3.3 Examples of opioids

What is Fentanyl?

Fentanyl is a potent synthetic opioid drug approved by the CDSA for use as an analgesic (pain relief) and as an anesthetic. It is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic.

What is its origin?

Fentanyl was first developed in 1959 and introduced in the 1960s as an intravenous anesthetic. It is legally manufactured in the United States.

How it is administered?

Fentanyl products are prescribed and are currently available orally, transdermally and injectable formulations.  Fentanyl can be injected, snorted/sniffed, smoked, taken orally by pill or tablet, and spiked onto blotter paper. Fentanyl patches can be used other than prescribed by removing its gel contents and then injecting or ingesting these contents. Patches have also been frozen, cut into pieces, and placed under the tongue or in the cheek cavity.

What is the effect on the body?

Fentanyl, similar to other commonly used opioid analgesics (e.g., morphine), produces effects such as relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.

IN THE NEWS: READ

Nova Scotia Health warns drugs laced with fentanyl sold in Cape Breton posted December 31, 2020 to CBC News Nova Scotia.

What is Heroin?

Heroin is a highly addictive substance and it is a rapidly acting opioid.

What is its Origin?

A powdery brown substance.
Heroin, Drugs of Abuse. Credit: U.S. Department of Justice Drug Enforcement Administration

Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants grown in Mexico, South America, Southwest Asia (Afghanistan and Pakistan), and Southeast Asia (Thailand, Laos, and Myanmar (Burma).

What Does it Look Like?

Heroin is typically sold as a white or brownish powder, or as the black sticky substance known as “black tar heroin.” Although purer heroin is becoming more common, most “regular” heroin is “cut” with other psychoactive substances or substances like sugar, starch, powdered milk, or quinine.

How is it administered?

Heroin can be injected, smoked, or sniffed/snorted. High purity heroin is usually snorted or smoked.

What is its effect on the body?

One of the most significant effects of heroin use is the frequency of the development of a substance use disorder.  With regular heroin use, tolerance to the substance develops. Once this happens, the person must use more heroin to achieve the same intensity. As higher doses of the substance are used over time, physical dependence and psychological dependence deepens and a substance use disorder can develop.  Effects of heroin use include drowsiness, respiratory depression, constricted pupils, nausea, a warm flushing of the skin, dry mouth, and heavy extremities.

IN THE NEWS: WATCH

Prescription heroin offered in Vancouver outside of clinical trial for first time.
Aired on CBC News: The National November 26, 2014. Available via YouTube.

What is Hydromorphone?

Hydromorphone has an analgesic potency of two to eight times greater than that of morphine and has a rapid onset of action.

What is its origin?

Hydromorphone is legally manufactured and distributed in the United States and shipped to Canada.

How it is administered?

Hydromorphone comes in tablets, capsules, oral solutions, and injectable formulations.

What is its Effect on the Body?

Hydromorphone may cause constipation, pupillary constriction, urinary retention, nausea, vomiting, respiratory depression, dizziness, impaired coordination, loss of appetite, rash, slow or rapid heartbeat, and changes in blood pressure.

IN THE NEWS: WATCH

Vending machine dispenses heroin substitute for at-risk drug users by The Canadian Press, January 27,  2020. Available via YouTube.

What is Methadone?

Cup with orange liquid, a vile of liquid, and white powder.
Methadone, Drugs of Abuse. Credit: U.S. Department of Justice Drug Enforcement Administration

Methadone is a synthetic (person-made) drug.  It is considered an opioid agonist therapy (OAT); used to treat opioid addiction.  It is also used to treat severe pain.

What is its origin?

German scientists synthesized methadone during World War II because of a shortage of morphine. Methadone was introduced to Canada in 1964.[1]t

How is it administered?

Methadone is available as a tablet, oral solution, or injectable liquid.

What is its effect on the body?

When an individual uses methadone, they may experience physical symptoms like sweating, itchy skin, or sleepiness. There is a risk for developing tolerance and subsequent dependence on the methadone. When use is stopped, individuals may experience withdrawal symptoms similar to other opioids including: Anxiety, muscle tremors, nausea, diarrhea, vomiting, and abdominal cramps.  A person can overdose on methadone, in which case Naloxone may be used to treat the overdose.  Learn more about methadone in this short clip below.[2]

IN THE NEWS: READ

It’s the end of the road for Halifax’s methadone bus by Elizabeth Chiu, posted Aug 30, 2018 to CBC News Nova Scotia.

What is Morphine?

Morphine is a non-synthetic opioid, it is derived from opium and is considered an analgesic. It is used for the treatment of pain, and is the most widely used pain treatment medication in the world.[3]

What is its origin?

Morphine was isolated from opium by Friedrich Serturner in 1805. Morphine is made from opium, which has been known for millennia to relieve pain. The Sumerian clay tablet (about 2100 BC) is considered to be the world’s oldest recorded list of medical prescriptions[4] and includes morphine.  It was not until the development of the hypodermic needle and syringe nearly 50 years later that the use of morphine became widespread using morphine for postoperative pain relief.[5]

How is it administered?

Traditionally, morphine was almost exclusively used by injection, today it can be taken by all routes of administration.  This includes oral solutions, immediate-and extended-release tablets and capsules, subcutaneous, transdermal and intramuscular.

What is its effect on the body?

Morphine use results in relief from physical pain, a decrease in hunger, and inhibition of the cough reflex.

IN THE NEWS: READ & WATCH

(WARNING, the article and attached video may cause activation).

Investigations launched after Atikamekw woman records Quebec hospital staff uttering slurs before her death posted September 9, 2020 to CBC News Montreal.

What is Oxycodone?

Oxycodone is a semi-synthetic opioid used to treat pain.  Oxycodone was developed in 1995, beginning as OxyContin.  It was created to provide long-lasting pain relief and was widely prescribed.  It was hailed as a miralce drug for long lasting pain; however those who had been perscribed oxy found it had highly addictive qualities.[6]

What is its origin?

Oxycodone is synthesized from thebaine, a constituent of the poppy plant.

How is it administered?

Oxycodone is administered orally or intravenously. The tablets can be crushed and sniffed or dissolved in water and injected. It can also be inhaled.

What is its effect on the body?

Physiological effects of oxycodone include pain relief, sedation, respiratory depression, constipation, papillary constriction, and cough suppression. Extended or chronic use of oxycodone containing acetaminophen may cause severe liver damage. 

IN THE NEWS: READ

Abuse-resistant OxyContin under consideration by The Associated Press, posted September 22, 2009 to CBC News.

Chapter Credit

Adapted from unit 3.3 Narcotics Continued in Drugs, Health & Behavior by Jacqueline Schwab. CC BY-NC-SA. Updated with Canadian Content.

Image Credits


  1. Eibl, J. K., Morin, K., Leinonen, E., & Marsh, D. C. (2017). The state of opioid agonist therapy in Canada 20 years after federal oversight. Canadian Journal of Psychiatry, 62(7), 444–450. https://doi.org/10.1177/0706743717711167
  2. Neuroscientifically Challenged (2019).  Two minute neuroscience: Methadone. [Video]. Youtube. https://www.youtube.com/watch?v=dw6laQ4-Zgs&feature =emb _imp_woyt
  3. Hamilton, G. R., & Baskett, T. F. (2000). In the arms of Morpheus; the development of morphine for postoperative pain relief. Canadian Journal of Anaesthesia, 47(4), 367-74. https://pubmed.ncbi.nlm.nih.gov/10764185
  4. Norn, S., Kruse, P. R., Kruse, E. (2005).  History of opium poppy and morphine. Danish Medicinhist Arbog33, 171-184. https://pubmed.ncbi.nlm.nih.gov/17152761/
  5. Hamilton, G. R., & Baskett, T. F. (2000). In the arms of Morpheus; the development of morphine for postoperative pain relief. Canadian Journal of Anaesthesia, 47(4), 367-74. https://pubmed.ncbi.nlm.nih.gov/10764185
  6. Centre for Addiction and Mental Health. (2021). Straight talk-Oxycodone.  https://www.camh.ca/en/health-info/guides-and-publications/straight-talk-oxycodone

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