Opioids - Overview

Opioids are powerful natural and man-made drugs. Opioids include heroin, oxycodone, hydrocodone, morphine, codeine, and fentanyl. Many of these drugs are used as pain relievers, but they also can be addictive. They can be deadly if taken in high doses, taken in combination with other drugs, or given to someone with certain pre-existing medical conditions. The misuse and abuse of opioids is a public health crisis (PDF) in Wisconsin. Addressing this crisis is a priority of Governor Scott Walker and the Department of Health Services.

Drug Facts

Death and disability from the misuse and abuse of opioids in Wisconsin can be reduced through learning more about these drugs, their impacts, and ways to protect and promote health and safety.

Spotlight: Fentanyl

Fentanyl is a man-made prescription drug approved for treating very severe pain. However, in recent years, illegal labs have been making this drug for nonmedical purposes. Illegal fentanyl is often mixed with heroin or other drugs. This can be a deadly combination.

 

Prescription Opioids

What are prescription opioids?

Prescription opioids are used to treat pain. These drugs bind to receptors in the brain or body to reduce the intensity of pain signals reaching the brain.

Medication Generic Names Brand Names
Codeine Various brand names; often combined with acetaminophen and aspirin
Hydrocodone Vicodin®, Lortab®, Lorcet®

Fentanyl

Duragesic®, Actiq®, Sublimaze®
Oxycodone OxyContin®, Percodan®, Percocet®
Oxymorphone Opana®
Meperidine Demoral®
Methadone Dolophine®
Morphine Kadian®, Avinza®, MS Contin®, Duramorph®, Roxanol®
 

What are the risks from prescription opioids?

Prescription opioids can cause people to stop breathing and die, especially at higher dosages or when combined with alcohol or other medications. They also are highly addictive.

Even when taken as directed, prescription opioids can have a number of side effects, including:

  • Tolerance or the need to take more of the medication for the same pain relief
  • Physical dependence or symptoms of withdrawal when the medication is stopped
  • Increased sensitivity to pain
  • Constipation
  • Nausea, vomiting, and dry mouth
  • Sleepiness and dizziness
  • Confusion
  • Depression
  • Low levels of testosterone that can result in lower sex drive, energy, and strength
  • Itching and sweating

What should I talk about with my medical professional?

Making an informed decision about the use of prescription opioids ensures these drugs are used only when they are likely to be effective and the harms are minimized.

  • Tell your medical professional about past or current alcohol and drug use.
  • Tell your medical professional about all medications and supplements you are taking to prevent any dangerous side effects. Use this table. (PDF)
  • Discuss with your medical professional all of the risks and benefits of taking prescription opioids.
  • Discuss with your medical professional pain treatment options that do not involve prescription opioids. Some of these options may work better and have fewer risks and side effects, including over-the-counter pain medications, cognitive behavioral therapy, physical therapy, exercise, and other treatment such as massage or chiropractic. 

What steps should I take if I'm prescribed opioids?

  • Use them only as instructed by your medical professional. Never take prescription opioids in greater amounts or more often than prescribed. If the medication isn't working, talk to your medical professional.
  • Consult your medical professional before using prescription opioids with other drugs.
    • Alcohol (including beer, wine, and liquor)
    • Antihistamines (including allergy medications such as Benadryl®)
    • Barbiturates and benzodiazepines (often used as sleeping pills and sedatives, such as Ambien®, Xanax®, and Valium®)
    • Cough medicine/cough syrup
    • General anesthetics (often used for surgery)
  • Talk regularly with your medical professional about any and all side effects and concerns.
  • Store prescription opioids in a locked location and out of the reach of others. Never sell or share prescription opioids.
  • Dispose of unused prescription opioids as soon as possible to limit the possiblity of illegal use. Find a free drug-take back site near you.

Heroin

What is heroin?

Heroin is illegal to possess, distribute, and use. It is a white or brown powder or a black sticky substance. It can be injected, snorted, sniffed, or smoked. Most users report a rush of good feelings immediately after taking it.

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What are risks of using heroin?

Heroin is very addictive.

Major health problems from heroin use include death from overdose, collapsed veins, infection of the heart lining and valves, abscesses, constipation and gastrointestinal cramping, pneumonia, and liver or kidney disease. People who inject the drug also risk getting infectious diseases, including HIV/AIDS and hepatitis.

Regular use of heroin can lead to tolerance. This means users need more and more drug to have the same effect. At higher doses over time, the body becomes dependent on heroin. If dependent users stop heroin, they have withdrawal symptoms. These symptoms include restlessness, muscle and bone pain, diarrhea and vomiting, and cold flashes with goose bumps.

Pure heroin is rare. Most heroin is mixed with toxins that can clog blood vessels leading to the lungs, liver, kidneys, or brain, causing permanent damage to vital organs and even death.

What are the signs of heroin use?

  • People on heroin may think slowly and might move slowly.
  • People on heroin may seem sleepy or act like they are in a dream.
  • People on heroin may have small pupils.
  • People on heroin who inject the drug will have marks on their skin where the needle went it.

What can be done to prevent heroin use?

Research suggests abuse of prescription opioids may lead to heroin use. Some individuals report switching to heroin because it is cheaper and easier to obtain than prescription opioids.

To prevent heroin use, take steps to prevent prescription opioid abuse.

  • Talk with your family and friends about the dangers of taking prescription opioids not prescribed for them.
  • Store your prescription opioids in a secure place.
  • Dispose of unwanted, unused prescription opioids at local drug take-back collection sites.

 

Managing Your Pain: Which Approach is Right for You?

Although prescription opioids can be effective at treating certain types of pain, there are different treatment options and therapies available. Whether one approach is safer and more effective than another will depend on your unique situation. Use this information to help you discuss your pain management options with your health care provider so that together you can identify the most effective approach to your care. This list is not exhaustive.

  • Acupuncture: Acupuncture is a practice that involves the stimulation of specific points on the body, usually through the insertion of thin needles into the skin.
  • Chiropractic: Chiropractic care typically involves manipulation or adjustment of the spine and other parts of the body by a chiropractor or osteopath.
  • Cognitive behavioral therapy: Cognitive behavioral therapy is a form of psychotherapy that focuses on helping patients change their thinking pattens in order to change unhealthy behavior or moods. Sessions involve structured meetings with a trained mental health counselor or psychologist for a limited amount of a time. Cognitive behavioral therapy often involves relaxation exercises, journal writing, and certain stress, and pain relief methods.
  • Massage therapy: Massage therapy may have many different forms, but typically massage therapy involves the manipulation of soft tissue for health-related issues.
  • Meditation and relaxation: Meditation and relaxation techniques are practices to provide the natural relaxation response of the body—slowing breathing, reducing heart rate and blood pressure, and producing a feeling of calm. Some common forms of meditation and relaxation techniques include guided imagery, deep breathing, biofeedback, self-hypnosis, and progressive relaxation.
  • Physical therapy: Physical therapy is a rehabilitative process that may include a number of different physical techniques, including heat and cold, exercise, massage, and electrical stimulation to improve functioning and pain. Practitioners of physical therapy are health care professionals who are licensed to practice in Wisconsin.
  • Yoga: Yoga is a mind body practice that combines breathing techniques, physical postures, and mediation or relaxation. Many different styles of yoga exist, varying in focus and intensity of physical movement.

 

Anyone Can Develop a Problem with Opioids

According to the National Institute on Drug Abuse, if you can't stop taking an opioid even if you want to, or if the urge to use opioids is too strong to control, even if you know the opioid is causing harm, you may have a health condition known as an opioid use disorder. Here are questions to ask yourself:

  • Did you ever try to stop or cut down on your opioid usage but couldn't?
  • Have you ever used an opioid without knowing what it was or what it would do to you?
  • Have you ever made mistakes at a job or at school because you were using an opioid?
  • Does the thought of running out of opioids scare you?
  • Have you ever stolen opioids or stolen to pay for opioids?
  • Have you ever been arrested or in the hospital because of your opioid use?
  • Have you ever overdosed on opioids?
  • Has using opioids hurt your relationships with other people?

If the answer to some or all of these questions is yes, you might have an opioid use disorder. People from all backgrounds and all ages can get an opioid use disorder.

Treatment is Effective. Recovery is Possible.

Opioid use disorder is a health condition that can be successfully treated. Medications are available to reduce drug cravings and withdrawal symptoms. These medications often are combined with counseling to help individuals regain control in their lives. Ongoing support is available to help people maintain healthy habits. 

Last Revised: February 14, 2018