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What are Opioids? | Chemistry, Use Cases, Dosage & Side Effects

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Opioids are a class of drugs that have been used for centuries to treat pain. As one of the oldest known medicines, opioids have become a part of modern medicine for both acute and chronic pain management. 

Opioids are a class of drugs that are chemically derived from the opium poppy plant. Some common opioids include morphine, codeine, and oxycodone. They work by binding to specific proteins called opioid receptors, which lead to the suppression of pain and the release of pleasure-inducing chemicals in the brain, leading to feelings of euphoria. 

In this blog post, we’ll be discussing the chemistry behind opioids, their use cases, and dosages, as well as the potential side effects associated with them. 

Chemical Composition 

Legal Status 


Morphine (C17H19NO3) Schedule II controlled substance ATC code: N02A

Opioids High-Level Fact Sheet

With the increased prevalence of opioid addiction in the U.S., it is important to know the basics about this powerful drug. The first thing we will talk about is the chemical composition of opioids, how they interact with our body, their legal status, and their various trade names.

Opioids Chemical Composition

Opioids are derived from the sap of poppy plants, which are native to Central Asia and South America. The main active ingredient in opium is morphine, which is responsible for the pain-relieving effects associated with opioids. 

The chemical formula for morphine is C17H19NO3. It is a benzylisoquinoline alkaloid and is found in opium in the highest concentration. Morphine is then combined with other compounds to create different types of opioids such as hydrocodone (Vicodin), oxycodone (OxyContin), codeine, fentanyl, and more. 

Opioids Legal Status 

Opioids are classified as Schedule II drugs, meaning they have the potential to be abused and cause dependence. Opioids can be prescribed by authorized physicians for pain relief, so long as there is a reasonable medical necessity and their use is monitored properly. 

Opioids Clinical Data

Opioids are a class of analgesic or painkiller drugs used to treat severe pain and are often prescribed for people with chronic pain conditions or post-surgical pain. 

Commonly known trade names of opioids include OxyContin, Percocet, Vicodin, Dilaudid, Morphine, Fentanyl, and Hydromorphone. They are also sometimes referred to as opiates, opium, and narcotic analgesics. 

Opioids Use Cases:

Opioids are a class of drugs that include both natural and synthetic compounds, derived from the opium poppy plant. They have been found to be effective in treating many medical conditions, as well as being used illegally for recreational and performance-enhancing purposes.


Opioids are commonly prescribed for pain relief due to their powerful painkilling properties. They are often prescribed for acute pain such as after major surgery or following an injury. However, they can also be used to treat chronic pain such as in cancer patients or those with terminal illnesses. In these cases, doctors must carefully monitor opioid intake and adjust dosages accordingly due to the risk of dependence or overdose if taken incorrectly. 

Performance Enhancement:

There is evidence that some athletes have used opioids for performance enhancement in recent years. This is due to opioids’ ability to reduce sensations of fatigue and increase focus during physical activity. 

However, this use has been largely discouraged due to the potential health risks associated with taking opioids beyond what is medically necessary. Not only can this lead to physical dependency but it can also cause serious psychological harm due to a lack of judgment while under the influence of opioids.  


Unfortunately, opioids are also sometimes abused recreationally either by taking higher doses than prescribed or by taking them without a prescription at all. This poses significant risks to users, including physical dependence, addiction, and overdose which can be fatal if not treated quickly enough. 

Not only is this type of drug abuse illegal but it can also be incredibly dangerous if done incorrectly; overdoses resulting from recreational opioid use are becoming increasingly common in many areas around the world.    

Opioids dosages by form and strength:

Opioids come in various forms, such as pills, patches, and injectable solutions, and they can vary in strength. The strength of an opioid is usually measured in milligrams (mg). Here is a general guide to the range of dosages for different forms of common opioids:

Oral pills:

There are several strengths of oral opioids available… immediate-release (IR) tablets and extended-release (ER) tablets, and Capsules. The specific strengths for these may vary depending on the specific opioid and the manufacturer. Here is a list of some common oral opioids and the strengths that they are available in:

  • Codeine: 15 mg, 30 mg, 60 mg
  • Fentanyl: 12.5 mcg, 25 mcg, 50 mcg, 75 mcg, 100 mcg
  • Hydrocodone: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg
  • Hydromorphone: 2 mg, 4 mg, 8 mg, 16 mg
  • Methadone: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg
  • Morphine: 15 mg, 30 mg, 60 mg, 100 mg, 200 mg
  • Oxycodone: 5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 80 mg
  • Oxymorphone: 5 mg, 10 mg, 15 mg, 20 mg


Opioid patches are meant to be applied to the skin and are designed to release a continuous dose of medication over some time, typically 24-72 hours. It is important to follow the dosage instructions given by a healthcare provider and to not adjust the dosage without consulting a healthcare provider. Here are some common opioid patches and their strengths:

  • Fentanyl: 12 mcg/hour, 25 mcg/hour, 50 mcg/hour, 75 mcg/hour, 100 mcg/hour
  • Hydromorphone: 5 mg/hour, 10 mg/hour, 15 mg/hour, 20 mg/hour
  • Morphine: 5 mg/hour, 10 mg/hour, 20 mg/hour, 30 mg/hour, 50 mg/hour, 60 mg/hour, 80 mg/hour
  • Oxycodone: 5 mg/hour, 10 mg/hour, 15 mg/hour, 20 mg/hour, 30 mg/hour, 40 mg/hour

Injectable solutions:

Opioid injectable solutions are typically administered by a healthcare provider in a medical setting, such as a hospital or clinic. Here are some commonly prescribed injectible opioids:

  • Fentanyl: 0.05 mg/ml, 0.1 mg/ml, 0.2 mg/ml, 0.5 mg/ml
  • Hydromorphone: 1 mg/ml, 2 mg/ml, 4 mg/ml, 8 mg/ml
  • Morphine: 10 mg/ml, 20 mg/ml, 50 mg/ml, 100 mg/ml
  • Oxycodone: 1 mg/ml, 2.5 mg/ml, 5 mg/ml, 10 mg/ml

Keep in mind that the appropriate dosage of an opioid may vary depending on the individual patient’s needs and medical history. It is important to follow the dosage instructions given by a healthcare provider and to not adjust the dosage without consulting a healthcare provider. These can be addictive and can have serious side effects such as opioids overdose, if taken at high dosages or for extended periods of time.

Opioids Side Effects:

While opioids can be beneficial in the short-term, both for acute and chronic pain relief, they can also have serious side effects if used improperly or for too long.

Common Side Effects on Opioids:

When taken as prescribed, opioids can provide significant pain relief with minimal side effects. However, there are still some common side effects associated with opioid use that may not be immediately visible but should still be monitored. 

These include nausea and vomiting, constipation, drowsiness or sedation, confusion and dizziness, itching, dry mouth and sweating. If any of these symptoms become severe or persist over time it’s important to contact a health care provider for further evaluation. 

Serious Side Effects on Opioids: 

In some cases, opioid use can cause serious side effects such as confusion and slowed breathing rate. It is also possible to experience an allergic reaction when taking opioids which may manifest as rash or hives on the skin. 

If you experience any of these symptoms while taking opioids you should seek medical attention immediately as they could be life-threatening. Additionally, opioid use carries an increased risk of addiction which can have serious consequences for both physical and mental health if left untreated. 

Opioids Long-Term Effects:

It is important to note that opioid use carries potential long-term risks such as tolerance build-up over time meaning that more of the drug will be needed in order to achieve the same effect, this can lead to an increased risk of overdose or addiction in extreme cases. 

Additionally, there are other possible long-term risks associated with opioid use including liver damage due to prolonged exposure, depression due to changes in brain chemistry, decreased sex drive, weakened immune system, impaired coordination, slowed reflexes, memory problems, and sleep apnea among others.

Opioids Addiction: 

Opioids addiction is a serious epidemic impacting millions of people across the United States and around the world. At its most basic, it is an addiction to powerful pain medications such as morphine and codeine, but many also become addicted to drugs like heroin and fentanyl. 

This type of drug use can have significant long-term impacts on physical health, mental well-being, and overall quality of life. Individuals who suffer from this condition often find it difficult to make progress in necessary areas such as education, finance, or career.

 In addition, people can often develop psychological symptoms such as social isolation due to the stigma associated with drug addiction.  If you or someone you know is suffering from opioid addiction it’s important to seek help right away – there are many treatment options for opioid addiction, including individual therapy and support groups that are geared towards aiding people with recovering from addiction.

Types of Drug Treatment for Opioids Addiction

Opioid addiction is a serious medical condition that requires comprehensive treatment and care to manage. Treatment options can range from inpatient hospital care, where an addicted individual can receive intensive attention and supervision during the detoxification period, to less intensive forms of therapy such as partial hospitalization or outpatient treatment. 

Each method has its own advantages and disadvantages depending on the severity of the individual’s opioid addiction and their access to various levels of care. Both psychological (CBT and psychotherapy) and pharmacological techniques (Medication Assisted Therapy) can be used alongside any one of these forms of drug treatment for opioid addiction. 

The ultimate goal is to give addicted individuals the help they need by providing resources and support that will equip them with the skills necessary for long-term recovery.

Opioids Withdrawal:  

Opioids are a class of drugs that are used for their effects on the central nervous system to alleviate pain. The prolonged use of these drugs can lead to physical and psychological dependence, causing the body to suffer from opioid withdrawal symptoms if the drug is abruptly discontinued or decreased in potency or quantity. 

Opioid withdrawal can range from mild to severe and has a wide variety of symptoms. The most common symptoms are nausea, vomiting, diarrhea, increased heart rate, and blood pressure, runny nose and watery eyes, fatigue, etc.

Furthermore, individuals typically experience strong cravings for opioids as they attempt to overcome their withdrawal symptoms. 

Commonly Seen Opioids Drug Combinations: 

Opioids, a class of drugs derived from the opium poppy plant, have long been used to treat pain as well as for recreational use. Unfortunately, the abuse of opioids is a serious public health issue and has become increasingly common in recent years. 

In many cases, individuals combine multiple opioids together in order to increase their desired effects. This practice can be particularly dangerous due to the increased risk of overdose and other health complications that can arise. 

Common opioid combinations involve two or more opioids with different strengths and effects. For instance, some people may combine oxycodone and hydrocodone together to achieve a more powerful effect than either drug alone can provide. 

Others may mix fentanyl with heroin or codeine with morphine, all of which are potent opioid medications that can create very strong highs if taken in combination. But mixing various opioids together can lead to increased risks for respiratory depression due to the cumulative depressant effects they have on breathing functions when taken concurrently. 

Additionally, some individuals also mix prescription opioids with illicit substances such as methamphetamine or alcohol in order to increase their high or counteract the unpleasant side effects of these drugs.

Ketamine and opioids is also very famous combination as it increases the sedative effects of both drugs but can impair judgment and coordination even further. This can increase the risk of accidents and injuries. In addition, the combination of ketamine and opioids can increase the risk of serious health consequences, such as respiratory depression and coma.

The dangers of combining multiple opioids together are numerous and varied; most notably, it increases the risk of overdose since both drugs are working on the same opioid receptors in the body simultaneously.

Moreover, it also has a greater risk for dependence since these powerful substances have a tendency to quickly build tolerance within an individual’s system

Opioids Facts and Statistics:

Opioids are a class of drugs that are used to relieve pain and can be addictive. Here are some facts and statistics about opioids:

  • In the United States, over 2 million people had an opioid use disorder in 2020, according to the National Institute on Drug Abuse (NIDA).
  • Opioid overdose deaths have been increasing in the United States in recent years. Deaths caused by opioid overdoses have increased by 36% in just one year (2019-2020), according to the Centers for Disease Control and Prevention (CDC).
  • Opioids, including prescription opioids and illicit opioids such as heroin, are the main cause of overdose deaths in the United States.
  • Opioid overdose deaths disproportionately affect certain groups of people, including men, people of color, and people living in rural areas.

Opioids History and Cultural Impact: 

Opioids have had a long and tumultuous history that stretches back to antiquity. It is believed that the first opium poppy was cultivated by the Sumerians as early as 3400 BC. From there, opium cultivation and use spread throughout the ancient world, being used for medicinal purposes in Egypt, Persia, India, and Greece. 

Eventually, it found its way to Europe during the 16th century, where it was mainly used as an analgesic by doctors. In more recent times in the 19th century, morphine and codeine were synthesized from raw opium, furthering its availability and efficacy among medical professionals. They were first discovered in 1806 by German pharmacist Friedrich Sertürner who named them after the Greek God of Dreams, Morpheus. 

The drug became popular in North America during the 19th century when it was commonly prescribed for various ailments without much regulation or oversight from medical authorities. This led to increased recreational use of opioids and subsequent health problems such as addiction and overdose deaths. 

The 20th century saw further restrictions placed on opioid usage with attempts to curb recreational abuse through various legislative acts such as the Harrison Narcotics Tax Act of 1914. 

There have been a number of famous cases and personalities related to the use and abuse of opioids. Many celebrities have died from opioid overdose, including musicians such as Prince, Tom Petty, and Mac Miller, and actors such as Philip Seymour Hoffman and Heath Ledger. Several celebrities, including Demi Lovato and Robert Downey Jr., have spoken publicly about their struggles with opioid addiction.

The opioid epidemic has been the subject of several movies, including “Beautiful Boy,” a movie based on the true story of a father’s struggle to help his son overcome opioid addiction.  

Moreover, the famous book series “Patrick Melrose” by English writer Edward St. Aubyn which was later turned into a TV series depicts the protagonist’s journey of overcoming heroin addiction. 

It is clear that opioids will continue to remain a fixture in our cultural consciousness for some time given their deep historical roots but also due to their continued presence in literature and film today.

Opioids Identifiers 

If you have been prescribed opioids for your treatment, here are some identifiers to help you buy FDA-approved medication:

  • ATC code N02A
  • MeSH             D000701
  • Pub Chem      C55H70N4O7 

Bottom Line: Opioids in the United States 

 In the United States, the epidemic shows no signs of slowing down and is only getting worse as time goes on. The only way to truly combat this problem is to address it from all angles… from medical professionals prescribing fewer opioids to lawmakers changing legislation, to everyday citizens being more mindful about their own opioid use. 

It’s going to take a collective effort to make any headway against this problem–but it’s a fight that we can’t afford to lose.


Warren Phillips

Warren is a Licensed Master Social Worker, who specializes in substance abuse and mental health treatment. Clinically, Warren has developed a therapeutic skillset that utilizes a strengths-based perspective, Twelve Step philosophies, Cognitive Behavioral Therapy and Motivational Interviewing.

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Located on the historic peninsula of Charleston, South Carolina, Lantana Recovery takes a modern approach to Substance Use Disorder treatment, offering intensive clinical care while also immersing our clients in local Charleston culture.