Opioids are natural or synthetic chemicals that bind to receptors in your brain or body. Opioid medications bind to the areas of the brain that control pain and emotions, driving up levels of the feel good hormone dopamine in the brain's reward areas producing intense feelings of euphoria. As the brain becomes used to these feelings, it often takes more and more of the drug to produce that same feeling of pain relief and euphoria which can lead to dependence and at times addiction. 

The United States is in the midst of a prescription opioid overdose epidemic. In 2014, more than 28,000 people died from opioid overdose, and at least half of those deaths involved a prescription opioid. Many more became addicted to prescription and illegal opioids such as heroin. Heroin-related deaths have also increased sharply, more than tripling since 2010. In 2014, more than 10,500 people died from heroin.

Examples of Opioids include:

• Hydrocodone (Vicodin, Lortab, Norco)
• Oxycodone (OxyContin, Percocet, Endocet, Roxicodone)
• Fentanyl (Duragestic, Fentora, Actiq)
• Codeine
• Heroin 

Prescription Opioids

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness.

The most common drugs involved in prescription opioid overdose deaths include: 

• Oxycodone (such as OxyContin)
• Hydrocodone (such as Vicodin)

Anyone who takes prescription opioids can become addicted to them. Taking too many prescription opioids can stop a person’s breathing—leading to death. 

Prescription opioid overdose deaths also often involve benzodiazepines. Benzodiazepines are central nervous system depressants used to sedate, induce sleep, prevent seizures, and relieve anxiety. Examples include alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan). Avoid taking benzodiazepines while taking prescription opioids whenever possible.

Heroin

Heroin use has increased sharply across the United States among men and women, most age groups, and all income levels.  Heroin is an illegal, highly addictive opioid drug. A heroin overdose can cause slow and shallow breathing, coma, and death.  People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.

Heroin is typically injected but is also smoked and snorted. When people inject heroin, they are at risk of serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.

Not only are people using heroin, they are also abusing multiple other substances, especially cocaine and prescription opioid pain relievers. Nearly all people who use heroin also use at least one other drug.

Fentanyl

Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain.  It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.

However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.

Overdose deaths involving synthetic opioids other than methadone, which includes fentanyl.  Reports from law enforcement indicate that much of the synthetic opioid overdose increase may be due to illegally made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7x from 2012 to 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.