What are opioids?
Opioids include three categories of pain-relieving drugs: (1) natural opioids (also called opiates) which are derived from the opium poppy, such as morphine and codeine; (2) semi-synthetic opioids, such as the prescription drugs hydrocodone and oxycodone and the illicit drug heroin; (3) synthetic opioids, such as methadone, tramadol, and fentanyl. Fentanyl is 50 to 100 times more potent than morphine. Fentanyl analogues, such as carfentanil, can be 10,000 times more potent than morphine. Overdose deaths from fentanyl have greatly increased since 2013 with the introduction of illicitly-manufactured fentanyl entering the drug supply [CDC 2016b; CDC 2018b]. The National Institute on Drug Abuse [NIDA 2018] has more information about types of opioids.
- Centers for Disease Control and Prevention (CDC)
All opioids are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, but because they produce euphoria in addition to pain relief, they can be misused (taken in a different way or in a larger quantity than prescribed, or taken without a doctor’s prescription). Regular use—even as prescribed by a doctor—can lead to dependence and, when misused, opioid pain relievers can lead to addiction, overdose incidents, and deaths.
- National Institute on Drug Abuse
What is the opioid epidemic?
From 1999–2018, almost 450,000 people died from an overdose involving any opioid, including prescription and illicit opioids.
This rise in opioid overdose deaths can be outlined in three distinct waves.
The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
2. The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
3. The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl. The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.
- Centers for Disease Control
Can an opioid overdose be reversed?
An opioid overdose can be reversed with the drug naloxone when given right away. Improvements have been seen in some regions of the country in the form of decreasing availability of prescription opioid pain relievers and decreasing misuse among the Nation’s teens. However, since 2007, overdose deaths related to heroin have been increasing. Fortunately, effective medications exist to treat opioid use disorders including methadone, buprenorphine, and naltrexone.
A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combination and an extended release naltrexone formulation are similarly effective in treating opioid addiction. However, naltrexone requires full detoxification, so initiating treatment among active users was more difficult. These medications help many people recover from opioid addiction.
- National Institute on Drug Abuse
OHIO - "County opioid overdose deaths up slightly in first quarter of 2020" (April 23, 2020)
COLORADO - "Fatal drug overdoses involving fentanyl tripled in Denver between 2018 and 2019" (April 15, 2020)
COVID - 19 - "Investigating the pandemic's effect on overdoses" (April 24, 2020)
N. CAROLINA - "Increase in overdose emergency department visits seen in Carteret County" (April 27, 2020)
Opioids in the News
Click on the graphs to enlarge
Figure 1. National Drug Overdose Deaths—Number Among All Ages, by Gender, 1999-2018.
More than 67,300 Americans died from drug-involved overdose in 2018, including illicit drugs and prescription opioids. The figure above is a bar and line graph showing the total number of U.S. drug overdose deaths involving any illicit or prescription opioid drug from 1999 to 2018. Drug overdose deaths rose from 38,329 in 2010 to 70,237 in 2017; followed by a significant decrease in 2018 to 67,367 deaths. The bars are overlaid by lines showing the number of deaths by gender from 1999 to 2018 (Source: CDC WONDER).
Figure 2. National Drug Overdose Deaths by Specific Category—Number Among All Ages, 1999-2018.
Overall, drug overdose deaths declined from 2017 to 2018 with 67,637 drug overdose deaths reported in 2018. Deaths involving other synthetic narcotics other than methadone (including fentanyl and fentanyl analogs) continued to rise with more than 31,335 overdose deaths reported in 2018. Those involving cocaine or psychostimulants with abuse potential (mostly methamphetamine) also continued to trend upward (Source: CDC WONDER).
Figure 3. National Drug Overdose Deaths Involving Any Opioid—Number Among All Ages, by Gender, 1999-2018. The figure above is a bar and line graph showing the total number of U.S. overdose deaths involving any opioid from 1999 to 2018.
Any opioid includes prescription opioids (and methadone), heroin and other synthetic narcotics (mainly fentanyl or fentanyl analogs). Opioid-involved overdose deaths rose from 21,088 in 2010 to 47,600 in 2017 and remained steady in 2018 with 46,802 deaths. The bars are overlaid by lines showing the number of deaths by gender from 1999 to 2018 (Source: CDC WONDER).
Figure 4. National Overdose Deaths Involving Prescription Opioids—Number Among All Ages, 1999-2018. The figure above is a bar and line graph showing the total number of U.S. overdose deaths involving prescriptions opioids (including methadone) from 1999 to 2018.
Drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017. From 2017 to 2018, however, the number of deaths dropped to 14,975. The bars are overlaid by lines showing the number of deaths by gender from 1999 to 2018 (Source: CDC WONDER)