Synthetic opioids are a major component of the modern opioid epidemic. Fentanyl specifically is now responsible for the most overdose deaths related to opioids each year. This is likely to continue for the foreseeable future unless major changes can be made.
What Are Synthetic Opioids?
Synthetic opioids are a type of opioid synthesized in a lab that act on the same parts of the brain as natural opioids like morphine. Unlike natural opioids, synthetic opioids aren’t made from poppy seeds.
While some synthetic opioids have legitimate medical purposes and are synthesized in officially sanctioned labs, many synthetic opioids found on the black market come from clandestine, criminal labs. The DEA claims a significant portion of synthetic opioids found on the black market are synthesized abroad and then trafficked over the border into the United States.
Common Synthetic Opioids
While any opioid, and especially any synthetic opioid, should be treated with caution, a few have emerged as the most commonly seen in both legal and illicit use.
Fentanyl is representative of some of the biggest dangers of synthetic opioids. Powerful and widely available, fentanyl has significant potential for misuse and opioid use disorder.
Since its development, it has quickly become responsible for the majority of opioid overdose deaths in the United States and elsewhere. Fentanyl is tens of times stronger than heroin. It is also frequently used to cut other drugs available on the black market, often without a buyer knowing, to make them have stronger effects and be more addictive.
While fentanyl has some specific uses in relieving patient pain, tramadol is a synthetic opioid that is more broadly used in this way. It is generally used to treat moderate to severe pain. This makes it similar to how most prescription opioids are commonly used.
Regardless of its medical uses, it still has significant misuse potential. It should only be used as prescribed and for as short a time as possible.
One common synthetic opioid is methadone, but it is generally talked about separately from other synthetic opioids. While methadone can be addictive and has misuse potential like any opioid, its misuse isn’t significantly widespread, and methadone overdose deaths are rare.
Methadone is also a good example of a synthetic opioid with a clear medical use. It is often used as part of evidence-based treatment for opioid use disorder to suppress drug cravings and allow an individual in recovery to avoid withdrawal. However, due to its higher misuse potential and more restrictions around how it’s dispensed to patients, methadone is less commonly prescribed for opioid use disorder. Suboxone is often preferred.
Synthetic Opioids & the Opioid Epidemic
Synthetic opioids seem to be one of the single biggest contributors to the scale of the current opioid epidemic which, despite growing awareness about the dangers of opioids, only seems to be growing in the United States. Synthetic opioids are often said to signal the “third wave” of the epidemic, which has been the largest and most dangerous thus far.
For context, the first wave was signaled by a rise in prescription opioid misuse. This was in the early days of the crisis before the public and many officials clearly understood the dangers of opioids.
The second wave was signaled by the proliferation of heroin, which overtook prescription opioid misuse as the primary concern regarding opioid use disorder and overdose deaths. Some experts posit we may be entering a fourth wave of the epidemic, signaled by a rise in mixing opioids with stimulants.
Is There an Overdose Risk With Synthetic Opioids?
Synthetic opioids have a significant overdose risk, with over 56,000 people in the United States dying in 2020, and the rate of deaths related to synthetic opioids largely trending upward. From 2013 to 2020, there was a spike in overdose deaths involving these drugs, with the amount of deaths in 2020 more than 18 times higher than in 2020.
The primary danger of synthetic opioids is similar to that of all other opioids. Opioids cause respiratory depression, causing a person’s breathing to weaken. With heavy enough opioid use, respiration can get so weak that a person literally can’t breathe enough to support their brain’s oxygen needs. This can cause them to lose consciousness, develop brain damage, and potentially die if not treated quickly.
Treatment Options for Opioid Use Disorder
An opioid use disorder is difficult to treat on your own, and professional help is generally needed to recover. Talk to an addiction treatment expert if you want to stop taking opioids but are struggling. There are a few different treatment options they can talk to you about, many of which can be combined as part of a comprehensive addiction treatment plan.
For example, many people benefit from medications for opioid use disorder. This involves the use of prescribed medication to manage withdrawal symptoms and cravings. Suboxone is the gold standard. Therapy is also part of the program, as medication does not treat opioid use disorder on its own.
Whatever a specific person’s needs, therapy will be a core part of treatment. Behavioral therapy is commonly used, and cognitive behavioral therapy (CBT) is a popular approach.
CBT involves an expert working with a patient to identify what motivates their substance misuse. They practice strategies to identify toxic thought patterns and channel them in healthier ways. They also work on how to change the way they think on a more fundamental level to avoid thoughts that may lead to drug misuse.
Other therapies may be used in addiction treatment, such as family therapy to repair relationships that may have been damaged in active addiction. Alternative therapies, such as adventure therapy or music therapy, may also be used.
Support group participation is often recommended. In these groups, individuals can learn from others who have an opioid use disorder. It’s a good way to build a support network and recognize that you are not alone in your journey to recovery.
Reviewed By: Peter Manza, PhD
- Synthetic Opioids. Drug Enforcement Administration. https://www.dea.gov/sites/default/files/2020-06/Synthetic%20Opioids-2020.pdf. April 2020. Accessed November 2022.
- Overdose Death Rates. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates. January 2022. Accessed November 2022.
- Synthetic Opioid Overdose Data. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/deaths/synthetic/index.html. June 2022. Accessed November 2022.
- Effective Treatments for Opioid Addiction. National Institute on Drug Abuse. https://nida.nih.gov/publications/effective-treatments-opioid-addiction. November 2016. Accessed November 2022.
- Family Therapy Techniques for Substance Abuse Treatment. Treating substance abuse: Theory and technique. https://psycnet.apa.org/record/2012-07981-010. 2012. Accessed November 2022.
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