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Prescription Opioids

Used legally for pain relief, opioids prescriptions have skyrocketed in the U.S. over the past decade. In fact, pills like oxycodone (Percocet) and hydrocodone (Vicodin) were prescribed enough last year to give every American their own bottle. The dramatic increase in availability, coupled with heroin-like effects, is leading to epidemic abuse with dramatic consequences.

Prescriptions written for opioids in U.S. last year
Heroin users that start with prescription opioids
Daily deaths from prescription opioid overdoses
Americans with opioid addiction
Prescriptions written for opioids in U.S. last year
259 million
Heroin users that start with prescription opioids
4 out of 5
Daily deaths from prescription opioid overdoses
Americans with opioid addiction
1.9 million

Health Effects

Short-Term Effects

Once in the brain, opioids bind to receptors on nerve cells that control the perception of pain and pleasure, as well as motor skills.

prescriotion drug in the brain

While prescription opioids do offer the positive short-term effects of pain relief and euphoria, there are many negative consequences similar to heroin, including:

  • Drowsiness
  • Nausea
  • Constipation
  • Confusion
  • Slowed Breathing

Long-Term Effects

Drug overdose is the leading cause of accidental death in the U.S. with 47,055 overdoses last year. Forty percent involved prescription pain relievers, which has more than tripled in the past 20 years.

Sadly, addiction is common. Prescription opioids alter the brain on a molecular level. With time, the over-stimulated receptors are not able to produce the same levels of pleasure and the brain starts to require opiates to function. This physical dependence leads to withdrawal symptoms if the use of the drug is abruptly reduced.

The symptoms of opioid withdrawal include:

  • Intense cravings
  • Restlessness
  • Muscle and bone pain
  • Insomnia
  • Diarrhea
  • Vomiting
  • Cold flashes
  • Leg spasms

Alcohol worsens adverse health effects and causes dangerous slowing of heart rate and breathing that can lead coma or death. During pregnancy, prescription opioids can cause miscarriage, low birth weight and birth defects.

Risk Factors

6 Obvious Warning Signs

If you or a loved one experience any of the signs below, now is the time to get help.

    1. Taking a high daily dose of prescription opiods.

    1. Obtaining overlapping prescriptions from multiple physicians and pharmacies.

    1. Seeking the drugs despite consequences or concern of loved ones.

    1. Feeling the drugs are needed to function normally, with the inability to stop.

    1. Crushing or injecting instead of taking the drug as prescribed.

  1. Using in combination with alcohol.
Avoiding Prescription Opioids
If suffering from mental heath conditions including depression, anxiety or substance abuse or if family members suffer from any kind of addiction, prescription pain relief should be avoided.

When tolerable, opt for over-the-counter medication and therapies to manage pain instead, even if offered by a physician. This eliminates the possibility of devastating, addiction-related physical and emotional pain.



The leading age group for prescription opioid abuse is 35-44.

Compared to other drugs, abusers are older and often start innocently with a legal prescription. The breakdown of drugs slows with age, and other medications can cause interactions, so the risk of abuse remains high with age. On the other hand, one in nine youth admit to abusing prescription drugs non-medically, and the average age of first use is 22.

More males abuse prescription opioids, but female addiction is growing at a faster rate.

While men are nearly twice as likely to abuse drugs generally, women are more likely to be prescribed prescription pain relievers, be given higher doses and use them for longer time periods. Women also become dependent on prescription pain relievers more quickly than men.

Rates of opioid prescriptions and overdose are highest among Caucasian patients.

Followed by African American patients, Hispanic patients and Asian or other race patients. Opioid overdose rates are nearly three times higher among American Indians and non-Hispanic whites than among blacks and Hispanic whites.

Abuse rates are highest in Southeastern and Northwestern states.

Rural regions also have higher rates of prescription opioid overdose than urban areas. However, there are not high rates of injuries, surgeries or chronic pain in these locations. The U.S is the largest consumer of prescription opioids in the world.

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I was prescribed Vicodin after a bad fall last year. I have never abused drugs or alcohol in my 62 years, but for some reason Vicodin spoke to me. I enjoyed the effect produced by the pain reliever, and soon enough I was no longer using it for pain. My daughter was concerned for my well-being since I was constantly sick, but she didn't know it was withdrawals. At my age, I didn't believe I could be addicted since I haven't shown signs of it in the past, but once I began hearing other people's stories, I realized I could get hooked just as easily as a 19 year old. I was shocked. I wasn't sure who to reach out to, so I admitted myself and called my family from the detox facility. I feel much better today. Being and feeling sober is what my body was made for. I can't believe I put that drug in my body, but I'm grateful to learn that addiction can come in any size, age, or shape.
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I started using codeine as a kid. My friends didn't understand why I couldn't just drink regular alcohol instead, but it was a totally different effect. What I failed to realize was that I was breaking on the inside. I had no confidence, low self-esteem, and I created this world of oblivion to escape in. I loved it and hated it. I became the person I always thought I was meant to be - but it turned me into a maniac. I have a full arrest record that I'm dealing with today, three years into recovery, because of the foolish decisions I made under the influence. Although I thought I loved who I became, I couldn't stand to look at myself and my own actions. Today, I'm finally free of the self-centeredness and self pity. I have a group of people who know who I really am, and I don't need any substance to hide my true nature. I'm grateful and lucky, because the path I was on lead me far astray. But I'm here today.
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I was introduced to Oxycodone after I had an injury in high school. Slowly but surely, I began to take more and more out of the medicine cabinet. I couldn't sleep without it, I couldn't eat without it. I even crushed it up and poured it on my cereal in the morning. Once the doctor cut me off, I experienced the worst withdrawals. My body was cold and sore, but I would get hot flashes and my legs wouldn't work. It was hell and I knew at that moment that I had become hopelessly addicted. I haven't touched the drug since. I found people who have been through the same thing and I gained a solid support system so I don't ever have to fall back into that lifestyle again.
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More On Prescription Drugs

What are some alternatives to manage pain?

Finding alternate methods to cope with and treat painful conditions elimiates the risk of addiction. Many alternate options for pain management exist including:

  • Acupuncture – the insertion of very thin needles into certain points on the body has demonstrated positive results in back pain and headache issues
  • Psychological therapy – engaging in cognitive-behavioral therapy, has been shown to help patients minimize the impact that pain has on their life, including thoughts and emotions.
  • Exercise/Physical therapy – Regular physical activity can provide major benefits for people suffering with painful condition.

Stress reduction practices can help alleviate the sense of pain:

  • Mindfulness meditation
  • Yoga
  • Music therapy
  • Massage
  • Biofeedback

How are prescription opioids and heroin linked?

Prescription opioids and heroin are in the same class of drugs. These substances have a high addiction potential because they both influence areas of the brain related to processing pleasure. In fact, some prescription opioids are even stronger than heroin.

Prescription opioid abuse often leads to heroin because the drug is cheaper and easier to find. In fact, 80% of heroin users started with prescription opioids. The pills create physiological and psychological vulnerabilities that make heroin more desirable.

Overdose rates for prescription opioids were nearly twice the overdose rates for heroin in 2014.

Why are prescription opioids abused?

The top three reasons for prescription opioid abuse are:

1. Self-medication
2. Recreational high
3. Compulsory habit due to dependence or addiction

The use and abuse of prescription drugs are viewed as more socially acceptable than illicit substances. The lack of education on the dangers of trying prescription opioids, even in the medical field, leave people unknowingly vulnerable. Using prescription medications is seen as normal and even encouraged by physicians. Often, patients could have managed the initial pain without these drugs and avoided the additional, all-consuming pain brought on by addiction that can ruin or even end a life.

Some users may be taking these opioids, with or without prescription, to treat a variety of problems such as:

  • managing acute pain
  • chronic pain
  • stress
  • psychological distress
  • emotional problems

Women are more likely to take these medications to deal with stress, while men are more likely to use them to cope with depression. In fact, 45% of people struggling with an opioid medication use disorder meet the criteria for depression and anxiety, and almost 80% of non-medical opioid medication users already have a history of depression and anxiety. College students are also particularly vulnerable because of stress, peer pressure and availability due to over-prescribing.

Which prescriptions are opioids?

Hydrocodone is the most common prescription opioid used for injury-related pain. Morphine is often used before and after surgical procedures to alleviate severe pain. Codeine is prescribed for more mild pain. In addition to pain-relieving properties, some medications — like codeine and diphenoxylate — are also used to relieve coughs and severe diarrhea.


Codeine (various brand names)


Captain Cody, Cody, Lean, Schoolboy, Sizzurp & Purple Drank (With glutethimide: Doors & Fours, Loads & Pancakes and Syrup)


Tablet, Capsule & Liquid


Injected, swallowed (often mixed with soda and flavorings)


Fentanyl (Actiq®, Duragesic® & Sublimaze®)


Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, Tango and Cash & TNT


Lozenge, Sublingual Tablet, Film & Buccal Tablet


Injected, smoked, snorted


Hydrocodone or Dihydrocodeinone (Vicodin®, Lortab®, Lorcet® & others)


Vike & Watson-387


Capsule, Liquid & Tablet


Swallowed, Snorted & Injected


Hydromorphone (Dilaudid®)


D, Dillies, Footballs, Juice & Smack


Liquid & Suppository


Injected & Rectal


Meperidine (Demerol®)


Demmies & Pain Killer


Tablet & Liquid


Swallowed, Snorted & Injected


Methadone (Dolophine® & Methadose®)


Amidone & Fizzies (With MDMA: Chocolate Chip Cookies)


Tablet, Dispersible Tablet & Liquid


Swallowed & Injected


Morphine (Duramorph® & Roxanol®)


M, Miss Emma, Monkey & White Stuff


Tablet, Liquid, Capsule & Suppository


Injected, Swallowed & Smoked


Oxycodone (OxyContin®, Percodan®, Percocet® & others)


O.C., Oxycet, Oxycotton, Oxy, Hillbilly Heroin & Percs


Capsule, Liquid & Tablet


Swallowed, Snorted & Injected


Oxymorphone (Opana®)


Biscuits, Blue Heaven, Blues, Mrs. O, O Bomb, Octagons & Stop Signs




Swallowed, Snorted & Injected

What medications help opioid addiction?

Several medications are available to help with withdraw, cravings and overdose. However, the below are tools, not “cures” for addiction.

  • Buprenorphine (Subutex) can prevent or reduce the unpleasant withdrawal symptoms and cravings from heroin. Many people stay on Buprenorphine long-term, but some people gradually reduce the dose and come off drugs altogether. Many general practitioners can assess and prescribe buprenorphine. Buprenorphine is usually administered as an injection or a tablet. It is usually prescribed as a once-daily dose, usually at least eight hours after taking your last dose of heroin. Do not mix any other drugs and don’t drink alcohol while on a maintenance drug. Possible side effects include constipation, dizziness, drowsiness, headache, nausea, sweating, and vomiting.
  • Buprenorphine-Naloxone (Suboxone) is used to help prevent withdrawal symptoms from narcotics. Suboxone is a tablet that is meant to dissolve under the tongue, do NOT swallow, crush, cut or chew the tablet. Dosage is usually once a day, often detailed by a doctor. The first dose should be no sooner than 6 hours after last use of heroin or other short-acting opioids. Gradual dose reduction is recommended in a treatment plan to avoid opioid withdrawal signs and symptoms. Possible side effects include headaches, diarrhea, constipation, and nausea.
  • Naloxone (Narcan) blocks or reverses the effects of opioids, including extreme drowsiness, slowed breathing, or loss of consciousness. Narcan is used to treat a narcotic overdose in an emergency situation. Naloxone is injected into a muscle, under the skin, or into a vein through an IV. After injecting Narcan, stay with the person and watch for continued signs of overdose. Naloxone side effects include nausea, diarrhea, fever, tremors or shivering, seizures or overactive reflexes. Because Narcan is used in emergency situations, there’s no likelihood of missing a dose.
    Naloxone does not replace emergency personnel nor does it cure addiction.

What are the signs of overdose?

Signs of an opoid overdose include:

  • Blue lips, fingernails or toenails
  • Very slow or no breathing
  • Faint pulse or no pulse
  • Pale and clammy skin
  • Unresponsive to calling their name or to pain
  • Snoring or gurgling noises while asleep or nodding out (fading in and out of consciousness)

To avoid an overdose, take the medication as prescribed. Never mix opioids with alcohol or other depressant drugs, which can slow breathing and heart rate. For drugs with opposite effects (like opioids with stimulants), overdose occurs because the effects counteract each other and too much of one drug is taken.

The medication Narcan can reverse opioid overdoses, saving lives.


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