Synthetic opioids are in a class of drugs that are human made and designed with a chemical makeup similar to opiates and semi-synthetic opioids that are derived naturally from the opium poppy. They include both prescription and illicit fentanyl and its analogs, carfentanil, methadone, U-47700, and Tramadol.
More specifically, although the chemical structure is similar between synthetic opioids and their natural counterparts, the compounds that make up synthetic opioids are exclusively made by humans, typically in a pharmaceutical lab.
This process is different than that used for natural opiates like the alkaloids codeine, morphine, and thebaine, which are extracted from opium pods and then refined and made into medication. Also different are semi-synthetic opioids, which include medications such as Oxycodone which derived from thebaine but also partially humanmade.
About Synthetic Opioids
Synthetic opioids are frequently used as cutting agents in other drugs such as heroin or pressed into pill form and sold on the black market as counterfeit painkillers or anti-anxiety medication. Because synthetic opioids are so potent and can be added to other dangerous drugs with the user unaware, accidental overdose is very common.
A tragic example of this occurring involved the death of the artist Prince in 2016. By his bedside was found a bottle of pills labeled as Vicodin. It was later discovered that the pills actually contained the powerful synthetic opioid fentanyl, and later this drug was determined to be the cause of his untimely death.
Fentanyl is among the most common synthetic opioids found in the United States. First developed in 1974, fentanyl is a powerful drug about 50 to 100 times more potent than morphine.
The drug is produced en masse by both drug companies for legal, legitimate purposes and by illicit drug manufacturers for illegal distribution. Currently, there are a number of fentanyl analogs that can be found on the street. These analogs are slight variations from one another that are potentially even more harmful to the body, and they are being introduced into the drug market with no prior or current approved medical use.
According to the National Institute on Drug Abuse (NIDA), an analysis of opioid-related overdose fatalities found that synthetic opioids such as fentanyl have exceeded prescription painkillers as the most common drug involved in overdose deaths in the United States. A letter published in the Journal of the American Medical Association (JAMA) reported that nearly half of opioid-related fatalities in 2016 involved fentanyl.
This report examined 2010-2016 mortality data from the National Vital Statistics System that includes information on all deaths in the United States, based on death certificates submitted by coroners and medical examiners and coroners. Results revealed that among the 42,249 opioid-related overdose fatalities in 2016, 19,413 (45.9%) involved fentanyl, while 17,087 (40.4%) involved prescription painkillers and 15,469 (36.6%) involved heroin.
Carfentanil is considered to be the most powerful opioid in the world. It is 10,000 times stronger than morphine and was created for use as a large animal tranquilizer. The powder form of the drug has been used as a deadly cutting agent in heroin. The illegal use of carfentanil has further increased the dramatic rise in opioid overdose deaths in the U.S.
Although not commonly found throughout the U.S., carfentanil has killed thousands of people in Ohio in the last few years, a trend that appears to be related to the inclusion of carfentanil into the cocaine supply, and to a lesser extent, meth. Moreover, most of these victims used these stimulants without knowing that lethal carfentanil had been used as an adulterant—the users had little or no tolerance to opioids.
Synthetic Opioids and the Opioid Epidemic
Between 2017-2018, deadly drug overdoses increased by 10% in the U.S., rising to a total of more than 72,000 Americans. The popularity of particularly deadly synthetic opioids continues to make up a majority of the ever-increasing death toll. Deaths from prescription opioids, which were blamed for the onset of the drug epidemic, began to level off around 2011, and many parts of the country even experienced a reduction.
Synthetic opioids, however, have added fuel to the fire. In what has been referred to as the “second wave” of the opioid epidemic, drug traffickers began using synthetic opioids to simulate the effects of other drugs. This strategy can be very profitable for dealers because fentanyl is inexpensive to make, and a little goes a long way.
Fentanyl is usually cheaper to make that cocaine or heroin, and when used as a filler or substitute, it also greatly increases the potency of the products and, subsequently, the user’s pleasure. And, because it is much stronger than heroin, it is even more addictive. If a person survives fentanyl use and does so repeatedly, he or she will likely be so strung out that even going back to regular heroin could prove very difficult.
The Effects of Synthetic Opioids on the Body
The effects that synthetic opioids have on the body is similar to that of other opiates and opioids, which primarily act on the brain and spinal cord. Prescription opioids are controlled by the Food and Drug Administration (FDA), with predesigned potencies and uniform effects on the body. Illicit synthetic opioids, however, are unregulated. This means that drug potency can vary in the manufacturing process, between individual batches, and from dealer to dealer, depending on how and with what other adulterants it is cut.
Using synthetic opioids to seek a stronger “high” usually results in an intensification of symptoms and the potential for overdose. Regardless of whether these drugs are administered orally, sublingually (under the tongue), intranasally (snorted), smoked, or intravenously, the general effects are similar.
Differences in effect include variations in intensity, time of onset, and, of course, the method of administration. Physical symptoms of opioid include feelings of well-being, pain reduction, drowsiness, sedation, and nausea.
Newer, more powerful synthetic opioids and their analogs are always being produced. Unfortunately, standard detection tests that can discriminate between opioids have yet to become accessible to coroners, emergency medical staff, or hospitals. Data does not yet confirm that synthetic opioids are innately more or less addictive than other opioids.
Treatment for Addiction
Synthetic opioid addiction is a very serious disorder. Each year, thousands of people are killed by accidental overdoses involving synthetic opioids. Many who die are not even aware that the drugs were in the product they were purchasing, which may have included cocaine, meth, or heroin.
Currently, drug markets are rife with incorrectly marketed products and drugs combined with other substances unknown to potential users. As such, anyone suffering from drug addiction is at a high risk of unintentional overdose, regardless of their drug of choice.
Midwood Addiction Treatment offers comprehensive treatment for substance abuse in both partial-hospitalization and outpatient formats. Our programs include clinically-proven services vital to the process of recovery, such as behavioral therapy, counseling, group support, and medication-assisted treatment (MAT).
MAT is especially beneficial for those dependent on opioids because medications such as Suboxone can reduce withdrawal symptoms and cravings and help people better focus on their recovery from the onset.
If you or someone you love is struggling with addiction to prescription or illicit drugs or alcohol, contact us today. Discover how we help people who are motivated to recover to break free from the cycle of addiction and reestablish happy and fulfilling lives!