Prescription opioid types and risks
Prescription opioids are often classified as short- and long-acting medications based on the onset and duration of their pain-relieving effects. They are sold under various brand names. Common examples include:
- Actiq, a short-acting form of prescription fentanyl.
- MS Contin, a long-acting form of morphine.
- Oxycontin, a long-acting form of oxycodone.
Opioids are also sometimes combined with nonopioid pain relievers, such as acetaminophen (Tylenol). Oxycodone-acetaminophen is marketed under the brand name Percocet, while hydrocodone-acetaminophen is sold as Lortab. Vicodin, another well-known brand of hydrocodone-acetaminophen, is no longer available.
Opioid painkillers have a chemical makeup similar to the illegal drug heroin. Dependence can form over time, and taking too much of these substances can slow breathing, induce coma, and cause brain damage or death.
Prescription opioid misuse, dependence, and overdoses have caused a public health crisis. According to government data, 9.5 million people ages 12 and older misused opioids in 2020; of those, 9.3 million misused prescription opioid pain relievers, while 902,000 people used heroin. Some of the most common prescription drugs involved in overdoses are hydrocodone, methadone, and oxycodone.
If you obtain and misuse counterfeit prescription opioids or illegal drugs such as cocaine, heroin, and methamphetamine, you may also be ingesting fentanyl, a highly potent opioid. Illegal drugs are increasingly being laced with fentanyl, which is heavily contributing to record rates of overdose death.
These additional factors could increase your risk of misusing, becoming dependent on, and facing serious harm from prescription opioids:
Age, lifestyle, and medical history. Dependence is more likely if you use or have used other drugs, have an untreated mental illness, or live in a situation that enables drug misuse. You may be at greater risk of overdosing on prescription opioids if you are over age 65 or have a health condition such as sleep-disordered breathing, end-organ dysfunction, or lung disease. Meanwhile, the rate of nonmedical opioid use is highest among people ages 18 to 25, and most people who misuse prescription opioids start using the drug in their early to late 20s. Prescription opioid overdose deaths occur mostly among people aged 25 to 54.
High dosage. Taking a higher dose comes with a greater risk of dependence than taking a lower dose does, but even taking a low dose is risky, according to Centers for Disease Control and Prevention (CDC) prescribing guidelines.
Long-term use. If you use opioids for even a few days, you could become dependent. An estimated 1 in 4 people receiving prescription opioids long-term in a primary care setting become dependent, according to research summarized by the CDC.
Extended-release formulations. Dependence is more common with drugs that act over a longer period than with those that act more immediately, CDC guidelines say.
Mixing prescription opioids with other substances. You increase your risk of serious harm, including overdosing, if you mix opioids with other substances. This is especially true for substances that make you drowsy, such as alcohol, benzodiazepines such as Valium or Xanax, muscle relaxants like Soma, and sleep aids such as Ambien.
Signs of prescription opioid misuse or dependence include:
- Taking pills in greater amounts or more frequently than prescribed.
- Finishing a prescription early.
- Using someone else’s prescription drugs.
- Mixing pain pills with other substances, like alcohol, illegal drugs, or other pharmaceuticals, whether prescribed or available over the counter.
- “Doctor shopping” — visiting multiple doctors and pharmacies — to obtain multiple prescriptions.
