Synthetic Opioids

What Are Synthetic Opioids?

Synthetic opioids are a class of drug manufactured in laboratories and designed to have a chemical structure which is similar to opioids naturally derived from the opium poppy. Though the chemical makeup is similar between synthetic opioids and “natural” varieties (like many prescription opioids), the specific compounds that make up synthetic opioids are entirely man-made — typically in a pharmaceutical laboratory. This is different than natural or non-synthetic opioids like morphine and codeine, which are extracted from naturally occurring chemicals in opium pods, then refined and made into medication.

Frequently, synthetic opioids are used as cutting agents in other drugs (especially heroin and cocaine) or pressed into pill form and sold on the street as counterfeit Painkillers. Because synthetic opioids are so powerful, accidental overdose is common.

One of the most common synthetic opioids in the US is fentanyl. First discovered in 1974 by Paul Janssen, the powerful drug (50 to 100 times more potent than morphine) became one of the most widely used opioids in medicine by 2017. The drug is produced in high quantities by both pharmaceutical companies for legal, surgical purposes and by illicit street manufacturers for illegal distribution. Today, there are a number of fentanyl analogues, or slight variations with harsher effects on the body, being introduced with no prior or current medical use.

Other synthetic opioids include:

Carfentanil, in particular, is one of the strongest opioids; it is 10,000 times more powerful than morphine and was created to be an elephant tranquilizer. A powder form of the drug is being used as a deadly cutting agent in heroin. The rise in illicit use of synthetic opioids has further increased already record-high numbers of opioid overdose deaths in the US.

Synthetic Opioids And The Opioid Epidemic

Following the outbreak of the COVID-19 pandemic, fatal drug overdoses in the United States reached an all-time peak, with 107,941 recorded deaths in 2022. The dramatic spike can largely be attributed to the synthetic opioid fentanyl, which was responsible for nearly 80% of all fatal drug overdoses in 2022. Since 2019, opioid-involved overdose deaths, primarily fentanyl, rose from 49,860 to 81,806 in 2022.

Deaths from prescription opioids began to level off in 2011, or even reverse, in many parts of the country. However, synthetic opioids have added fuel to the fire. In what is commonly considered the “Second Wave” of the opioid epidemic, drug trafficking organizations began using synthetic opioids to mimic other drugs. Fentanyl and drugs like xylazine are typically sold on the street as a counterfeit for popular medications (usually oxycodone or hydrocodone). Those looking to buy prescription opioids illegally often believe they are purchasing OxyContin or Vicodin, but are actually receiving much more powerful and fast-acting synthetic opioids with higher likelihoods of overdose.

Additionally, drugs like heroin and xylazine are being mixed (or “cut”) with fentanyl and carfentanil, increasing the risk of fatal overdose even among individuals with high opioid tolerances. Xylazine has become a serious epidemic in the US, with deaths involving the drug rising from just 102 in 2018 to 3,468 in 2021; with 99% involving fentanyl, according to the journal Substance Use and Addiction.

Synthetic Opioids’ Effect On The Body

The effects of synthetic opioids on the body are similar to that of other opioids. These drugs are opioid receptor agonists and act primarily on the brain and spinal cord. Legally prescribed opioids are regulated by the FDA, with predetermined potencies and consistent effects on the body. However, illicit synthetic opioids are unregulated, and potency can vary from lab to lab and drug dealer to drug dealer.

Using synthetic opioids to seek stronger “highs” generally results in an escalation of symptoms with a potential for overdose. Whether administered orally through pills, sublingually (under the tongue), through nasal inhalation, smoked, or injected intravenously, the effects are much the same, although they may vary in intensity, time of onset, and method of administration.

Symptoms of opioid abuse include:

• Feelings of euphoria
• Drowsiness
• Sedation
• Nausea

As newer, more potent synthetic opioids are created, standard detection tests that can distinguish between opioids have yet to become available to coroners, emergency medical personnel, or hospitals. Still, data does not yet demonstrate that synthetic opioids are any more or less addictive than other opioids.

Synthetic Opioid Statistics

Synthetic Opioid Overdose

Typically, fatal opioid overdoses are caused by a lack of oxygen when a person stops breathing. Because synthetic opioids are so similar to “natural” opioids, the signs of dependency, addiction, and overdose to both are very similar. Fentanyl is a longer-acting opiate, like morphine, heroin, or oxycodone. The primary difference between overdose from oxycodone and fentanyl or carfentanil is that the latter is exponentially stronger and, therefore, presents a greater risk of complications. Moreover, fentanyl’s ability to start affecting the body soon after ingestion can lead to overdose even faster.

Signs of overdose are more pronounced versions of symptoms the drug already produces — slowed breathing may stop entirely, reduced consciousness may become unconsciousness. Today, opioid overdose is more likely to be fatal because of high potency. However, it is possible to survive an opioid overdose if the victim is provided medical attention quickly enough.

To reverse an overdose, and allow an individual to begin breathing normally again, high doses of naloxone are required. Naloxone, an opioid receptor antagonist, can block the effects of all opioids in a person’s system, reviving them and preventing them from getting any higher. The most common form of naloxone, Narcan, comes in a nasal spray in a 4 mg dose. Multiple doses may need to be administered to fully revive an individual.

Get Help For A Synthetic Opioid Addiction

Regardless of the type of opioid, detoxing can be painful and — in extreme cases — deadly. Medical professionals generally recommend individuals seek assistance from a drug rehab facility, as medical assistance increases the likelihood of success as well as comfort. Followed by inpatient drug rehab or outpatient rehab, people can recover and maintain sobriety afterward through support groups or therapy.

If you’re ready to start your journey to recovery, contact a treatment provider today.