Opiates are drugs that are produced from the opium poppy plant (papaver somniferum). Sometimes people refer to this class of substances as "opioids", which include other substances that produce similar effects. The characteristic opiate effects are: dreamy-euphoric state, decreased sensations of pain, slowed breathing, constipation, and pinpoint pupils.

Opiates are usually smoked (using a pipe), snorted, or injected intravenously. Intravenous injection delivers the quickest effect, but is also the most dangerous. Consumption of prescription opiates such as oxycodone (Percodan©, OxyContin©), hydrocodone (Vicodin©), and hydromorphone (Dilaudid©) has become more common - especially among young adults. Prescription opiate use has been on the rise since the introduction of OxyContin© in 1996. A notable trend is for habitual opiate users to "jump" from prescription pills to heroin use because of the lower price and street availability of heroin. This "jumping" leads to riskier use due to the risk for Hepatitis C and HIV and other negative health effects of intravenous drug use.

Opiates act on specific receptor molecules for the endorphin/enkephalin class of neurotransmitters in the brain. These neurotransmitter systems impact a number of vital functions including: mood, movement, digestion, body temperature, and breathing. Opiates also activate the endogenous opioids - natural brain chemicals - to produce their effect.

There is currently an opioid epidemic in the United States. "Drug overdose deaths and opioid-involved deaths continue to increase in the United States. The majority of drug overdose deaths (more than six out of ten) involve an opioid. From 2000 to 2015, more than half a million people died from drug overdoses. Ninety-one Americans die every day from an opioid overdose. Since 1999, the number of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have more than quadrupled since 1999. (Center for Disease Control & Prevention, 2016)."

Opiates are highly addictive. People taking opiates for even a few weeks can develop significant physiological dependence - which essentially means going through a painful withdrawal if they stop using. Withdrawal from opiates has been described as having "the worst flu you have ever experienced." Milder withdrawal symptoms from opiates include: watery eyes, runny nose, and sweating. Severe withdrawal symptoms include diarrhea, muscle pain, increased pain sensitivity, dysphoria, and a strong urge to use opiates (essentially to end the withdrawal). Many people continue using opiates due to fear of withdrawal. The major risk factor in opiate use is overdose. Overdosing on opiates frequently leads to death due to the suppression of breathing. In order to prevent death due to opiate overdose, medical personnel (EMTs, emergency room nurses and doctors) often use an opiate antagonist called naloxone or Narcan©. This immediately reverses the effects of the opiates in an intoxicated user. Unfortunately, death due to opiate overdose is on the rise in the US. Community and government agencies are working hard to stop this epidemic.

References

Kuhn, C., Swartzwelder, S., & Wilson, W. (2008) Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy.

National Institute on Drug Abuse: www.drugabuse.gov/

Center for Disease Control & Prevention: https://www.cdc.gov/drugoverdose/epidemic/index.html

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