Opioid facts for kids

Quick facts for kids Opioid
Drug class
Chemical structure of morphine, the prototypical opioid.
Class identifiers
Use	Pain relief
ATC code	N02A
Mode of action	Opioid receptor
Legal status
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Opioids are a class of drugs that derive from, or mimic, natural substances found in the opium poppy plant. Opioids work in the brain to produce a variety of effects, including pain relief. As a class of substances, they act on opioid receptors to produce morphine-like effects.

The terms 'opioid' and 'opiate' are sometimes used interchangeably, but there are key differences based on the manufacturing processes of these medications.

Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea and suppressing cough. Extremely potent opioids such as carfentanil are approved only for veterinary use. Opioids can cause death and have been used for executions in the United States.

Side effects of opioids may include itchiness, sedation, nausea, respiratory depression, constipation, and euphoria. Long-term use can cause tolerance, meaning that increased doses are required to achieve the same effect, and physical dependence, meaning that abruptly discontinuing the drug leads to unpleasant withdrawal symptoms. An overdose or concurrent use with other depressant drugs like benzodiazepines commonly results in death from respiratory depression.

Because opioids are addictive and may result in fatal overdose, most are controlled substances.

Medical uses

Pain

The weak opioid codeine, in low doses and combined with one or more other drugs, is commonly available in prescription medicines and without a prescription to treat mild pain. Other opioids are usually reserved for the relief of moderate to severe pain.

Acute pain

Opioids are effective for the treatment of acute pain (such as pain following surgery). For immediate relief of moderate to severe acute pain, opioids are frequently the treatment of choice due to their rapid onset, efficacy and reduced risk of dependence. They have also been found to be important in palliative care to help with the severe, chronic, disabling pain that may occur in some terminal conditions such as cancer, and degenerative conditions such as rheumatoid arthritis. In many cases opioids are a successful long-term care strategy for those with chronic cancer pain.

Just over half of all states in the US have enacted laws that restrict the prescribing or dispensing of opioids for acute pain.

Chronic non-cancer pain

Guidelines have suggested that the risk of opioids is likely greater than their benefits when used for most non-cancer chronic conditions including headaches, back pain, and fibromyalgia. Thus they should be used cautiously in chronic non-cancer pain. If used the benefits and harms should be reassessed at least every three months.

Cough

Codeine was once viewed as the "gold standard" in cough suppressants, but this position is now questioned. It is not recommended for children.

Low dose morphine may help chronic cough but its use is limited by side effects.

Diarrhea

In cases of diarrhea-predominate irritable bowel syndrome, opioids may be used to suppress diarrhea. Loperamide is a peripherally selective opioid available without a prescription used to suppress diarrhea.

Shortness of breath

Opioids may help with shortness of breath particularly in advanced diseases such as cancer and COPD among others. However, findings from two recent systematic reviews of the literature found that opioids were not necessarily more effective in treating shortness of breath in patients who have advanced cancer.

Adverse effects

Common and short term

• Itching
• Nausea
• Vomiting
• Constipation
• Drowsiness
• Dry mouth

Other

• Cognitive effects
• Opioid dependence
• Dizziness
• Loss of appetite
• Delayed gastric emptying
• Decreased testosterone levels
• Depression
• Immunodeficiency
• Increased pain sensitivity
• Irregular menstruation
• Increased risk of falls
• Slowed breathing
• Coma

Each year 69,000 people worldwide die of opioid overdose, and 15 million people have an opioid addiction.

Opium alkaloids and derivatives

Opium alkaloids

Phenanthrenes naturally occurring in (opium):

Preparations of mixed opium alkaloids, including papaveretum, are still occasionally used.

Semi-synthetic alkaloid derivatives

Opioid antagonists

See also

In Spanish: Opioide para niños