3. Opioids: From bathroom cabinet to epidemic. How everyday drugs affect our health.

What is prescription opioid misuse?

Also known as: Oxy, Percs, Happy Pills, Hillbilly Heroin, OC, or Vikes

Prescription opioids are medications that are chemically similar to endorphins – opioids that our body makes naturally to relieve pain – and also similar to the illegal drug heroin.  In nature, opioids are found in the seed pod of the opium poppy plant. Opioid medications can be natural (made from the plant), semi-synthetic (modified in a lab from the plant), and fully synthetic (completely made by people).

Prescription opioids usually come in pill form and are given to treat severe pain—for example, pain from dental surgery, serious sports injuries, or cancer. Opioids are also commonly prescribed to treat other kinds of pain that lasts a long time (chronic pain), but it is unclear if they are effective for long term pain.

For most people, when opioids are taken as prescribed by a medical professional for a short time, they are relatively safe and can reduce pain effectively. However, dependence and addiction are still potential risks when taking prescription opioids. Dependence means you feel withdrawal symptoms when not taking the drug. Continued use can can lead to addiction, where you continue to use despite negative consequences. These risks increase when these medications are misused. Prescription medications are some of the most commonly misused drugs by teens, after tobacco, alcohol, and marijuana.

Common opioids and their medical uses are listed below.

Opioid Types	Conditions They Treat
oxycodone (OxyContin, Percodan, Percocet) hydrocodone (Vicodin, Lortab, Lorcet) diphenoxylate (Lomotil) morphine (Kadian, Avinza, MS Contin) codeine fentanyl (Duragesic) propoxyphene (Darvon) hydromorphone (Dilaudid) meperidine (Demerol) methadone	severe pain, often after surgery acute (severe) pain some forms of chronic pain (severe) cough and diarrhea

Fentanyl has been in the news recently.  It is a powerful opioid prescribed for extreme pain that is 50 to 100 times more potent than morphine. It is extremely dangerous if misused, and is sometimes added to illicit drugs sold by drug dealers. Find out more about Fentanyl.

Types of opioids:

Type of Opioid	How Are They Derived	Examples
Natural opioids (sometimes called opiates)	nitrogen-containing base chemical compounds,  called alkaloids, that occur in plants such as the  opium poppy	morphine, codeine, thebaine
Semi-synthetic/man-made opioids	created in labs from natural opioids	hydromorphone, hydrocodone, and oxycodone (the  prescription drug OxyContin), heroin (which is made  from morphine)
Fully synthetic/man-made opioids	completely man-made	fentanyl, pethidine, levorphanol,  methadone, tramadol,  dextropropoxyphene

How Prescription Opioids Are Misused
People misuse prescription opioid medications by taking them in a way that is not intended, such as:

• Taking someone else’s prescription, even if it is for a legitimate medical purpose like relieving pain.
• Taking an opioid medication in a way other than prescribed—for instance, taking more than your prescribed dose or taking it more often, or crushing pills into powder to snort or inject the drug.
• Taking the opioid prescription to get high.
• Mixing them with alcohol or certain other drugs. Your pharmacist can tell you what other drugs are safe to use with prescription pain relievers.

Prescription opioids are chemically closely related to heroin, and their effects, especially when misused, can be very similar. Because heroin may be cheaper to get, people who have become addicted to prescription pain medications sometimes switch to using heroin. Nearly 80 percent of people addicted to heroin started first with prescription opioids. However, the transition to heroin use from prescription opioids is still rare; only about 4 percent of people who misuse prescription opioids use heroin. Even so, because millions of people are using prescription opioids, this adds up to hundreds of thousands of heroin users.

Source: The National Institute on Drug Abuse Blog Team. (). Prescription Pain Medications (Opioids). Retrieved from https://teens.drugabuse.gov/drug-facts/prescription-pain-medications-opioids on June 14, 2017.

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Praise for Healing the Brain

"A book that can help medical professionals as well as the general public, Mr. Balog has tackled a subject that is complex and he makes it quite approachable. It has added and enriched my own practice of medicine by making me more aware of issues not often discussed in medical circles."--Peter Paganussi, MD, Virginia

"Author David Balog has done an excellent job of creating a book for educators (or anyone working with youth) that explains the complicated workings of the brain in an easy to understand manner. Balog goes on to discuss various types of trauma and how the adolescent brain responds to trauma such as depression, stress, addiction, risk taking, PTSD, etc. LGBT/Q youth may experience trauma in ways majority youth often do not. The author shares important coping strategies....I highly recommend this book!"--Carol Dopp, M.Ed. 

"David Balog understands the strain of alienation, so he tackles this subject with compassion and concern. Mr. Balog draws on his knowledge of brain science to give readers insight into what happens to young people under tremendous stress, and he offers practical advice on how to help and cope."--Gary Cottle, author

"Provides comfort and learning to the reader. Flows easily from one topic to the next and knits tidbits of information together in a unifying mosaic. Easy to read. Difficult to put down." --Michael J. Colucciello, Jr., New York State Dept. of Mental Health researcher, retired.

"Well researched, fleshed out with relevant case histories, this book packs a lot of solid information into its 152 pages. Written in an engaging style for the layman, it covers a wide range of topics. One learns a great deal about the biology of stress, particularly the vulnerability of the brain in the pre-adult years. This book also provides a glossary of key brain science terms and a listing of organizations serving the LGBT /Q community and resources on the brain."--Gary Bordzuk, librarian