Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Q & A: All about opioids, their benefits and risks

The escalating problem of prescription drug abuse has cast a spotlight on opioids, the narcotic painkillers that doctors are prescribing in record numbers, yet are being abused and killing more people than ever. In 2006, the most recent year for which federal statistics are available, 180 million prescriptions were written for these drugs. And 11,000 people died from misusing them. Experts say the numbers have continued to skyrocket since then.

Though laws have been passed in Florida over the past year to curb abuse of prescription drugs, including opioids like oxycodone and hydrocodone, some wonder why doctors prescribe such potentially dangerous drugs in the first place. The answer is simple: When taken as directed, doctors say, opioids can quickly, effectively, inexpensively — and safely — curb severe pain. The trouble comes when patients don't follow orders or when doctors don't carefully monitor patients.

What are opioids?

Opioids are narcotic pain medications that are chemically similar to opium, a substance collected from the poppy plant, which is the source of heroin. Besides oxycodone and hydrocodone, other legal opioids include morphine, fentanyl, methadone and codeine.

How do they work?

Pain messages are sent from the point of injury through your nerves, to your spine and then to your brain. Opioid drugs essentially block the pain messages to your brain, changing the way pain is experienced. Opioids can also affect other regions of the brain, causing the user to experience euphoria.

Opioids work differently from medications such as ibuprofen or aspirin. Dr. Charles Brock, an associate professor of neurology at the University of South Florida, explained that, for instance, ibuprofen reduces the inflammation associated with painful conditions like arthritis. "It reduces the actual reason for the pain," he said. "An opioid blocks the perception of the pain, but it's not doing anything to reduce the reason for the pain."

What are the side effects and dangers?

Just as they change perception of pain, they also can affect perception of reality, leading to confusion or delirium, Brock said. Minor side effects include drowsiness and constipation. Most serious: A large single dose can kill you by stopping your breathing, according to the National Institutes of Health.

Alcohol, antihistamines, barbiturates and benzodiazepines all aggravate these dangers and should not be used with opioids.

Extended use can lead to dependence, addiction and increased tolerance. Over time, more drug is needed to achieve the same affect, the NIH says.

How can doctors ensure patients' safety?

Brock said the opioids should be considered just one option for pain, along with other medications and nondrug treatments like physical therapy. Patients need to be counseled on the potential risks of opioids and need to be closely monitored.

NIH adds that patients should be medically supervised when stopping opioids to reduce symptoms of withdrawal.

So, why aren't other treatments like surgery, physical therapy or acupuncture the first course of action?

Dr. Alfred Chapman, a pain management physician in Clearwater, said that in a bad economy — and with millions of Americans lacking health insurance — many people turn to opioids for fast, cheap relief. Consumer Reports estimates the average monthly cost of generic codeine with acetaminophen, in 120-milligram daily doses, at $31. Generic oxycodone, in 20-milligram daily doses, is $86 to $100.

Richard Martin can be reached at or (727) 893-8330.

Q & A: All about opioids, their benefits and risks 06/04/10 [Last modified: Saturday, June 5, 2010 9:36pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Support for gay marriage surges, even among groups once wary


    NEW YORK — In the two years since same-sex marriage was legalized nationwide, support for it has surged even among groups that recently were broadly opposed, according to a new national survey.

    People gather in Washington's Lafayette Park to see the White House lit up in rainbow colors on June 26, 2015, the day the Supreme Court ruled that same-sex marriage legal. In the two years since same-sex marriage was legalized nationwide, support for it has surged even among groups that recently were broadly opposed, according to a new national survey released on Monday, June 26, 2017. [Associated Press]
  2. June 26 marks the 20th anniversary of the Harry Potter series.
  3. Air bag recalls, lawsuits lead Takata to file for bankruptcy


    Shattered by recall costs and lawsuits, Japanese air bag maker Takata Corp. filed Monday for bankruptcy protection in Tokyo and the U.S., saying it was the only way it could keep on supplying replacements for faulty air bag inflators linked to the deaths of at least 16 people.

    Japanese air bag maker Takata Corp. CEO Shigehisa Takada bows during a press conference in Tokyo on Monday. Takata has filed for bankruptcy protection in Tokyo and the U.S., overwhelmed by lawsuits and recall costs related to its production of defective air bag inflators.
[(AP Photo/Shizuo Kambayashi]
  4. Philando Castile family reaches $3 million settlement in death


    MINNEAPOLIS — The mother of Philando Castile, a black motorist killed by a Minnesota police officer last year, has reached a nearly $3 million settlement in his death, according to an announcement Monday by her attorneys and the Minneapolis suburb that employed the officer.

    A handout dashboard camera image of Officer Jeronimo Yanez firing at Philando Castile during a traffic stop in Falcon Heights, Minn., July 6, 2016. [Minnesota Bureau of Criminal Apprehension via The New York Times]
  5. From the food editor: Almond-Crusted Chicken Tenders


    I decided my almond chicken obsession was becoming a bit much.

    Almond Crusted Chicken Tenders. Photo by Michelle Stark, Times food editor.