By Sean J. Ennevor, M.D.

Increased risk and alternative awareness is required due to the opioid crisis.

Another crisis is ongoing during the pandemic, and that is the ongoing opioid crisis. The crisis has been in place since the 1990s, but it has only recently received the attention it deserves. Overdoes from opioids kill over 130 people every day. This epidemic is defined as opioid abuse accounting for 70% of all overdose deaths.

Pain is controlled by opioid receptors, which are found in our brains and other parts of the body. These same receptors, when stimulated, can promote feelings of pleasure by releasing endorphins. The receptor trigger also causes the release of dopamine, which is responsible for our energy and motivation. Unfortunately, these same receptors can cause decreased respiration or heart rates, both of which can be fatal.

What exactly are opiates?

You may have come across the terms narcotic, opiate, or opioid. Opiates are naturally occurring substances that stimulate the same brain receptors. Morphine, heroin, and codeine are among the many drugs found in the opium poppy plant. Fentanyl and methadone are examples of synthetic or man-made substances. There are also semi-organic semi-synthetic substances. Hydrocodone (Vicodin) and oxycodone are two examples (aka Oxycontin).

The term “opioid” refers to both natural and synthetic substances. Narcotics include opium, opium derivatives, and semisynthetic substances. The more modern term for all of the above substances is opioid. Prescription pain medications contain all of the substances listed above, with many of them typically taken orally. This is true of codeine, hydrocodone, and oxycodone, all of which are commonly prescribed for pain relief.

Heroin and opium are illegal street opioids that are more likely to be injected, smoked, or inhaled. Any of the drugs listed above are abused by people of all socioeconomic backgrounds, races, and genders. Morphine, fentanyl, and heroin are used to reduce pain perception, but they may also cause pleasure and sedation upon absorption. Opioids are highly addictive and can result in breathing cessation or a very low heart rate.

Morphine is a natural narcotic derived from the opium of poppy plants that has been used by humans for thousands of years. Heroin, like morphine, is a potent opiate with a similar chemical structure. It is derived from morphine and is twice as potent as morphine. Fentanyl, a synthetic opioid prescribed for acute pain, is not found in nature. It is similar to morphine, but it is 50 to 100 times more potent. Misuse is common due to its extreme potency and addiction potential. Psychological and physical addictions are very possible, and its use should be accompanied by close supervision.

Addiction and abuse

If people use opioids against their doctors’ orders, they will develop abuse symptoms over time. Increased tolerance, inability to function without opioids, and illegal behaviour to obtain the drugs can all be indicators of abuse. If an opioid is abruptly stopped after long-term use, withdrawal symptoms may develop. Sweating, headaches, insomnia, an irregular heart rate, and irritability are some withdrawal symptoms. Abuse and withdrawal symptoms can both cause problems in life.

Even though the symptoms of abuse have negative consequences, addiction evolves. Regardless, the person is unable to stop consuming. Addiction may result from overprescribing practises or from individuals seeking coping mechanisms during times of distress. The pandemic, which resulted in the loss of jobs and livelihoods, exacerbated opioid abuse.

Unfortunately, fentanyl is becoming more common in opioid overdoses and is replacing heroin in abuse. Because of its increased potency, it is overdosed more frequently. Fentanyl, which is relatively cheap, is added to cheap compounds that resemble prescription medications. Fentanyl is even mixed in with cocaine and Xanax. This is extremely dangerous, as people are dying as a result of these potent mixtures.

The causes of the crisis are complex, but the solution involves being aware of what is prescribed or sold on the streets. We must all be aware that none of the opioids are without risk. It is necessary to raise patient awareness about alternative pain management options as well as provide education. More time should be spent discussing not only the risks of opioids, but also alternatives for treating pain, depression, anxiety, or any other life stressor.

Sean J. Ennevor, M.D. received his B.A.S. in biology and economics from Stanford University and his M.D. as a Dean’s Scholar from UCLA School of Medicine. He completed his medical residency and fellowship in anesthesiology at Yale University, where he was chief resident and on staff. He practised medicine in the Twin Cities for over 14 years and now works as an advisor and investor for medical technology companies across the country.