Opioids are a class of drugs that include natural opiates, semi-synthetic opioids, and synthetic opioids. They are commonly known for their potent analgesic (pain-relieving) properties and are often prescribed for the management of moderate to severe pain. Additionally, opioids can produce a sense of euphoria, leading to their potential for misuse and dependence.

Here are the main categories of opioids:

1. Natural Opiates:
   • Examples: Morphine and codeine.
   • Source: Derived directly from the opium poppy plant.
2. Semi-Synthetic Opioids:
   • Examples: Oxycodone, hydrocodone, and heroin.
   • Source: Chemically modified derivatives of natural opiates.
3. Synthetic Opioids:
   • Examples: Fentanyl, tramadol, and methadone.
   • Source: Completely synthesized in a laboratory.

Opioids work by binding to specific receptors, known as opioid receptors, in the central nervous system. These receptors are primarily located in the brain and spinal cord. When opioids bind to these receptors, they modulate the transmission of pain signals and alter the perception of pain, leading to pain relief.

A list of Opioid Analgesics

Opioid analgesics are a class of medications that work by binding to specific receptors in the brain and spinal cord, known as opioid receptors, to reduce the perception of pain. These drugs can be effective for managing moderate to severe pain but also carry a risk of dependence and addiction. Here is a list of opioid analgesics along with some details:

1. Morphine:
   • Description: One of the oldest and most potent opioid analgesics.
   • Uses: Commonly used for acute and chronic pain, including post-surgical pain and cancer pain.
   • Forms: Available in various formulations, including oral tablets, injectable solutions, and sustained-release formulations.
2. Codeine:
   • Description: Generally less potent than morphine.
   • Uses: Often used for mild to moderate pain. Frequently prescribed in combination with other medications, such as acetaminophen or ibuprofen.
   • Forms: Available in oral formulations.
3. Hydrocodone:
   • Description: Semi-synthetic opioid.
   • Uses: Commonly prescribed for moderate to severe pain and as an antitussive (cough suppressant).
   • Forms: Often combined with acetaminophen or ibuprofen in oral formulations.
4. Oxycodone:
   • Description: Semi-synthetic opioid with a potency similar to morphine.
   • Uses: Used for moderate to severe pain, including post-surgical and cancer pain.
   • Forms: Available in immediate-release and extended-release formulations. Often combined with acetaminophen or other analgesics.
5. Fentanyl:
   • Description: Synthetic opioid that is highly potent.
   • Uses: Used for severe pain, particularly in cancer patients. Also available in patch form for long-term pain management.
   • Forms: Available in various formulations, including transdermal patches, lozenges, and injectable solutions.
6. Methadone:
   • Description: Synthetic opioid with unique pharmacokinetics.
   • Uses: Used for chronic pain management and as part of opioid addiction treatment programs.
   • Forms: Available in oral formulations.
7. Hydromorphone:
   • Description: Semi-synthetic opioid, more potent than morphine.
   • Uses: Used for moderate to severe pain.
   • Forms: Available in oral formulations and injectable solutions.
8. Oxymorphone:
   • Description: Semi-synthetic opioid, more potent than morphine.
   • Uses: Used for moderate to severe pain.
   • Forms: Available in oral formulations and injectable solutions.
9. Tramadol:
   • Description: Atypical opioid with both opioid and non-opioid mechanisms of action.
   • Uses: Used for moderate to moderately severe pain.
   • Forms: Available in oral formulations.

Common medical uses of opioids include the management of acute pain (such as post-surgical pain) and chronic pain conditions (like cancer-related pain). They are also used for pain associated with certain medical procedures and in palliative care.

Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Opioids can be made from the poppy plant — for example, morphine (Kadian, Ms Contin, others) — or synthesized in a laboratory — for example, fentanyl (Actiq, Duragesic, others).

When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure.

What Are the Side Effects of Opioid Analgesics ?

However, the use of opioids carries risks, including the potential for tolerance (requiring higher doses for the same effect), physical dependence, and addiction. Misuse of opioids, whether for recreational purposes or to cope with chronic pain, can lead to serious health consequences, including overdose and death.

Due to the potential for abuse and the opioid epidemic, healthcare providers carefully consider the risks and benefits when prescribing opioids. Non-opioid alternatives and other pain management strategies are often explored first, especially for chronic pain conditions.

Opioid analgesics commonly cause drowsiness, dizziness, and respiratory depression. However, these side effects usually disappear with continued use.

 

Opioid Side Effects

One of the reasons why your doctor needs to manage pain medications so closely is that they can cause side effects, such as:

• Constipation
• Drowsiness
• Nausea and vomiting

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The drugs lubiprostone (Amitiza), methylnaltrexone (Relistor), naldemedine (Symproic), and naloxegol (Movantik) are approved to treat constipation due to opioid use in those with chronic pain.

Opioids can be dangerous if you take them with alcohol, or with certain drugs such as:

• Some antidepressants and anxiety medications (particularly benzodiazepines such as alprazolam, ativan and clonazpam)
• Some antibiotics
• Sleeping pills

Make sure your doctor knows all of the other medicines you’re taking. That includes:

• Prescription drugs
• Over-the-counter drugs
• Herbal supplements

Opioid Tolerance and Addiction

After taking opioid pain medication for a while, you might find that you need more and more of the drug to achieve the same effect in easing pain. This is called tolerance. It’s not the same as addiction, which involves a compulsive use of a drug.

When you use opioid medication over an extended period of time, you can have dependence. This can happen when your body becomes so used to the drug that if you abruptly stop taking it, you get withdrawal symptoms such as:

• Diarrhea, nausea, and vomiting
• Muscle pain
• Anxiety
• Irritability

You can also get a serious addiction to opioid pain medications. People who are addicted compulsively seek out the pain medications. Their behavior usually leads to negative consequences in their personal lives or workplace. They might take someone else’s pills or buy them off the street, which is especially dangerous since those drugs are often laced with lethal amounts of fentanyl.  Learn more about what can happen when opioid addiction goes untreated.

If you are having a problem with addiction, you need to see your doctor or an addiction specialist.

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However, constipation, another common side effect, tends to persist. In addition, opioid use may lead to addiction or dependence. Other possible side effects of opioid analgesics include:

1. Euphoria, dysphoria, agitation, seizures, hallucinations
2. Lowered blood pressure and heart rate
3. Muscular rigidity and contractions
4. Nausea and vomiting
5. Non-allergic itching
6. Pupil constriction
7. Sexual dysfunction
8. Urinary retention

When Opioid Medications are Dangerous ?

What makes opioid medications effective for treating pain can also make them dangerous.

At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death. And the feelings of pleasure that result from taking an opioid can make you want to continue experiencing those feelings, which may lead to addiction.

You can reduce your risk of dangerous side effects by following your doctor’s instructions carefully and taking your medication exactly as prescribed. Make sure your doctor knows all of the other medications and supplements you’re taking.