About Opioids

It is not necessarily the face you would expect. It could be your neighbor, your mother, father, husband, wife, son, daughter, teacher, and many other faces you see every day, even yours.

Studies show that three out of four people using heroin began with the use of prescription medication. Taken as prescribed, opioids may help manage pain when taken for a short amount of time. However, prolonged use often leads to physical dependence and the risk of addiction occurs.

That risk is even greater when medications are taken at higher than recommended doses, combined with alcohol or other drugs, or taken without a prescription.

What are Opioids?

Opioids include illegal drugs such as heroin but also prescription medications used to treat pain such as Percocet, Darvocet, OxyContin, Codeine and others (see list below). Often, what is simply needed to help relieve pain becomes its own nightmare.

Dependence often begins as tolerance, the need to take higher doses of a medication to get the same effect. This is your first warning sign and you should discuss this with your doctor.

The dangers of addiction are greater than anyone realizes —and easier than one imagines.

How it works: Opioids attach to proteins in the body and reduce the intensity of pain signals reaching the brain. Opioids can produce drowsiness, vomiting, allergic reactions, mental confusion, nausea, constipation and can cause respiration problems.

Common Opioids

  • Codeine (Tylenol w/Codeine, Phenaphen w/ Codeine)
  • Darvon
  • Darvocet
  • Demerol
  • Dilaudid
  • Fentanyl (Actiq, Duragesic, Fentora)
  • Heroin
  • Hydrocodone (Hysingla ER, Zohydro ER)
  • Hydrocodone/acetaminaphen (Lortab, Vicodin, Lorcet, Norco)
  • Methadone (Dolophine, Methadose)
  • Morphine (Kadian, Avinza, Astramorph, MS Contin)
  • Oxycodone (OxyContin, Oxecta, Roxicodone)
  • Oxycodone/acetaminophen (Percocet, Endocet, Roxicet)
  • Suboxone (Talwin, Buprenorphine)
  • Tramadol, Ultram

One in three teens report being offered a prescription or over the counter (OTC) drug for the purpose of misuse and the same number say they have a close friend who abuses prescription painkillers to get high. Even more teens say they take prescription drugs from their own medicine cabinets.


Number of Prescriptions for Opioids (in millions) 

The number of prescriptions for opioids has escalated from around 76 million in 1991 to nearly 207 million in 2013 and that number grows each year.

Surveyed in Howard County

In Howard County, 87% of respondents to an on-line survey agreed that it would be somewhat easy or very easy to get prescription opioids from a friend or family member to get high.


Focus group participants report that opioids and heroin are available in Howard County everywhere and that dealers are coming to the County due to the relative affluence of residents. And, dealers even take credit cards.


In Maryland, during the three years between 2010 and 2013, officials estimate that deaths from heroin and related drugs increased 95%.

Dependence vs. Addiction

Physical dependence occurs because of normal adaptations to chronic exposure to a drug and is not the same as addiction. Addiction, which can include physical dependence, is distinguished by compulsive drug seeking and use despite sometimes devastating consequences.

Someone who is physically dependent on a medication will experience withdrawal symptoms when use of the drug is abruptly reduced or stopped. These symptoms can be mild or severe (depending on the drug) and can usually be managed medically or avoided by using a slow drug taper.

Dependence is often accompanied by tolerance, or the need to take higher doses of a medication to get the same effect. When tolerance occurs, it can be difficult for a physician to evaluate whether a patient is developing a drug problem, or has a real medical need for higher doses to control their symptoms. For this reason, physicians need to be vigilant and attentive to their patients’ symptoms and level of functioning to treat them appropriately.