The term “opiate” refers to any drug that is derived from opium, which is the sap of the opium poppy, Papaver somniferum. Opium was one of the earliest drugs discovered by man and has been used since before recorded history. Opiates are a type of analgesic meaning that they reduce or modulate the sensation of pain so that it is more bearable and they are still used for this effect in modern medicine. Opiates achieve their effect by binding to a class of receptors in the brain that have been called (not surprisingly) “opioid receptors” which are normally bound by substances produced by the body called endorphins and enkephalins. Technically, “opioids” are defined as any substance than binds to opioid receptors while “opiates” are the subset of these substances that are derived from opium. Until relatively recently, there was no difference between opioids and opiates because all opioids were derived from opium; however, there are now many entirely synthetic drugs that bind to these receptors. Examples of purely synthetic opioids include fentanyl, and meperidine (Demerol). Examples of opioids derived from opium that are still used in modern medicine are morphine, hydrocodone (in Vicodin), oxycodone (in Oxycontin and Percocet), and hydromophone (Dilaudid).
While opiates have alleviated much suffering through their conservative use in medicine, they have also ruined many lives through addiction. Unfortunately, all opiates cause tolerance (the need to take more for the same effect) and withdrawal (the experience of unpleasant symptoms when the drug is stopped). Scientists have searched for many years to find a medication with the analgesic properties of opiates but which doesn’t cause tolerance and withdrawal, but have been unsuccessful to date. It appears that there is no way to activate opioid receptors in the brain without also causing the development of tolerance and withdrawal.
In addition to analgesia, opiates cause numerous other effects including constipation, miosis (constriction of the pupils), sedation, respiratory depression, and euphoria. It is this last effect of opiates that has led to the creation of opiate addicts throughout history. When taken in sufficient doses, opiates produce a feeling of calm and well being that cause susceptible individuals to become addicted to them. In many parts of the world, opium itself is the most commonly abused opiates but in the Western society are heroin and prescription opioid analgesics such as Vicodin, Percocet, Oxycontin, and Dilaudid.
Once someone has become addicted to an opiate it can be nearly impossible for them to stop using on their own. This is partially due to the fact that withdrawal from opiates is extremely unpleasant and involves nausea, vomiting, diarrhea, muscle cramps, depression, and cold sweats. Addiction to opiates is also very difficult to break without help because once an individual knows what it is like to experience relief from emotional and psychological pain it can be very hard to live without this relief. This is particularly true for individuals with co-occurring psychiatric illness such as depression or anxiety.
The good news is that there is help for opiate addiction and people can and do recover from it. The most important step in recovery is the acknowledgement that there is a problem and the acceptance of help. If you or a loved one is struggling with opiate addiction, call us now to speak with an addiction specialist who can help you to begin the recovery process.