etflix’s new drama Painkiller tells the story of how Richard Sackler took advantage of a broken healthcare system to build a vast pharmaceutical empire, launching OxyContin, a small white pill that is up to twice as powerful as morphine.
The series has enlivened the conversations around opioids, including Oxycontin.
Tom Petty, Mac Miller and Juice WRLD are among the celebrities whose deaths have been linked to opioids in recent years.
These prescription painkillers – which also cause euphoria – have led to particular problems in America, where 70,000 people died in 2018 due to the drugs.
From a medicine first derived from poppies, the opioid business is now worth tens of billions of pounds, and there are now chemically synthesised forms of these drugs.
What are opioids?
Opioids are a type of powerful painkiller used to treat a range of pains, including post-surgery, acute and cancer pains.
They include oxycodone – also known as Oxycontin – fentanyl, morphine, methadone, codeine and diamorphine, also known as heroin.
The name opioid comes from the word opium, as the first versions of the drug came from opium poppies.
When scientists discovered the part of the brain affected by these drugs, they named them the opioid receptors.
Newer, synthesized, versions of the drugs such as fentanyl do not come from a poppy but use the same name because they affect the same part of the brain.
As well as being a painkiller, opioids can be used recreationally and can also cause addiction.
What are they prescribed for?
According to the NHS, opioids can help with a range of different types of pain.
Advice from the health service says: “Opioids can be used for a short time after surgery or trauma (acute pain). This type of pain will ease as you heal. The dose will be reduced until you no longer need it. Opioids can also help with increased pain caused by other conditions.
“For example, they are effective for cancer pain, where it is common to start at a low dose and gradually increase until the pain is controlled.
“With cancer pain, it is common to use a long-acting medicine twice daily.”
Opioids have also been prescribed for chronic pain in the past.
However, they are less useful for this and this is where the addictive nature of the drugs can cause an issue.
The NHS advice adds that for chronic conditions “it is better to use the smallest dose for the shortest time, ideally only using the medication when you need it, rather than regularly”.
Opioids have also been prescribed for chronic pain in the past.
/ PA ArchiveAre they legal?
Yes, certain opioids are legal in the UK. Most of them require a prescription from a doctor if people need them.
Some over-the-counter medicines from pharmacies contain small amounts of codeine in combination with milder painkillers such as ibuprofen and paracetamol.
However, heroin is a Class A restricted drug and being caught with it could land a person in prison for up to seven years.
Methadone, which is used in the treatment of opioid addiction is also Class A.
Codeine is Class B and carries a five-year jail term for possession.
What are the dangers of opioids?
As opioids are addictive, they can lead to a significant disruption in a person’s life.
While they are mainly prescribed to treat pain, they can cause a raft of side effects.
These include constipation, nausea, excessive sleeping, and poor concentration.
But more seriously ,opioids can cause the respiratory system to not work properly which, when matched with a person being asleep, can lead to death.
Opioids such as morphine, fentanyl and codeine are super-strength medications for pain which can be highly addictive (Lauren Hurley/PA)
/ PA ArchiveThe opioid epidemic in the UK and the USA
During the 1990s, opioids were widely prescribed for chronic pain – something they have now been found to be not very good at treating.
Patients constantly taking the medicines lead to massive addiction problems and prompted President Donald Trump to declare a public health emergency in 2017.
At least 200,000 people are thought to have died from prescription opioid problems in the US between 1999 and 2016.
The numbers are still rising, with 70,237 deaths from the drugs in 2017 – up 9.6 per cent from the year before.
In the UK, the number of deaths is nowhere near as high but the country is still facing some problems. The number of opioid overdose cases admitted to hospitals in 2018 was 20,130 – a rise of 85 per cent in a decade.
Synthetic drugs like fentanyl have seen a particular uptick, with poisonings from the simulated strand of opioids rising 550 per cent to 2018 with 5,486 admissions over 10 years.
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