What are “opiates” or “opioids?”

Opioids usually come in pill form and are prescribed to reduce pain. Medical doctors and dentists prescribe them after surgery or to help patients with severe pain or pain that lasts a long time. When opioids are taken as prescribed by a medical professional, they are relatively safe and can reduce pain effectively. However, dependence and addiction are still potential risks when taking prescription opioids. These risks increase when these drugs are abused. Painkillers are one of the most commonly abused drugs by teens, after tobacco, alcohol, and marijuana.

Listed below are common types of opioids:

  • Hydrocodone (Vicodin, Lortab, Lorcet)
  • Morphine (Kadian, Avinza, MS Contin)
  • Codeine
  • Fentanyl (Duragesic)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Methadone

Is it risky to use any prescription painkiller?

All medications carry risks. Pain medications that contain synthetic opiates (also known as opioids) are no exception.

If you are prescribed opioid medications by your doctor, thoroughly discuss the risks and benefits of the medication. Use the medication only as prescribed and do not share it. This significantly reduces the likelihood that you will develop an addiction.

Explain the role of fentanyl and other synthetic opioids in Pennsylvania’s opioid epidemic.

Fentanyl is a potent, fast-acting opioid that’s 50-100 times as strong as morphine. It is a growing contributor to the opioid epidemic in Pennsylvania. In 2017, approximately two-thirds of people who died of drug overdose had fentanyl in their bodies, which means fentanyl contributed to more overdose deaths than heroin or prescription opioids that year.

Fentanyl overdose has grown sharply in Pennsylvania because heroin is often mixed with fentanyl to make it more potent. Because fentanyl is so strong–and so fast-acting–overdose risk is very high.

The same responses to other opioid use still apply to fentanyl. For example, naloxone (brand name Narcan) reverses a fentanyl overdose, just as it does with an overdose from heroin or painkillers. Addiction to fentanyl can be treated in the same way as other opioids: medications like buprenorphine and methadone can be effective, so can individual and group therapy. Recovery support over the long-term is important for people with fentanyl addiction, just as it is for people addicted to other opioids.

Does everyone who develops an addiction to prescription painkillers move on to heroin?

Not everyone who uses prescription painkillers does or will use heroin. However, a survey of opioid users in Philadelphia indicated that more than half of the respondents reported using pills before heroin.

In interviews, people who switched from painkillers to heroin said they made the transition because painkillers became unavailable, because heroin is cheaper, and because they were desperate for relief from opiate withdrawal.

There is evidence that, as prescription painkillers become less freely available, heroin use is increasing. There has been a worrying rise in heroin deaths over the last few years. Nationally, heroin-related overdose deaths have increased by 425% since 2010.

We encourage Pennsylvanians to take steps to prevent non-medical use of prescription painkillers and, in so doing, to break the connection between heroin and prescription painkillers. Together, we can stop opioid addiction before it starts.

What can I do to make sure my child doesn’t get involved with drugs?

There is no guaranteed protection against substance use, but there are protective factors. These factors reduce the chances that your child will use drugs or alcohol and develop an addiction.

Parents often feel that their influence over their adolescent children is minimal. In fact, research and clinical experience show that parents can have a significant influence over their children’s decision to use drugs or alcohol. Parents are advised to build a trusting relationship with their children, regularly discuss the risks of substance use, and model healthy behaviors for children to learn from. Parents should also be aware of and monitor childrens’ risk factors. Children with a family history of addiction, a mental health condition, an impulsive/risk-taking personality, and/or a history of trauma are at greater risk of substance use and addiction.

For specifics, see and download our Family Toolkit.

What’s the difference between treatment and Twelve Step support groups?

Twelve Step support groups are a form of peer support. They are the most widely available mutual support groups for people trying to break the cycle of addiction and those in recovery. In addition there are other peer support options including: Women for Sobriety (WFS), SMART Recovery (Self-Management and Recovery Training), and Secular Organizations for Sobriety/Save Our Selves (SOS).

Although they are not professional treatment, Twelve Step groups can complement and extend the effects of professional treatment.

Professional treatment involves a structured program over time that includes credentialed counseling for substance abuse which is often accompanied by closely supervised medication. This can occur in a treatment facility for in-patient or out-patient clients. Out-patient treatment can also be received in a variety of community based locations.

For specifics, see and download our Family Toolkit.

What’s the difference between detox and treatment?

Detox is a process of managing the acute physical symptoms of withdrawal. Detox may be medically managed in an inpatient facility or hospital. It may also occur on an outpatient basis. Detox is a short-term process, usually lasting less than a week.

Treatment addresses the biological, psychological, and social aspects of addiction. It should last longer than detox. Research tells us that most addicted people need at least three months in treatment to really reduce or stop their drug use and that longer treatment times result in better outcomes.

Depending on the type of treatment, detox may be the first step in a drug treatment program. But detox alone with no follow up is not treatment.

Detox treats withdrawal. Treatment treats addiction. Treating withdrawal is not the same as treating addiction.

For specifics, see and download our Family Toolkit.

I have some reservations about the use of methadone or Suboxone to recover from opiate addiction. Isn’t that just trading one addiction for another?

Used properly, medications do not create another addiction. Medications allow an addicted person to regain a normal state of mind, free of drug-induced highs and lows. It frees the person from thinking all the time about the drug. It can reduce problems of withdrawal and craving. These changes can give the person the chance to focus on the lifestyle changes that lead back to healthy living.

Medication-assisted treatment for opiate addiction is just that: medication-assisted. The medication is just one ingredient. To recover from opiate addiction, most people also need some form of counseling and support from friends, family, or other members of the recovery community.

For specifics, see and download our Family Toolkit.

What should I do with old medications?

There are several safe ways to dispose of unused medications. Many regions in Pennsylvania have medication drop boxes which allow citizens to turn in unused drugs in specific locations.

Medications can also be placed in the trash. The FDA recommends flushing some prescription painkillers down the sink or toilet, but it is important to know which ones.

Do not share unwanted medications. A medication that has been safely prescribed to you could be dangerous for someone else.

For specifics, see and download our Family Toolkit.

Are heroin and prescription painkillers basically the same thing? What’s the difference?

Prescription opioids and heroin affect the brain and body very similarly. Therefore, people who misuse or become addicted to prescription pain relievers may also develop problems with heroin. In interviews, people who switched from painkillers to heroin said they made the transition because painkillers became unavailable, because heroin is cheaper, and because they were desperate for relief from opiate withdrawal.

There is evidence that, as prescription painkillers become less freely available, heroin use is increasing. There has been a worrying rise in heroin deaths over the last few years. Nationally, heroin-related overdose deaths have increased by 425% since 2010.

We encourage Pennsylvanians to take steps to prevent non-medical use of prescription painkillers and, in so doing, to break the connection between heroin and prescription painkillers. Together, we can stop opioid addiction before it starts.