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You take two pills as the label indicates: one in the morning and one at night, both times with a full glass of water. The bright orange bottle of painkillers was prescribed to you after a particularly nasty car accident left your leg broken in three places. It helps alleviate the pain – but you’re beginning to worry that the craving you get a half hour before you take the pill might not be healthy. You shake off the anxiety by reassuring yourself that the doctor wouldn’t have prescribed you opioids if he hadn’t thought they were safe. What you don’t realize, however, is that the danger creeps in by small doses of dependence and the craving sticks around even after the pills run out.


The situation we currently face is unprecedented; in 2016, over 65,000 people in America died from drug overdose. But how did this happen, and why? The answer is complicated, and requires us to look into how opioids addict in the first place. “Opioid” is a catch-all term for medications derived from the poppy plant and those synthetically produced to have a similar impact. Now, it should be noted that humans have been struggling with addiction to poppy-derived drugs such as opium, morphine, heroin, and codeine for years – often as a means for battling acute or chronic pain. These drugs work by attaching themselves to opioid receptor proteins in the spinal cord and brain and preventing the conveyance of pain signals. Because these receptors regulate our perceptions of pain and pleasure, they have a tremendous capability to limit pain – and a high risk of addiction.


Worse, though, are synthetic opioids such as fentanyl and methadone. These are chemically produced to have a similar effect to naturally-cultivated drug varieties, only at a much high concentration. While fentanyl is often used legitimately by anaesthesiologists prior to surgeries, the vast majority of the circulating supply of the drug is produced illegally. As a powder, small quantities of fentanyl can be easily cut into heroin doses to make a stronger high; however, due to the concentration of the drug itself, users have a high fatality rate. In heavily-affected regions of the country, analysts estimate that as many as half of all opioid overdoses are due to a dangerously high concentration of fentanyl.


But why is this happening? Wouldn’t people steer clear of fentanyl and street-grade hard drugs if they knew it held such a high risk of death? Unfortunately, most users only realize that fentanyl was cut into their supply once they suffer an overdose – and many never intended use heroin in the first place. For many, the path to addiction starts begins with a prescription for legal opioid pain medication. If taken for too long or too often, however, these legal pills can be just as addictive as anything on the street, and does little to solve long-term chronic pain problems. Opioid habits remain even after prescriptions run out, leaving many in an addictive spiral towards dangerous alternatives such as heroin.


Opioids do have a place in modern medicine as short-term solutions to severe pain. However, we need to develop a strategy to address the dangerous consequences that long-term prescription drug use can leverage against patients, and find alternative means of chronic pain management that does not pose such a high risk of addiction.