What are Synthetic Opioids?
We are in the middle of one of the worst drug overdose epidemics in recorded history. Substance use disorder including addiction and alcoholism is at an all-time high. While there are many factors involved in the spike in drug overdoses, perhaps the largest single culprit is synthetic opioids. What are synthetic opioids? To begin, first let’s recap the classes of opioids.
There are four primary classes of opioids listed below:
- Natural Opiates: These include morphine and codeine as well as semi-natural opioids such as oxycodone. These medications are typically prescribed as analgesics or pain relievers.
- Methadone: This is a special synthetic opioid used to treat opioid use disorder and is most commonly dispensed from a designated methadone clinic.
- Synthetic Opioids: This includes fentanyl and other less commonly known synthetic opioids that are being produced on the black market. Fentanyl is a short-acting pain medication that is extremely potent. Fentanyl is roughly 100 times as powerful as morphine.
- Heroin: This is an illicit substance that is synthesized from morphine. It can be found in powder form or in a dark-colored sticky tar-like form. It is classified as having a high potential for abuse with no current accepted medical use.
According to the DEA(Drug Enforcement Agency): “Synthetic opioids are substances that are synthesized in a laboratory and that act on the same targets in the brain as natural opioids (e.g., morphine and codeine) to produce analgesic (pain relief) effects. In contrast, natural opioids are naturally occurring substances extracted from the seed pod of certain varieties of poppy plants. Some synthetic opioids, such as fentanyl and methadone, have been approved for medical use.”
Drug Overdose Epidemic:
This drug overdose epidemic has evolved in stages:
- Stage 1: Began in the 1990s with the rampant prescribing of oxycodone and oxycontin. Most drug-related deaths were due to natural opioids that were prescribed medications.
- Stage 2: In 2010 as prescribing requirements tightened up, the supply of prescription pain medication began to dry up. Those already suffering with substance use disorder and addiction were forced to find other means of acquiring drugs.This led to a large increase in heroin use among already opioid-addicted individuals. This is where we began to see a huge spike in overdoses.
- Stage 3: In 2013 we began to see an increase in overdoses involving synthetic opioids such as fentanyl. Drug overdose rates have continued to rise year over year since this point, now reaching a crisis point.
Why are synthetic opioids so dangerous?
To answer this question simply: potency. As mentioned previously, fentanyl is nearly 100 times more powerful than morphine. As little as 2 milligrams of fentanyl can be a deadly dose depending on a person’s size and opioid tolerance. To make this even more dangerous, fentanyl is typically mixed with heroin as well as other cutting agents prior to being sold. This means most users don’t even know if or how much fentanyl they are actually ingesting when they use.
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