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Substance Use Prevention and Harm Reduction

About opioids

Opioids are a class of drugs that relieve pain. Misusing them can cause addiction, overdose, and sometimes death.

What are opioids?

Opioids are a class of drugs that relieve pain. Opioids include drugs derived from the opium poppy as well as synthetic drugs that are made in a laboratory.

Taking opioids regularly can cause physical dependence that can be treated with medications. An opioid overdose occurs when someone takes more of an opioid than their body can handle, and their breathing slows until it stops.

Opioids include:

  • Oxycodone (OxyContin, Percocet, or Roxicodone)
  • Oxymorphone (Opana)
  • Hydromorphone (Dilaudid)
  • Hydrocodone (Vicodin, Lortab, Norco)
  • Morphine
  • Codeine
  • Buprenorphine (Suboxone)
  • Methadone
  • Fentanyl (Duragesic)
  • Heroin

Opioids can cause physical dependence

Opioids act on receptors in the brain and block the feeling of pain. These drugs can also lead to a euphoric feeling (a “high”), which may reinforce the person’s desire to use them again.

Over time the brain gets used to the presence of opioids, which is called developing a tolerance. When this happens it takes a larger amount of opioids to get high again. The repeated use of opioids eventually creates physical dependence, at which point the absence of the drugs can lead to intense withdrawal symptoms.

This pattern also occurs with other substances like coffee, nicotine, and alcohol. Medication for opioid use disorder can help prevent withdrawal and relieve cravings if someone wants to stop using opioids.


Prescription opioid use can lead to heroin use

Prescription painkillers are chemically similar to heroin. Between 1999 and 2010, sales of prescription opioids nearly quadrupled in the United States. Some people who were prescribed these opioids became physically dependent and began to use street-based opioids when their prescriptions were up.

While Philadelphia’s heroin was at one point among the purest in the country, today other drugs, including fentanyl and xylazine (PDF) , are commonly mixed in. This puts people who use heroin, street-bought counterfeit pills, cocaine, and crack at a higher risk of a drug overdose. Today, instead of prescription opioids, fentanyl is seen in the majority of all fatal overdoses.

To learn more about the opioid epidemic in Philadelphia, watch this opioid overview training video.


Fentanyl is causing more deaths

Fentanyl is a synthetic opioid painkiller that is 50 to 100 times stronger than morphine. Fentanyl is frequently added to heroin because it is cheap and strong. It has also been found in street-bought pills, cocaine, and crack.

The fentanyl we see on the street today is illicitly manufactured, meaning that it is not made by a pharmaceutical company — it is not the same fentanyl administered or prescribed by a doctor. Fentanyl is very potent and can cause overdose, regardless of how frequently someone uses opioids.

In 2020, fentanyl or a fentanyl analogue was found in 81% of overdose deaths. Many of those who died likely did not realize they were using fentanyl, so they didn’t know to take precautions to prevent their overdose. It is recommended to routinely use fentanyl test strips to test all drugs for fentanyl before use. Fentanyl test strips are available for free.

Read about OD Stat and Substance Use Philadelphia to learn more about overdose trends in Philadelphia.


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