What are opioids?

The term “opiate” is often used to refer to a substance that contains opium or which produces an effect like that of opium. In fact, the term “opioid” means nothing more than “like opium” and is used to designate such products. In medicine, opioids are used for their analgesic properties; they reduce pain, in other words. They can be beneficial when used for that purpose, say for patients suffering from chronic pain due to diseases like cancer. They also have narcotic properties in that they induce sleep. As a result, they are often called “narcotics” or “narcotic analgesics.”

There are many types of opioid that can be obtained by prescription. The most common are. . .

  • oxycodone,
  • morphine,
  • hydromorphone,
  • fentanyl,
  • codeine,
  • methadone, and
  • therapeutic heroin.

Opioids can be prescribed in a variety of forms, notably. . .

  • cough syrups,
  • tablets or capsules,
  • nasal sprays,
  • transdermic patches,
  • suppositories, or
  • liquids for injection.

Though intended to relieve severe pain, opioids also cause a feeling of euphoria—what users call a “high.” Opioids can accordingly be diverted from their original purpose and used for purposes other than pain management. They can be found on the black market, most commonly in the form of heroin, oxycodone, fentanyl or carfentanil.

Addiction and withdrawal

Whether legally or illegally sourced, opioids can be highly addictive, both physically and psychologically.

When people stop using opioids, they may start feeling withdrawal symptoms. The weaning process can be very unpleasant, even painful, but is never fatal. Withdrawal symptoms include. . .

  • heavy sweating,
  • shivering,
  • migraines,
  • muscle or joint pain,
  • stomach cramps,
  • nausea/vomiting,
  • diarrhea,
  • anxiety,
  • fatigue, and
  • sleep disorders.

Some medical assistance can help users wean themselves off opioids. Methadone or buprenorphine/naloxone, both of which reduce the severity of symptoms, are the most common.

High risk of overdose

If the prescribed dosage is not followed, however, the risk of opioid overdose increases. This is because opioids affect the part of the brain that controls breathing. Sometimes the dose is higher than the body can tolerate, which can slow breathing and even cause death.

The risk of dying is higher when opioids come from the black market, since it is impossible to determine their exact composition. In recent years, black-market heroin is increasingly being “cut,” i.e. combined, with fentanyl. Fentanyl is a dangerous drug, 100 times stronger than heroin, and can cause overdoses even in very small quantities. The problem is that there is no way for heroin users to know whether their drugs contain fentanyl, or how much of it there is.

The opioid crisis in Canada

In Canada, the use of “street” opioids is particularly lethal. Between January 2016 and September 2020, there were 19,355 opioid-related deaths across the country. In half a year, from January to September 2020, 82% of these deaths involved fentanyl. While the crisis more severely affects Western Canada, particularly British Columbia, opioid overdose deaths continue to rise in Québec as well. Canada’s opioid crisis has also been greatly aggravated by the COVID-19 pandemic.

The early stages of an opioid overdose can be treated with naloxone. Naloxone reverses the effects of the drug by restoring breathing within 2 to 4 minutes. However, the effects of naloxone are only temporary, so it remains important to call 911. Regardless of the outcome, overdose victims must still receive medical attention.

Naloxone kits are available free of charge in most pharmacies in Québec or from certain organizations.

Good to know: There are risks other than overdose associated with opioid use, more particularly if the drugs were bought on the black market or administered intravenously. Examples include transmission of diseases like HIV and hepatitis B or C (from sharing needles), infections, and burst or damaged veins.

We can help you

If you are concerned about your opioid use or that of a loved one, you do not need to worry alone. Call us at 1-800-265-2626 or log into the chat room via the link at the bottom right of our home page. We can provide you with personalized support and information and refer you to resources specializing in your situation. Our services are available 24/7.

Sources : Diagnostic and Statistical Manual of Mental Disorders (DSM-5) / Les psychotropes : pharmacologie et toxicomanie, Louis Léonard et Mohamed Ben Amar (2002) / Government of Canada / Gouvernement du Québec / Centre for Addiction and Mental Health (CAMH) / Institut national de santé publique du Québec (INSPQ) / Canadian Centre on Substance Use and Addiction (CCSA) / Canadian Public Health Association / McMaster University