Opioids

What are they?

Opioids are drugs that reduce pain and slow down or “depress” the body’s systems. They work by attaching to opioid receptors in the brain and blocking pain signals. This process can create a sense of calm, relaxation, or even euphoria (“the high”). They can be made naturally from poppy plants or synthetically in a lab.  

Opioids come in many forms, pills, powders, or liquids. They are used by swallowing, snorting, smoking, or injecting. 

When used repeatedly, opioids can change how the brain works. Over time, the body can start to rely on them to feel “normal.” This process can lead to cravings, dependence, and withdrawal when someone suddenly stops using them. 

Prescription vs. counterfeit pills 

Prescription opioids are sometimes prescribed for moderate or severe pain. For example, after surgery or injury. Common examples include: 

• Oxycodone (OxyContin, Percocet)
• Hydrocodone (Vicodin) 
• Morphine 
• Hydromorphone (Dilaudid) 
• Fentanyl (prescribed in hospitals for severe pain) 
• Street names: Oxys, Perks, Vikes, M30s, Blues, Lean (when codeine is mixed into drinks) 

Counterfeit pills 

Fake pills are a big reason overdose deaths have increased. They’re often made to look identical to real prescriptions but can be “laced” with, or contain deadly levels of, fentanyl or other drugs. 

What’s fentanyl? 

Fentanyl is a powerful synthetic opioid, meaning it’s made in a lab. It is used by medical professionals to treat severe pain. It’s about 50 times stronger than heroin and 100 times stronger than morphine. Even a tiny amount can cause an overdose in seconds, especially if you don’t know it’s there. 

Here’s the danger: 

• About 6 in 10 fake prescription pills tested by the DEA contained a potentially lethal dose of fentanyl. 
• Just 2 milligrams of fentanyl (about the size of 10-15 grains of salt) can cause a fatal overdose. 
• You can’t see, taste, or smell fentanyl, and it can take minutes for someone to overdose. 

Illegally made fentanyl is often mixed into counterfeit pills and powders to make them more potent and addictive. Adding fentanyl to other drugs also makes them unpredictable and dangerous. 

Only take pills prescribed to you by a licensed health care provider or filled at a pharmacy. Even if you think you know your source, there’s no way to be sure what’s in the pill. 

Heroin 

Heroin is an illegal opioid made from morphine. It can be injected, smoked, or snorted, and enters the brain very quickly. This quick entrance causes an intense high, but also a high risk for overdose and addiction. 

Heroin is becoming less common because fentanyl is cheaper and stronger.  

People who inject heroin or other opioids are also at higher risk for infections like HIV and hepatitis C from sharing or reusing needles. 

Naloxone

Naloxone is a medication that can reverse an opioid overdose. 
It’s safe, easy to use, and won’t harm someone who hasn’t taken opioids. 
Learn more about naloxone and other ways to stay safe.

How they work

Opioids slow down the messages between your brain and body. That’s why they dull pain and can make you feel calm or sleepy. They also slow breathing, heart rate, and reflexes. 

Mixing opioids with alcohol, benzos, or other depressants greatly increases overdose risk, as the combination of these substances slow breathing even more. 

Impacts on mental health

Opioids don’t just affect the body. They also change how your brain works. These drugs attach to receptors that control pain, mood, and emotions. At first, that can bring a wave of calm or euphoria. But over time, your brain adapts by making fewer of its own “feel good” chemicals like dopamine and endorphins. 

The same brain changes that cause cravings and dependence can also mess with mental health. Many people experience depression, anxiety, mood swings, or trouble thinking clearly — sometimes long after they stop using opioids. 

If someone already struggles with stress, trauma, or mental health challenges, misusing opioids can make symptoms worse or harder to manage. What might start as pain relief or a way to cope can end up creating a cycle in which your brain thinks it needs opioids to survive.  

There’s a reason that willpower alone doesn’t feel like enough to break addiction. When someone’s brain becomes dependent on a substance to function, it will obsess over obtaining the drug at the expense of other processes that maintain mental and physical health. That’s why people need medical and emotional support when going through this process.   

Our brains and bodies are resilient and recovery is possible.

Treatment options  

What is MOUD or MAT? 

Medication for Opioid Use Disorder (MOUD) refers to the use of safe, prescribed medications to reduce cravings and withdrawal symptoms. Examples include  buprenorphine, methadone, or naltrexone. These medications help your brain rebalance and make recovery safer and more manageable. 

Medication-Assisted Treatment (MAT) includes MOUD as part of a more comprehensive approach. MAT combines medication with counseling, behavioral therapy, and other recovery supports to address both the physical and emotional aspects of opioid use disorder. 

In short: MOUD = medication only while MAT = medication plus therapy and support. 

Resources