Synthetic Opioids

What Are Synthetic Opioids?

Synthetic opioids are drugs created in a pharmaceutical laboratory. They are designed to be similar in chemical structure and effect to natural opioid drugs, which are made from the opium poppy.

Synthetic opioids have been contributing, at an increasing rate, to opioid-related deaths. A study from the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report found that, in 2022, approximately 69,893 overdose deaths involved a synthetic opioid. These powerful drugs are often used as a cutting agent for other drugs or are sold on the street in pill form, increasing the risk of accidental overdose.

Types Of Synthetic Opioids

There are many forms of synthetic opioids, and one of the most common in the US is fentanyl. Fentanyl is 50 to 100 times more potent than morphine, available in intravenous, intramuscular, transdermal, intranasal, and intrathecal forms. Fentanyl is legally produced for medicinal purposes but is also manufactured by illicit manufacturers and diverted from legitimate prescriptions for illicit purposes.

Other synthetic opioids include:

• Tramadol
• Methadone
• Derivatives of fentanyl such as carfentanil, acetyfentanyl, butyrylfentanyl, furanylfentanyl, and 3-methylfentanyl
• U-47700
• Nitazenes
• Demerol (Meperidine)
• Levorphanol

Some synthetic opioids have legitimate medical uses, while others are made and distributed illegally. For example, fentanyl, tramadol, and Demerol are all used for chronic pain, while methadone is used for moderate to severe chronic pain, as well as for the treatment of opioid use disorder (OUD).

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How To Identify Synthetic Opioids

It may be nearly impossible to identify synthetic opioids by looking at them. Even using taste or smell may be unreliable. Synthetic opioids are often mixed with other drugs, which makes them even more challenging to detect, however, common forms include:

• Powders: Synthetic opioids like fentanyl and nitazenes are frequently found as powders. They can be white, off-white, yellow, brown, or an array of other colors (known as “rainbow fentanyl”). The powder often looks identical to other substances like heroin, cocaine, or methamphetamine, with which they are commonly mixed.
• Pills & Tablets: Illicit synthetic opioids are often made to resemble prescription pain medications such as oxycodone, hydrocodone, or benzodiazepines. These fake pills can be indistinguishable from the real ones but often contain lethal doses of synthetic opioids without the user’s knowledge.
• Liquids:  Illicit synthetic opioids can also come in liquid forms, such as nasal sprays or eye drops, or even dropped onto small candies or blotter paper.

Fentanyl testing strips are available to detect the presence of fentanyl. A small amount of the drug is combined with water, and the strip is dipped into the liquid to detect whether fentanyl is present.

Unfortunately, these strips won’t necessarily detect other forms of synthetic opioids. Additionally, these strips don’t indicate how much fentanyl is present. The test may be falsely negative in the presence of large amounts of other drugs such as methamphetamine, diphenhydramine, and MDMA. While fentanyl test strips are a tool that may help decrease the risk of opioid overdose, they are not always reliable.

Handheld detectors, vapor detectors, and other specialized tools are used by first responders, law enforcement personnel, and medical professionals to test for the presence of illegal drugs.

Synthetic Opioids Vs. Natural Opioids

Natural opioids are directly derived from the poppy plant. These drugs are derived from opium, which is made from the seed pods of the poppy. Morphine and codeine are two examples of natural opioids that are used for medical purposes.

Synthetic opioids are manufactured in a laboratory and are not derived from opium or any natural products or ingredients. Some of these synthetic opioids have legal medical uses and are manufactured in a pharmaceutical setting. Other synthetic opioids have no legitimate medical use and are manufactured illegally.

There is a third group of opioids known as semisynthetic opioids. These are made in a laboratory by chemically altering natural opioids. Examples of semisynthetic opioids include oxycodone, hydrocodone, oxymorphone, and heroin. As with synthetic opioids, some of the semisynthetic opioids have legitimate medical uses, while others are illicit.

How Are They Abused?

Synthetic opioids are abused if they are used other than prescribed. These drugs can be administered orally, inhaled, or injected, depending on their formulation.

Illegally manufactured synthetic opioids are often combined with other drugs. These drugs are more potent than other opioids and can cause overdose, which may be deadly.

What Are The Effects Of Synthetic Opioids?

Synthetic opioids activate opioid receptors in the brain, with effects including:

• Pain relief
• Relaxation
• Euphoria
• Sleepiness
• Decreased breathing
• Slowed heart rate
• Constipation

Synthetic opioid use can lead to tolerance, where increasing doses of the drug are needed to achieve the same effects over time. This may lead to opioid use disorder, which results in cravings for opioids and the continued use of opioids even though the use is negatively affecting the individual’s life.

Dangers Of Synthetic Opioids

There are several potential dangers of synthetic opioids. Use of opioids can lead to physical and psychological dependence, whether or not the use is legal. Continued use can lead to OUD and synthetic opioid addiction.

One of the most dangerous potential consequences of synthetic opioid use is an overdose. Opioid overdose can result in a lack of oxygen to the brain due to decreased breathing. This can cause brain damage, coma, or even death. Slowing of the heart rate due to opioids can result in heart failure, low blood pressure, or cardiac arrest.

Other potential adverse effects of synthetic opioids include:

• Depression
• Sedation
• Constipation
• Nausea and vomiting
• Headache
• Slowed heart rate
• Increased sensitivity to pain
• Sexual dysfunction
• Impaired immune system

Opioid use disorder can result in significant personal and legal ramifications.

The Opioid Epidemic

One of the most significant public health crises in US history is the opioid epidemic. Synthetic opioids, like fentanyl and drugs similar to fentanyl, have been increasingly involved in opioid related deaths since 2010. These drugs are often stronger and easier to manufacture than heroin, which has led to increased availability.

Fentanyl is usually combined with heroin, and the combination of the two may be more complex to treat with naloxone, leading to an increased risk of death during overdose.

Treatment For Synthetic Opioid Addiction

Synthetic opioid addiction is a form of opioid use disorder. OUD can be treated with several addiction treatment medications. Methadone and buprenorphine are often used for opioid use disorder in a highly supervised setting. Both of these medications reduce opioid withdrawal symptoms by activating the opioid receptors more slowly. This allows them to control the cravings and stave off withdrawal symptoms while not triggering the pleasure feelings as strongly.

Naltrexone is another drug used to treat opioid use disorder. This blocks the opioid receptors, preventing opioids from being able to activate those receptors.

Find A Treatment Center Today

Opioid use disorder can have significant negative repercussions and impacts on a person’s life. Whether one is struggling with synthetic opioid addiction for the first time or experiencing a relapse, finding a treatment center that can meet their needs is vitally important. From intensive outpatient treatment to residential rehab, there are options available for everyone.

If you or a loved one is struggling with opioid addiction or experiencing a relapse, help is available. Visit our rehab directory or contact a treatment provider today to explore your many rehab options.