Millions of Americans have suffered from opioid abuse since the 1990s when addiction began reaching epidemic levels. Hundreds of thousands have died in what the Surgeon General deems a public health crisis. Many more may become victims as the opioid black market continues to flourish.

Key facts

The US Department of Health and Human Services estimated that 47,600 people died from opioid overdoses in 2018 alone, with around 130 people dying every day. Around 10.3 million Americans had abused prescription opioids that year while 808,000 had used heroin, causing 15,349 overdoses in the 12-month period ending in February 2019. Some 2.2 million people misused prescription opioids for the first time in 2018 while 81,000 people first tried heroin.

What is an opioid?

Opioids, which all act upon the human neurological receptor of the same name, include some of the world’s oldest drugs. Found naturally in the latex of the opium poppy, they have long been used by humans for pain treatment but also have a long history of recreational abuse. The main intoxicating component in opium is morphine, which scientists began extracting in the 19th century. It is from morphine that chemists first began manufacturing heroin in the late 19th Century. Codeine, another drug used both legitimately and illicitly, is also found in opium. Today, numerous synthetic opioids, such as hydrocodone, fentanyl and oxycodone, are manufactured both legally and illegally.

How did the opioid crisis begin?

The opioid crisis is generally thought to have begun in the late 1990s at a time when pharmaceutical companies were aggressively marketing new, synthetic brands of opioids. Patients were often told that the new drugs were less addictive than the old ones. Unfortunately, many thousands did become addicted. When their prescriptions ran out, many resorted to the flourishing black market of opioid pharmaceuticals where they paid exorbitant prices. As illicit demand increased, many people switched to heroin as the price for illegally-sourced pharmaceuticals exceeded its banned cousin.

What are the effects?

Opioids give immense feelings of euphoria to their users. Pain, both physical and mental, is greatly reducing leading to a strong sense of contentment. But as physical dependence kicks in, opioids become necessary to prevent pain from their absence as the human body loses its ability to regulate its own supply of the endogenous opioids that it naturally produces. Withdrawal includes intense flu-like symptoms, such as vomiting and muscle pain. But even after the initial symptoms subside in a couple weeks, recovering users struggle with longing for the immense contentment that they felt while abusing narcotics.

How can you tell if someone is on opioids?

One of the most obvious symptoms for opioid abusers is the shape of the pupil. When someone is on an opioid, the pupils constrict. It is common for someone addicted to opioids to have their pupils never fully dilate back to their normal size until they are off the drugs. People who regularly use opioids may also demonstrate dramatic mood shifts, showing feelings of joy and agreeability while high and agitation while sober. The mood swings may become less visible over time as the user may simply avoid human contact while not on drugs.

How can you help someone addicted to opioids?

It is important to avoid appearing accusatory. Understand that while opioid addiction is a dangerous disease, people must want to seek treatment in order to recover. Explain that you love him or her and only want to see them get better. If he or she appears reluctant to get help, showing anger is only likely to cause feelings of alienation. At the same time, do not be an enabler. If someone you suspect is using opioids asks you for money, do not be afraid to ask how they will spend it.

Moving forward

Opioid abuse is not limited to any particular segment of society. Anyone ranging from at-risk teenagers to wealthy retirees may become hooked if they begin using. They may come from any race, economic class or religion. If you suspect that you or someone you love may be addicted to opioids, do not turn away.