fentanyl. In this case, the dose is unknown and other non-opioid drugs may be added. This means that  heroin and fentanyl may be especially dangerous and can cause death from overdose. 

• Opioids are best for the severe, short-term pain people have right after injury or surgery.  They reduce the feeling of pain and the emotional stress it causes.

• However, even following surgery, you can develop a tolerance to opioids  within a week or so. This means you need to take more and more to relieve your pain.

• Even if you use opioids for only a short time, they may alter your mental state and affect your judgement after you stop taking them.

Opioids have a negative effect on almost all your body’s systems and organs. Here are some examples.

• Brain and mood: Taking prescription opioids can cause your body to reduce or even stop producing it’s own opioids which keep many of your bodies systems in balance, especially your mood.  Your naturally produced opioids affect your internal reward systems and also affect social interaction and bonding. As a result, taking opioids may decrease your experiences of joy and also your sense of connection with other people.

• Hormones: Opioids decrease your body’s production of testosterone and estrogen, lowering your sex drive.

• Lungs: Opioids can make it harder for you to breathe. This can make lung conditions, such as asthma and bronchitis,  worse. High doses of opioids can also make you stop breathing altogether .

• Heart and circulation: Opioids increase your risk of heart and circulation problems, such as stiff arteries and an irregular heartbeat (atrial fibrillation). If you have cancer, they can also encourage the growth of new blood vessels on tumors.

• Immune system: There is strong evidence that taking opioids for long periods of time can suppress your body’s immune system, putting you at higher risk for serious infections and affecting your body’s ability to fight illness. 

• You can develop opioid tolerance and dependence even if you take opioids exactly as your doctor prescribes.

• As you develop tolerance to opioids, you have less pain relief from the medication. As a result, you end up needing more opioids to manage your pain to the same degree.

• Tolerance increases the risk of an accidental overdose, particularly if you are older.  As you age, your metabolism, and kidney and liver functions change. As a result, your body starts to react differently to the same dose of opioids.

• As you develop tolerance, you also become physically dependent on opioids. This means that if you stop opioids abruptly, you will get withdrawal symptoms, such as nausea, chills, stomach cramps, and muscle aches. Withdrawal can also cause psychological symptoms like anxiety, depression, trouble sleeping, and even thoughts of suicide.

• Dependence may also create a sense of your life revolving around your opioid medications and thinking about your next dose. This may seem like a natural result of worrying about your pain, but it may instead be a result of the opioids.

• Many people have “between dose” withdrawal. This means they get withdrawal symptoms as their opioid dose wears off. You may hear this called “interdose withdrawal.”

• Opioids may also increase the number of pain receptors in your body.

• A symptom of withdrawal can be pain. This is not your pain coming back (breakthrough pain). Instead, it is pain caused by your body starting to go into withdrawal.

• Many people who gradually reduce (taper) or stop taking opioids over a period of weeks or months don’t have increased pain — instead their pain stays the same or even gets better.

• An opioid overdose—taking more opioids than your body can handle—can cause you to lose consciousness and in some cases stop breathing and die.

• An overdose may have causes other than misuse of your opioid prescription, such as accidentally forgetting that you already took your medication, mixing opioids with other medications or substances such as alcohol, and changes in metabolism or other organ function, such as your kidneys.

• If you are taking opioids, it is strongly advised that you have Narcan/Naloxone in case of an accidental overdose.