Medical Uses of Opioids

Instructor: Ashley Dugger

Ashley is an attorney. She has taught and written various introductory law courses.

Opioid drugs are narcotic pain relievers. They are drugs that help block pain messages in the user's brain. This lesson discusses the use of opioids and other opiate-like drugs for medical purposes.

Opioids and Opium

So what exactly is an opioid? That's a strange name for a medicine, isn't it? Well put simply, an opioid is a narcotic. It's a pain relieving medicine that's designed to work like opium.

You've likely heard of opium. Opium is an ancient medicine made from poppy seed pods. It was used in tribal ceremonies, and also as an anesthesia and painkiller.

Opium poppy seeds pods such as those used to make opium

Opium was typically smoked. As people throughout the world discovered opium's pleasant effects, recreational use of opium spread. Opium is known to cause intense joy and relaxation.

Even though opium was a heavily abused recreational drug at the time, it was still being used as a medicine in the U.S. through the Civil War. Around that time, opioid drugs were developed and replaced the medical use of opium. Some of these opioid drugs were actually derived from certain compounds found in opium. Drugs derived from opium are called opiates.

The new opioid drugs were injected. Today's opioids still come in a liquid form for injection or hospital IV use, and are also usually produced in pill or tablet form.

Opioids for Pain Relief

Opioids are opium-like drugs, in that they work by binding to certain receptors in the user's brain, spinal cord and other nerve areas. These special receptors are known as opioid receptors. Generally speaking, this means opioids help block pain messages in the user's brain in the same way opium does.

For example, let's say I hurt my knee. It's throbbing and painful beyond belief. Think of the opioid drugs as a cushion, or a shield, for the receptors in my brain. Once I take the opioid, the painful messages sent from my knee simply aren't received, or aren't fully received, in my brain. The message is dulled.

Opioids are best known, and most commonly used, for pain relief. In fact, opioids are medically defined as narcotic pain relieving drugs that work by dulling the user's sense of pain. Sometimes people use the term 'narcotics' to refer to any type of drug, but that's incorrect. A narcotic is a specific type of drug that works by affecting the user's brain receptors. Opioids are narcotics.

There are many types of pain relieving opioid drugs, including:

  • Morphine, which is used frequently in hospital settings and marketed under brand names Kadian and Avinza
  • Codeine, which is often prescribed in combination with other medicines, such as Tylenol with codeine
  • Oxycodone, also known as OxyContin and Percocet, which are popularly prescribed pills but also a popular source of prescription drug abuse
  • Hydrocodone, which is also prescribed as a combination drug with acetaminophen under the brand names Vicodin and Lortab
  • Heroin, which has not been used as a medicine since the 1920s, when its use was outlawed due to widespread addiction

Note that these opioids are all controlled substances under the Controlled Substances Act. The Controlled Substances Act schedules, or classifies, drugs according to their medicinal value and potential for abuse. Heroin is listed as a Schedule I drug. This means it's considered to have no medical benefit and has a high potential for abuse. Schedule I drugs are considered to be the most dangerous class of drugs.

Most other opioids are Schedule II drugs. This means they are drugs with a high potential for abuse, and use potentially leading to severe psychological or physical dependence, but still with some medicinal value. Schedule II drugs are considered to be the second most dangerous class of drugs, and therefore have major restrictions applied to their usage.

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