Opioids (1)

Opioids

Opioids are drugs formulated to replicate the pain-educing properties of opium. Prescription painkillers like morphine (吗啡), oxycodone (羟考酮) and hydrocodone (氢可酮) are opioids.

There are four categories:

  1. Natural opioids (including morphine and codeine 可待因) and semi-synthetic opioids (drugs like oxycodone, hydrocodone, hydromorphone 氢吗啡酮, and oxymorphone 羟吗啡酮)
  2. Methadone (美沙酮), a synthetic opioid
  3. Synthetic opioids other than methadone (drugs like tramadol and fentanyl)
  4. Heroin, an illicit (illegally made) opioid synthesized from morphine that can be a white or brown powder, or a black sticky substance.
Source: CDC

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of drug overdose deaths. Opioids were involved in 47,600 overdose deaths in 2017 (67.8% of all drug overdose deaths).

Opioids such as morphine and codeine are naturally derived from opium poppy plants more commonly grown in Asia, Central America and South America. Heroin is an illegal drug synthesized from morphine.

Hydrocodone (such as Vicodin) and oxycodone (such as OxyContin) are semi-synthetic opioids, manufactured in labs with natural and synthetic ingredients.

Fentanyl is a fully synthetic opioid, originally developed as a powerful anesthetic for surgery. It is also administered to alleviate severe pain associated with terminal illnesses like cancer. The drug is up to 100 times more powerful than morphine.

Methadone is another fully synthetic opioid. It is commonly dispensed to recovering heroin addicts to relieve the symptoms of withdrawal.

Three Waves of Opioid Overdose Deaths

From 1999-2017, almost 400,000 people died from an overdose involving any opioid, including prescription and illicit opioids.

This rise in opioid overdose deaths can be outlined in three distinct waves.

3 waves of the rise in opioid overdose deaths

 

  1. The first wave began with increased prescribing of opioids in the 1990s 3, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
  2. The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
  3. The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids – particularly those involving illicitly-manufactured fentanyl (IMF). The IMF market continues to change, and IMF can be found in combination with heroin, counterfeit pills, and cocaine.