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Types and Classification of Opioids

Types and Classification of Opioids

Opioid addiction is a catastrophe. In the U.S. it’s an especially prominent issue, with an average of 115 people overdosing each day in 2016. With the severity of the situation, it’s critical to work on education and prevention of the issue.

One of the problems stems from the fact that many people view opioids as “safe.” After all, they are mostly prescription medications, which gives opioid addicts a false sense of security. In raising awareness about opiates and what they can do to our bodies, it’s essential to know what medications are opioids and how dangerous each of them is.

How Are Opioids Categorized?

Opioids generally work in similar ways, by mimicking endorphins in our brain. Endorphins act as natural pain relievers, and opioids take on that characteristic to relieve the patient’s pain reliably. However, there are many categorizations of opioids, depending on how they affect people, how they’re made, and how they are taken. Let’s take a closer look into some of the more common opioid categorizations.

How They’re Made

Depending on how opioids are made, they classify as either natural or synthetic. However, all natural and semi-synthetic opioids derive in some measure from the opium poppy plant. Those that are entirely synthetic are lab produced.

Naturally derived opioids

Are drugs that can be directly extracted from the poppy plant, most notably morphine and codeine;

Semi-synthetic opioids

These drugs go through some laboratory chemical modifications but also derive from the poppy plant, most notably oxycodone (Percocet) and hydrocodone (Vicodin).

Synthetic opioids

These are entirely manufactured in a lab, and they’re made to mimic the chemical structure of natural opiates, most notably fentanyl (Duragesic) which is often used to relieve cancer-related pain.

How They’re Classified According to Abuse Potential

Another classification of opioids is related to their potential for abuse and likelihood of dependence. It is called the “Schedule” classification, which is determined by the Drug Enforcement Agency (DEA). Interestingly enough, some opioids were long thought to be less addiction-inducing than they are, which eventually resulted in changing them to different schedules.

Schedule I drugs

Drugs like heroin, which have an extremely high potential for abuse with the addition of no medical purpose.

Schedule II drugs

Drugs like hydrocodone, fentanyl, and codeine, which have high potential both for abuse and physical and psychological dependence, but they do have a medical purpose.

Schedule III drugs

Drugs like buprenorphine and naloxone, which don’t have a very high potential for abuse but they can still cause dependence, both psychological and physical.

Schedule IV drugs

Drugs like tramadol, which are a little less severe when it comes to the potential for abuse than the drugs in schedule III, but they can still cause mental and physical dependence.

Schedule V drugs

Drugs like Robitussin AC, which are the lowest both in the potential for abuse and the possibility to cause psychological or physical dependence.

How They’re Administered

Opioids are also often classified by how they’re administered, and with a variety of formulations.

Capsules and tablets

Most often, opioids can be found in the form of tablets and capsules to be taken orally, after which the medication enters the bloodstream through the digestive system.

Oral liquids

For those patients who have trouble swallowing pills, there is a liquid form of some opioids available, such as morphine and oxycodone.

Skin patches

For absorption through the skin, there are skin patches that deliver opioids, m

ost frequently buprenorphine and fentanyl.

Injections

Opioids such as morphine are available in an injectable form, sometimes used in hospitals.

Nasal sprays

Naloxone is one of the opiates that are in the way of a nasal spray.

Oral lozenges

Opioid lozenges such as Actiq are administered orally; they absorb through the mucous membrane under the tongue.

What Medications Are Opioids?

It’s imperative to know which medications are opioids as well as which schedule they’re classified. That will help you better understand the possible risks when prescribed an opioid, and it can help encourage responsible use.

Morphine

A naturally derived opioid belonging to the group of Schedule II narcotics, it can produce initial feelings of euphoria in addition to relieving severe pain, but it’s highly addictive.

Oxycodone

A semi-synthetic opioid depressant sold under brand names Oxycontin, Roxicodone, Percocet, Endocet; it is classified as Schedule II narcotic and used for relieving moderate to severe pain.

Fentanyl

A synthetic opiate analgesic sold under brand names Actiq, Duragesic and Sublimaze; it is a Schedule II narcotic that works similarly to morphine but is much stronger, typically prescribed to cancer patients.

Hydrocodone

A semi-synthetic drug classified as a Schedule II narcotic, it is combined with acetaminophen, which is a less potent pain reliever that enhances its effects, and sold under brand names Vicodin, Polygesic, Norco, Lorcet, Liquicet.

Methadone

A synthetic drug classified as a Schedule II narcotic, it’s used to help wane addicts off opiates, as well as a pain reliever, and sold under the brand names Dolophine, Symoron, Methadose, Physeptone.

Buprenorphine

A synthetic opioid classified as a Schedule III narcotic, it is used to treat pain and opioid addiction because it has a lower abuse potential than most opioids; sold under brand names Subutex, Butrans, Belbuca, Sublocade.

Opioid Overdose and Treatment

Most of the opioids that have a high potential for abuse could easily cause an overdose. With the increasing doses of opioids, a tolerance may start building, which causes those abusing the drug to take more of it for the same effect. An opioid overdose can cause life-threatening symptoms or death since too many opioids in the body affect breathing which can decrease the amount of oxygen that reaches the brain.

Naloxone or Narcan (which is the brand name) is available as a nasal spray, and it counteracts the effect of opioids. It’s used to treat and reverse an opioid overdose and has saved many lives already.

Opioids are dangerous substances that shouldn’t be taken lightly. Even as a prescription, caution is advised for patients so they would avoid addiction. The statistics are clear — opioid abuse is a huge problem that won’t quietly go away. We have to act in the best interest of our nation’s people to raise awareness of this issue and take preventative measures to stop the crisis.

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