What are Opioids?
Opioids are a class of drugs that produce various effects, including pain relief and feelings of being relaxed or “high.” Unfortunately, they can also cause slowed breathing, nausea, confusion, and drowsiness. Opioids are highly addictive and are the class of drugs that cause the highest number of overdose deaths in the US.

There are several types of opioids:

• Prescription opioids such as oxycodone (OxyContin®), hydrocodone (Vicodin®), and morphine. 
• Heroin, which is illegally produced, is much more potent, and consequently, more addictive than morphine.
• Fentanyl, which has emerged in recent years, is a synthetic opioid that is 50 to 100 times more potent than morphine (1). While fentanyl can be legally prescribed to individuals who experience chronic pain, it is also often illegally mixed into heroin – with or without consumers’ knowledge. Due to its potency, the use of fentanyl has led death rates from opioid overdoses to skyrocket.

There are many paths to opioid addiction (2). Some people start taking legally prescribed opioids to reduce chronic (e.g., from a back injury) or acute (e.g., from a dental procedure) pain. Others may start by taking opioids recreationally, such as by injecting heroin or taking a friend or family member’s prescribed opioid painkillers. People may then find they enjoy the “high” or sedative feel of opioids, need higher doses to achieve the same effects, or realize that the drugs numb unpleasant feelings such as depression, grief, and anxiety. At this point, they may ask their doctors to increase their doses, use other people’s prescriptions, or start to buy illegal street drugs such as heroin (which may be laced with fentanyl) because they are cheaper. Unfortunately, opioids are one of the easiest drugs on which people can overdose. In high concentrations, opioids affect the part of the brain that regulates breathing, leading to high rates of deaths from opioid overdoses. 

What is the US Opioid Epidemic?
Due to the addictive nature of opioids, there has been a decades-long epidemic of overdose deaths in the US. The CDC describes three waves of opioid-related deaths (3). The first wave started in the 1990s when doctors began to prescribe opioid medications (such as OxyContin®) to patients at unprecedented rates. The second wave started in 2010 when there was a stark increase in deaths due to heroin use. The third wave came in 2013 mostly due to fentanyl (CDC, 2020). These three waves are shown in Figure 1 below. 

Figure 1. Opioid Overdose Deaths (1999-2018)