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What Are They?

Also called narcotics, opioids are a kind of pain medication your doctor may give you after an accident or surgery, or as treatment for a chronic disease like arthritis. Most are made from the opium plant, but some (called synthetic opioids) are made in a lab. Either way, they affect the reward center of your brain and boost your levels of certain brain chemicals that block pain, slow your breathing, and generally make you feel calm.

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Types

Opioids have different strengths, and some are legal and some aren’t. Examples include:

  • Codeine
  • Meperidine (Demerol)
  • Oxycodone (OxyContin)
  • Oxycodone and acetaminophen (Percocet)
  • Fentanyl
  • Hydrocodone and acetaminophen (Lortab, Norco, Vicodin)
  • Methadone
  • Morphine
  • Heroin
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Short-Acting vs. Long-Acting

Short-acting opioids, like Vicodin or Percocet, get medication into your system quickly. When you take them as directed, like immediately after surgery, you probably won’t have any issues. But if you take them for too long, it may be hard to stop. Long-acting opioids, like OxyContin, give your body a smaller amount of medication over a longer time. They’re used to treat diseases that cause chronic pain, like fibromyalgia or arthritis.

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How to Use Opioids

If your doctor prescribes them for you, be sure to follow the directions. It’s usually best to take them on a regular schedule. If you wait until the pain is bad, you might need more medication, which makes you more likely to have side effects.

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Common Side Effects

All medications have side effects, and opioids are no different. The most common one with short-term use is constipation. Others include:

  • Depression
  • Hot flashes
  • Erectile dysfunction
  • Weight gain
  • Weak immune system
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Dependence

The longer you take opioids, the greater the chances that your body will get dependent on them. If that happens, you may have withdrawal symptoms -- like anxiety, a fast heart rate, sweating, nausea, and chills -- when you stop taking them. This is more likely if you try to stop too quickly instead of tapering off slowly. Talk to your doctor about how to stop safely.

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Dependence vs. Addiction

If you've become addicted to an opioid, you'll have strong cravings for them that will be hard to resist. Other signs can include:

  • Using more than your doctor prescribed 
  • Feeling powerless to stop the cravings
  • Acting irresponsibly, possibly in an effort to get more drugs
  • Mood swings, irritability, and feeling agitated
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A Growing Problem

While most people use these medications safely, up to 12% of people who take them for chronic pain become dependent on or addicted to them. From there, some people move on to street drugs. About 80% of people who use the illegal opioid heroin say they misused a prescription one first. Heroin is often cheaper and easier to get.

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What Raises Your Chances of Addiction?

Anyone can become addicted to opioids, especially if they don’t follow their doctors’ instructions. But some people may be more likely to than others. This includes people who:

  • Have had addiction issues with alcohol, tobacco, or other substances
  • Have a family history of substance abuse
  • Are in their teens or early 20s
  • Are female. (Women report chronic pain more often, and they may also become dependent more quickly than men.)
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Treatment for Addiction

If you've become addicted, you may need a specialized program that could include medication to ease withdrawal symptoms, counseling to deal with cravings and depression, and guidance to help you avoid a relapse. For help with an opioid addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA).

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What to Do in Case of Overdose

This can be life-threatening. If you think someone might have overdosed, call 911 right away. Warning signs include:

  • Loss of consciousness or being very sleepy
  • Slow or irregular breathing
  • A slow pulse
  • Vomiting
  • Small pupils

If you or a loved one is dealing with opioid addiction, ask your doctor about a prescription nasal spray called naloxone (Narcan) that can quickly reverse the effects of an overdose. You may be able to keep it on hand in case of an emergency.

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Other Options for Pain Relief

Ask your doctor if a strong nonsteroidal anti-inflammatory drug (NSAID), like diclofenac (Cataflam) or prescription-strength ibuprofen, might work for moderate pain. For chronic pain, you might try nondrug treatments like massage, exercise, or acupuncture, along with non-opioid medication.

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Sources | Medically Reviewed on 11/7/2017 Reviewed by Carol DerSarkissian on November 07, 2017

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SOURCES:

American Academy of Family Physicians: "Opioid Addiction."
American Association of Poison Control Centers: "Opioid (Narcotic) Pain Medications."

American Cancer Society: “Common opioids by generic name.”

American Society of Addiction Medicine: "Opioid Addiction 2016 Facts and Figures."

Arthritis Foundation: "Stopping Narcotic Pain Medication."

CDC: "CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016," "Opioid Basics," "Prescription Opioids."

Cleveland Clinic: "Choose Painkiller Carefully if You Take Coumadin," "The Down Side and Side Effects of Painkillers."

FDA: "A Guide to Safe Use of Pain Medicine," "What to Ask Your Doctor Before Taking Opioids."

Hospital for Special Surgery: "The Top 10 Myths of Chronic Pain."

Mayo Clinic: "Pain Medications After Surgery," "Prescription Drug Abuse Risk Factors."

National Alliance of Advocates for Buprenorphine Treatment: "How Do Opioids Work in the Brain?" "Physical Dependence and Addiction," "What Drugs Are Opioids?"
National Institute on Drug Abuse: "America’s Addiction to Opioids: Heroin and Prescription Drug Abuse," "Commonly Used Long-Acting Opioids Chart," "Opioids," "Opioid Crisis," "Prescription Opioid Use is a Risk Factor for Heroin Use," "Treatment Approaches for Drug Addiction."
St. Peter's Hospital: "Understanding the Basics of Pain Management: Facts and Myths."
UptoDate: "Opioid Withdrawal: Clinical Manifestations, Course, Assessment, and Diagnosis."

Reviewed by Carol DerSarkissian on November 07, 2017

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.