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opioids

Opioids and Opioid Use Disorder (OUD)

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made from the opium plant, and others are synthetic (man-made).

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

What are the side effects and risks of opioids?

Opioids can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. If someone has signs of an overdose, call 911. These signs may include:

When using opioids, there is also a risk of opioid use disorder (OUD).

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

The risk of OUD is higher if you misuse the medicines. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

Opioid use disorder and overdoses are serious public health problems in the United States. As more people misuse opioids, more women are misusing opioids during pregnancy. This can lead to health risks for the mother and baby. The baby may be born with neonatal abstinence syndrome (NAS). NAS is a group of withdrawal symptoms that a baby has after being exposed to drugs during pregnancy.

Another problem with increased opioid misuse is that it can also lead to more heroin use. There are some people who switch from prescription opioids to heroin because heroin may be cheaper and easier to get.

How are opioid use disorder (OUD) and opioid overdose treated?

There are effective medicines to treat OUD. Using medicines to treat OUD is called medications for opioid use disorder (MOUD). MOUD can help you stop using the drug, get through withdrawal, and cope with cravings. It is often combined with behavioral therapy and counseling. Having support from family and friends can also help.

There is also a medicine called naloxone which can treat opioid overdoses. It can reverse the effects of the overdose and prevent death if it is given quickly.

How can I prevent problems when taking prescription opioids?

To prevent problems with prescription opioids, be sure to follow your doctor's instructions when taking them. Do not share your medicines with anyone else. Contact your doctor if you have any concerns about taking the medicines.

NIH: National Institute on Drug Abuse

Opioid Use Disorder (OUD) Treatment

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers, such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some health care providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, opioid use disorder (OUD) is still a possible risk.

What is opioid use disorder (OUD)?

Opioid use disorder (OUD) means that you have a problematic pattern of using opioids. The pattern causes a lot of distress and impairment (meaning that it causes problems in and interferes with your daily life). Instead of OUD, sometimes people use the terms "opioid dependence" and "opioid addiction." Dependence means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm.

What are the treatments for opioid use disorder (OUD)?

Treatments for OUD include:

Which medicines treat opioid opioid use disorder (OUD)?

The medicines used in MOUD are methadone, buprenorphine, and naltrexone:

How does counseling help treat opioid use disorder (OUD)?

Counseling for OUD can help you:

There are different types of counseling for OUD, including:

Counselors can also refer you to other resources that you might need, such as:

What are residential and hospital-based treatments for opioid use disorder (OUD)?

Residential programs combine housing and treatment services. You are living with your peers, and you can support each other to stay in recovery. Inpatient hospital-based programs combine health care and OUD treatment services for people with medical problems. Hospitals may also offer intensive outpatient treatment. All these types of treatments are very structured, and usually include several different kinds of counseling and behavioral therapies. They usually also include MOUD.

Opioid Overdose

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when these medicines are misused. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

What is an opioid overdose?

Opioids affect the part of the brain that regulates breathing. When people take high doses of opioids, it can lead to an overdose, with the slowing or stopping of breathing and sometimes death.

What causes an opioid overdose?

An opioid overdose can happen for a variety of reasons, including if you:

There is also a risk of overdose if you are getting medications for opioid use disorder (MOUD). MOUD is a treatment for OUD. Many of the medicines used for MOUD are also controlled substances that can be misused.

Who is at risk of an opioid overdose?

Anyone who takes an opioid can be at risk of an overdose, but you are at higher risk if you:

What are the signs of an opioid overdose?

The signs of an opioid overdose include:

What should I do if I think that someone is having an opioid overdose?

If you think someone is having an opioid overdose:

Naloxone won't harm someone if they're overdosing on drugs other than opioids, so it's best to use it if you think someone is overdosing.

Can an opioid overdose be prevented?

If you are taking opioid pain medicine, there are steps you can take to help prevent an opioid overdose:

It is also important to teach your family and friends how to respond to an overdose. If you are at higher risk of an overdose, you will want get naloxone and carry it with you wherever you go. You can buy naloxone at a pharmacy.

Pregnancy and Opioids

You may need to take medicines while you are pregnant. But not all medicines are safe during pregnancy. Many medicines carry risks for you, your baby, or both. Opioids, especially when misused, can cause problems for you and your baby while you are pregnant.

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when these medicines are misused. Misuse can include taking your opioid medicines in greater amounts or more often than you are supposed to, using them to get high, or taking someone else's opioids.

What are the risks of taking opioids during pregnancy?

Taking opioids during pregnancy can cause problems for you and your baby. The possible risks include:

If your provider suggests that you take opioids during pregnancy, you should first discuss the risks and benefits. Then if you both decide that you need to take the opioids, you should work together to try to minimize the risks. Some of the ways to do this include:

If I am already taking opioids and I become pregnant, what should I do?

If you have been taking opioids and you become pregnant, contact your provider. But don't stop taking the opioids on your own. If you suddenly stop taking opioids, it could cause severe health problems for you or your baby. In some cases, stopping suddenly during pregnancy may be more harmful than taking the medicines.

Can I breastfeed while taking opioids?

If you regularly take opioid medicines, you may be able to breastfeed. It depends on which medicine you are taking. But you should not breastfeed if you have HIV or take illegal drugs. Check with your provider before breastfeeding.

What is the treatments for opioid use disorder (OUD) in pregnancy?

If you are pregnant and have an opioid use disorder, do not stop taking opioids suddenly. Instead, see your provider so you can get help. The treatment for opioid use disorder (OUD) is called medication for opioid use disorder (MOUD). For MOUD during pregnancy, providers prescribe either buprenorphine or methadone. These medicines can reduce your cravings and help prevent withdrawal.

Counseling, including behavioral therapies, can also help you to change your attitudes and behaviors related to drug use and build healthy life skills.

Safe Opioid Use

What are opioids?

Opioids, sometimes called narcotics, are a type of drug. They include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid.

A health care provider may give you a prescription opioid to reduce pain after you have had a major injury or surgery. You may get them if you have severe pain from health conditions like cancer. Some providers prescribe them for chronic pain.

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by your provider. However, people who take opioids are at risk for opioid use disorder (OUD) and overdose. These risks increase when opioids are misused. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's opioids.

How do I know if I need to take opioid medicines?

First, you need to talk with your provider about whether you need to take opioids. You should discuss:

What do I need to know if I am going to take opioid medicines?

If you and your provider decide that you need to take opioids, make sure that you understand:

If you have a high risk for an overdose, you will want to get naloxone from a pharmacy and carry it with with you wherever you go. Naloxone is a medicine that can reverse the effects of an opioid overdose.

How can I take my opioid medicine safely?

You should always be careful when taking any medicine, but you need to take extra care when taking opioids:

How can I safely store and dispose opioid medicines?

It is important to store and dispose of opioid medicines properly:

Pregnancy and Substance Use

During pregnancy, there are many things you can do to keep yourself and your baby healthy. They include getting regular prenatal care, eating healthy, and staying active. But it's also very important to avoid substances that could be harmful to you and your baby, such as tobacco, alcohol, and drugs.

Tobacco

Smoking during pregnancy passes nicotine, carbon monoxide, and many other harmful chemicals to your baby. Nicotine is not only a health danger for you, but it can also damage your developing baby's brain and lungs. Carbon monoxide can keep the developing baby from getting enough oxygen.

If you smoke while pregnant, it raises the risk of your baby being born too small, too early, or with birth defects. During the first year of life, there is a higher risk of your baby dying from sudden infant death syndrome (SIDS). And later in life, your child may be more likely to have health problems, such as asthma and obesity.

Other tobacco products, including e-cigarettes, also contain nicotine and are not safe to use during pregnancy. And some of the flavorings used in e-cigarettes may be harmful to developing babies.

You will also want to try to avoid secondhand smoke, which has some of the same risks as smoking during pregnancy.

Alcohol

There is no known amount of alcohol that is safe for you to drink during pregnancy and while trying to get pregnant. All types of alcohol are equally harmful, including all wines and beer. The risks from drinking during pregnancy include problems with the growth of the developing baby and fetal alcohol spectrum disorders (FASD). FASD is a life-long condition that can cause a mix of physical, behavioral, and learning problems.

Illegal drugs

Using illegal drugs, such as cocaine, methamphetamines, and club drugs, during pregnancy can cause problems for both you and your baby. They may cause low birth weight babies, birth defects, or miscarriage. Your child may be more likely to have learning and developmental disabilities. And if you are injecting the drugs, that puts you at risk for HIV. HIV can be passed along to your baby during pregnancy.

Prescription drug misuse

Misusing prescription drugs can also be harmful. Misuse can include taking more than your prescribed dose or taking it more often, using it to get high, or taking someone else's medicines. The possible effects of misusing a medicine during pregnancy will depend on which medicine you are misusing.

Opioids

One type of drug that is a concern during pregnancy is opioids. Opioids include strong prescription pain relievers such as oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Taking opioids during pregnancy can cause problems for you and your baby. The risks include birth defects, preterm birth, the loss of the baby, and neonatal abstinence syndrome (NAS). NAS causes withdrawal symptoms in newborn babies.

If you have pain and your health care provider suggests that you take prescription opioids during pregnancy, first discuss the risks and benefits with the provider. Then if you both decide that you need to take the opioids, you can work together to try to minimize the risks.

Cannabis (marijuana)

Cannabis (marijuana)

Getting help

If you are taking opioids or are addicted to drugs, don't stop taking them suddenly. That can be dangerous to you and the baby. Instead, contact your provider for help with getting off the drugs safely.

Heroin

What is heroin?

Heroin is an illegal, very addictive opioid drug. It's made from morphine, which comes from the seedpod of opium poppy plants. These plants grow in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin.

How do people use heroin?

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, which is called "speedballing." All these ways of taking heroin send it to the brain very quickly, which makes it highly addictive.

What are the short-term effects of heroin?

People who use heroin report feeling a "rush" (a surge of pleasure). And then they may feel other effects, such as a warm flushing of the skin, dry mouth, and a heavy feeling in the arms and legs. They may also have severe itching, nausea, and vomiting. After these first effects, they will usually be drowsy for several hours, and their breathing will slow down.

What are the long-term effects of heroin?

People who use heroin over the long term may develop many different health problems. These problems could include liver, kidney, and lung disease, mental disorders, and abscesses.

People who inject the drug also risk getting infectious diseases such as HIV, hepatitis, and bacterial infections of the skin, bloodstream, and heart (endocarditis). They can also get collapsed veins. When a vein collapses, the blood cannot flow through it.

Repeated use of heroin can lead to tolerance. This means users need more and more of the drug to have the same effect. At higher doses over time, the body becomes dependent on heroin. If someone who is dependent on heroin stops using it, they have withdrawal symptoms. These symptoms can include restlessness, muscle and bone pain, diarrhea, vomiting, and cold flashes with goose bumps.

Repeated use of heroin often leads to heroin use disorder, sometimes called addiction. This is more than physical dependence. It's a chronic (long-lasting) brain disorder. When someone has it, they continue to use heroin even though it causes problems in their life. Some examples include health problems and not being able to meet responsibilities at work, school, or home. Getting and using heroin becomes their main purpose in life.

Can a person overdose on heroin?

It's possible to overdose on heroin. This happens when a person uses so much heroin that it causes a life-threatening reaction or death. All heroin users are at risk of an overdose because they never know the actual strength of the drug they are taking or what may have been added to it. And people often use heroin along with other drugs or alcohol. This can increase the risk of an overdose.

When people overdose on heroin, their heart rate and breathing slow down. Their breathing may slow do so much that not enough oxygen reaches the brain. This condition is called hypoxia. Hypoxia can lead to a coma, permanent brain damage, or death.

How can a heroin overdose be treated?

A medicine called naloxone can treat a heroin (or other opioid) overdose if it is given in time. It works by blocking the effects of the opioid on the body. Sometimes more than one dose of the medicine is needed.

There are two forms of naloxone that anyone can use without medical training: nasal spray and injectable. People at risk of an overdose are encouraged to carry naloxone with them. They can buy naloxone at a pharmacy.

What are the treatments for heroin use disorder?

Treatments for heroin use disorder include medicines to treat withdrawal symptoms, medicine to block the effects of opioids, and behavioral treatments. Often, a combination of medicine and behavioral treatment works best. People getting treatment for heroin use disorder should work with their health care providers to come up with a treatment plan that fits their needs.

NIH: National Institute on Drug Abuse

Pain Relievers

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

Over-the-counter (OTC) medicines are good for many types of pain. There are two main types of OTC pain medicines: acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, naproxen (Aleve), and ibuprofen (Advil, Motrin) are examples of OTC NSAIDs.

If OTC medicines don't relieve your pain, your doctor may prescribe something stronger. Many NSAIDs are also available at higher prescription doses. The most powerful pain relievers are opioids. They are very effective, but they can sometimes have serious side effects. There is also a risk of opioids. Because of the risks, you must use them only under a doctor's supervision.

There are many things you can do to help ease pain. Pain relievers are just one part of a pain treatment plan.

Delirium

What is delirium?

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

What causes delirium?

There are many different problems that can cause delirium. Some of the more common causes include:

Who is more likely to get delirium?

Certain factors put you at risk for delirium, including:

What are the symptoms of delirium?

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

How is delirium diagnosed?

Your health care provider may use many tools to make a diagnosis:

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

What are the treatments for delirium?

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

Can delirium be prevented?

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Non-Drug Pain Management

What is pain?

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen, chest, pelvis, or you may feel pain all over.

There are two types of pain:

What are pain relievers?

Pain relievers are medicines that reduce or relieve pain. There are many different pain medicines, and each one has advantages and risks. Some are over-the-counter (OTC) medicines. Others are stronger medicines, which are available by prescription. The most powerful prescription pain relievers are opioids. They are very effective, but people who take them are at risk of addiction and overdose.

Because of the side effects and risks of pain relievers, you may want to try non-drug treatments first. And if you do need to take medicines, also doing some non-drug treatments may allow you to take a lower dose.

What are some non-drug treatments for pain?

There are many non-drug treatments that can help with pain. It is important to check with your health care provider before trying any of them:

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