New York Daily News

WHAT YOU NEED TO KNOW ABOUT OPIOIDS

As opioids claim an ever-greater number of American lives, the Daily News provides a medical experts’ guide to the hard facts. We will keep it continuall­y updated at nydn.us/opioids until this crisis is past.

- BY DR. YASMIN HURD AND DR. EDWIN A. SALSITZ

1 WHAT ARE OPIOIDS?

Opioids are synthetic, laboratory-created drugs derived from naturally occurring alkaloids in the opium poppy. They are prescribed as analgesics, or painkiller­s. The most common opioids are methadone, oxycodone, hydrocodon­e, hydromorph­one and fentanyl.

METHADONE

— A potent opioid medication commonly used as a pain reliever and also as a medication-assisted therapy for addiction to both heroin and prescripti­on painkiller­s.

OXYCODONE

— Frequently dispensed as Percocet and OxyContin, oxycodone became the “face” of the prescripti­on opioid epidemic, especially in its long-acting version, OxyContin. It is roughly twice as strong as morphine, so is similar in potency to heroin.

HYDROCODON­E

— Sold as Vicodin, Lorcet and Lortab, hydrocodon­e is derived from codeine and about half as strong as oxycodone. It is among the most widely prescribed medication­s in the United States, which consumes 90% of the world’s hydrocodon­e supply.

HYDROMORPH­ONE

— Much more potent than heroin, hydromorph­one (also known as Dilaudid) is the most potent oral prescripti­on opioid.

FENTANYL (DURAGESIC)

— The most potent of the prescribed opioid analgesics, fentanyl (sold as Duragesic) is commonly delivered by skin patch to treat severe chronic pain. Illicitly produced fentanyl is now found in 90% of seized heroin, accounting for increased overdose deaths across the country. The sheer potency of fentanyl contribute­s to the greater chance of overdose, especially when individual­s unknowingl­y consume drugs such as heroin or cocaine without knowing fentanyl has been added.

2 WHAT ARE OPIATES?

Like opioids, opiates are derived from alkaloids, naturally occurring chemicals in the opium poppy. They are sometimes called “natural” since the activeingr­edient molecules are made by nature, not manufactur­ed by chemical synthesis. Opiates include:

MORPHINE

— Found in the opium poppy, morphine has been the traditiona­l opiate used to treat moderate to severe pain in the United States for at least 100 years. Morphine (MS Contin, among other branded formulatio­ns) is still commonly prescribed for post-surgical pain.

CODEINE

— A “weak” painkiller, codeine is converted in the liver to morphine. It is also used as a cough suppressan­t.

HEROIN

— The most widely available illicit opiate, heroin is a major cause of fatal overdoses in the United States. Twice as strong as morphine, from which it is made, it is injected, sniffed and smoked, which allows it to pass quickly through the blood-brain barrier, which accounts for its strong euphoric effects.

OPIUM

— The oldest opiate, opium is the milky resin in the poppy plant from which morphine and codeine are extracted. Its use for medical and recreation­al purposes was superseded in modern times by the synthesis of morphine and other more potent opiates.

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