Opioid Fact Sheet

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  Opioid Fact Sheet

Coast to Forest Resources

Thank you for exploring our fact sheet series. To learn more about substance use and mental health, check out our other fact sheets. To find local resources, check out the Coast to Forest County-Specific Resource Guides. For a variety of national and state-focused resources, please visit our Helplines & Practical Tools page.

What are Opioids?

Opioids, also known as narcotics, are a class of drugs that provide pain relief.1 Opioids may be prescribed by a healthcare provider to manage moderate-to-severe pain after surgery or for chronic diseases like cancer.2 Opioids are controlled substances in the U.S., meaning that they are regulated by the government and have varying potential to be misused. It is important to note, that while the terms opioid and opiate are often used interchangeably, opioids refer to all synthetic, semi-synthetic, and natural opioids while opiates refer only to natural opioids.3 

Natural vs. Semi-Synthetic vs. Synthetic Opioids1,3 

The Opioid Crisis

  • 1990: First wave begins. Most overdose deaths related to prescription opioids4 

  • 1995: American Pain Society launched “pain as the fifth vital sign”. Unfortunately, this led to a reliance on opioids for management4 

  • 2010: Second wave of the opioid crisis begins. Most overdose deaths related to Heroin5

  • 2013: Third wave begins. Most overdose deaths related to synthetic opioids4 

  • Current Data suggests that a fourth wave is beginning that is characterized by polysubstance use, with a noted increase in stimulant and/or opioid use.15 Research is underway to better understand this new wave and pinpoint when it began. 

Facts and Statistics

National: 

  • In 2020, 68,630 deaths involved opioids6 

  • In 2020, 56,516 overdose deaths reportedly involved synthetic opioids (excluding methadone)6 

Oregon: 

  • On average 5 Oregonians die each week of opioid overdose7 

  • From July 2019-June 2020 heroin and fentanyl were involved in 29.7% and 23.7% of overdose deaths, respectively8

  • From 2019 to 2020, the number of fentanyl related deaths increased from 75 to 2988 

Common Names

Smack, Horse, Mud, Brown Sugar, Junk, Black Tat, Big H, Paregoric, Dover’s Powder, MPTP (New Heroin), Hillbilly, Heroin, Lean or Purple Drank, OC, Ox, Oxy, Oxycotton, Sippin Syrup1 

Prescription Names

  • Oxycodone:

    • OxyContin®, Roxicodone®, Oxecta®, Oxaydo®, Xtampza ER®, Percodan®, Targiniq®, Xartemis XR®, Oxycet®, Roxicet®, Tylox®, Percocet®9 

  • Hydrocodone-Acetaminophen: 

    • Vicodin®, Norco®, Lorcet®, Zamicet®, Verdrocet®, Lortab®, Anexsia®, Co-Gesic®, Hycet®, Liquicet®, Maxidone®, Norco®, Xodol 10/300®, Zolvit®, Zydone®9

  • Morphine: 

    • Duramorph®, Infumorph P/F®, MS Contin®, Oramorph SR®, Avinza®, Arymo ER®, Kadian®, Morphabond®, Roxanol-T®9

  • Fentanyl Cirtrate: 

    • Actiq®, Fentora®, Abstral®, Lazanda®, Onsolis®, Sublimaze®9

  • Fentanyl: Duragesic®, Subsys®9 

Forms

  • Tablets, pills, capsules1 

  • Skin patches1 

  • Powder or chunks ranging in color from white to brown or black1 

  • Liquid that may be consumed orally, via injection or suppository1 

  • Lollipops1 

How Opioids Work

Opioids work by binding to opioid receptors found primarily in the central nervous system (CNS), resulting in reduced cell excitability and neurotransmission.10 Thus, opioids do not treat the cause of pain, but rather work by decreasing the perception of pain. 

Short Term Health Effects

  • Drowsiness10  

  • Confusion10 

  • Nausea10 

  • Constipation10 

  • Euphoria10 

  • Slowed breathing10 

  • Overdose10 

Long Term Health Effects

  • Overdose10 

  • Breathing problems during sleep14 

  • Constipation14  

  • Insomnia14 

  • Tooth decay14 

  • Tolerance, dependence, and opioid use disorder (OUD): 

    • Tolerance: Reduced response to a substance with repeated use3 

    • Dependence: Adaptation to a substance that produces symptoms of withdrawal when the substance use is halted3 

    • OUD: Follows opioid tolerance and dependence and involves a pattern of opioid use that results in significant impairment and distress3 

Withdrawal Symptoms

  • Early symptoms:  

    • Watery eyes, runny nose, yawning, and sweating1 

  • Later symptoms: 

    • Restlessness, irritability, loss of appetite, nausea, tremors, severe cravings, severe depression, vomiting, increased heart rate and blood pressure, and chills alternating with flushing and excessive sweating1 

  • Given the symptoms of withdrawal, a person may need medical supervision to ensure their safety during the process.16 

Overdose

  • An overdose can be intentional or unintentional, and is when a large enough dose of an opioid is taken to have serious adverse health effects, including life threatening symptoms or death1 

  • Physical signs: 

    • Constricted (pinpoint) pupils, cold clammy skin, confusion, convulsions, extreme drowsiness, and slowed breathing1 

  • In the event of a suspected overdose:  

    • Call 911

    • Administer CPR if breathing has stopped11 

    • Administer naloxone11 

Opioid Use Disorder Treatment

  • Studies have shown that a combination of medical and therapeutic interventions, such as Medication Assisted Treatment (MAT) is the most effective treatment12 

  • Medications  

    • Buprenorphine (Suboxone®, Subutex®), Methadone, and extended-release Naltrexone (Vivitrol®)13 

  • Therapeutic interventions:  

    • Cognitive Behavioral Therapy (CBT)12

    • Contingency Management12 

    • Motivational interviewing12 

    • Multidimensional Family Therapy12 

  • Treatments in development: 

    • Vaccines13 

    • Transcranial Direct Current Stimulation1 

Resources

SAMHSA National Helpline: 1-800-662-HELP 

  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders 

"Talk. They Hear You." Mobile App: https://www.samhsa.gov/talk-they-hear-you/mobile-application  

  • A phone app geared towards parents or caregivers to help facilitate conversations with children about drug use 

CDC Preventing Opioid Overdose: https://www.cdc.gov/overdose-prevention/prevention/index.html 

  • Includes in-depth opioid and pain management prescribing resources for healthcare providers and patients 

CDC National Center for Injury Prevention and Control - Opioid Overdose: https://www.cdc.gov/drugoverdose/index.html 

  • A gateway website to access the CDC’s latest data and critical updates about drug overdoses 

References

  1. Drug Fact Sheet: Narcotics  

  2. About Prescription Opioids

  3. Commonly Used Terms

  4. A Brief History of the Opioid Epidemic and Strategies for Pain Medicine  

  5. Understanding the Opioid Overdose Epidemic

  6. Drug Overdose Death Rates  

  7. Reducing Opioid Overdose and Misuse  

  8. 2021 Opioid overdose in Oregon: Report to the Legislature  

  9. Opioids  

  10. Prescription Opioids DrugFacts  

  11. Opioid Overdose  

  12. Treatment  

  13. Effective Treatments for Opioid Addiction  

  14. A Review of Potential Adverse Effects of Long-Term Opioid Therapy: A Practitioner’s Guide  

  15. The fourth wave of the US opioid epidemic and its implications for the rural US: A federal perspective  

  16. Withdrawal  

Acknowledgments

This fact sheet was developed by the Oregon State University Coast to Forest team, a collaboration of the College of Health, OSU Center for Health Innovation and OSU Extension Service Family & Community Health program. We would like to thank the H 310 Health Field Experience students for their contributions.

For more information and to explore local resources, check out the Coast to Forest County-Specific Resource Guides.