What are synthetic opioids? Explore more about synthetic opioids below. Find out what the term synthetic opioids refer to, what the risks are of this type of drug, overdose rates for synthetic opioids and more.
What Are Synthetic Opioids?
If you have heard about the opioid epidemic, you’ve probably wondered to yourself what are synthetic opioids. Synthetic opioid is a term that can refer to prescription drugs used to treat pain, or to counterfeit drugs sold on the streets that dealers claim are opioids. Often these types of synthetic opioids are extremely dangerous or deadly.
The rising death rates related to synthetic opioids highlights the changing landscape of the opioid epidemic. For example, in 2011 the opioid linked to the most overdose deaths was oxycodone. Then, from 2012 to 2015 it was heroin. By 2016, overdose deaths related to fentanyl (a synthetic opioid) were most common. This is sometimes referred to as the third wave of the opioid epidemic.
Sometimes different types of synthetic opioids are referred to as synthetic heroin as well, even though the more accurate comparison is between natural prescription opioids and synthetic opioids.
Prescription Synthetic Opioids
The first part of the answer to “what are synthetic opioids” can be explored by looking at prescription drugs. Prescription synthetic opioids are made to relieve pain, and they replicate the effects of natural opioids and activate the same opioid receptor sites. Prescription naturally-derived opioids include morphine and codeine.
Most prescription synthetic opioids are very powerful. Two of the most commonly used prescription synthetic opioids are tramadol and fentanyl. Technically methadone is synthetic as well, although death rates related to this drug are tracked separately from other synthetic opioids.
If a drug comes directly from the opium poppy plant, it’s considered a naturally occurring opioid. In technical terms, opiate is what’s used to described naturally-derived drugs. Opioid is intended to refer to synthetic or partially synthetic opioids, although the two terms are often used interchangeably.
Illegal Synthetic Opioids
Along with prescription drugs used only in medical situations, there’s something even scarier to consider with the topic of synthetic opioids. These are illicitly manufactured drugs made in illegal laboratories.
These illegal laboratories become a source for synthetic opioids including not only fentanyl but also carfentanil, which is used as an elephant tranquilizer. Carfentanil can lead to a nearly instantaneous overdose when only a small amount is ingested.
Whether someone refers to these drugs as synthetic opioids, just opioids or as synthetic heroin, the effects are incredibly dangerous and deadly.
What is Fentanyl?
One of the most commonly talked about synthetic opioids or forms of “synthetic heroin” right now is fentanyl. It’s impossible to answer the question of “what are synthetic opioids” without looking at fentanyl.
Fentanyl is a synthetic opioid that’s anywhere from 80 to 100 times stronger than morphine. Pharmaceutically, fentanyl was created to help treat pain in cancer patients and manage end-of-life pain.
Unfortunately, due to the strong effects of the drug, it’s both diverted from medical use and also manufactured illegally.
Sometimes fentanyl is intentionally added to heroin to make it stronger, or dealers will also sell fentanyl and tell buyers it’s heroin. The buyer then has no idea of the tremendous potency of the drug they’re using—often leading to overdose deaths.
Illegally-made fentanyl primarily comes from Mexican drug labs.
In prescription form, fentanyl can be used as a lozenge, often referred to as a fentanyl lollipop (brand-name Actiq), tables available under the brand name Fentora and sublingual sprays like Subsys.
With fentanyl abuse, routes of administration include snorting or sniffing it, smoking it, taking it orally or using fentanyl patches. With fentanyl patches, the medication can be extracted from the gel these patches contain and then injected or ingested.
What Is Carfentanil?
Another drug to talk about when answering the question of “what are synthetic opioids” is carfentanil. As troubling as the effects of fentanyl are, the effects of carfentanil can be even more devastating.
Carfentanil is a synthetic opioid often used in veterinary medicine as a large animal tranquilizer. Carfentanil is estimated to be 10,000 times more powerful than morphine and 100 times more potent than fentanyl.
What will often happen is that drug dealers will mix heroin or other opioids with carfentanil to make them stronger. The result is a significant risk of death.
Even when first responders are exposed to carfentanil (as small as a tiny speck), they can experience symptoms of an opioid overdose such as shallow breathing and dizziness. If someone overdoses on carfentanil, in many cases even multiple administrations of Narcan don’t reverse the effects.
What Are Semi-Synthetic Opioids?
There are also semi-synthetic opioids. Many of the most commonly prescribed opioid pain medications are semi-synthetic. Hydrocodone and oxycodone are examples of semi-synthetic opioids which are derived from the poppy plant.
Hydromorphone is another example of a semi-synthetic opioid. Hydromorphone is available under the brand name Dilaudid. Hydromorphone is a powerful prescription opioid.
Synthetic Opioid Death Rates and Statistics
The death rates in the United States related to synthetic opioids—both prescription and illicit—has soared in recent years. The following are some death rates and other statistics related to synthetic opioids and synthetic heroin in the United States:
- There were more than 28,000 deaths related to synthetic opioids (not including methadone) in the United States in 2017. This amounted to more deaths than any other type of opioid.
- In 2017, the demographic seeing the biggest uptick in synthetic opioid death rates was males aged 25 to 44.
- 23 states and Washington D.C. saw increased deaths related to synthetic opioids in 2017.
- The states with the highest death rates from synthetic opioids were West Virginia, Ohio and New Hampshire.
- In 2012, fentanyl was involved in an estimated 1,600 overdose deaths. By 2016, fentanyl was related to 18,335 overdose deaths. It was linked to 29% of all overdose deaths in 2016.
- Overdose deaths involving fentanyl also often include heroin and cocaine, representing the fact that fentanyl is frequently mixed in with other illegally distributed opioids, often without the person taking the drugs knowing.
- In Ohio, there were a reported 400 deaths related to carfentanil from July to December 2016.
- Ohio reported the largest number of deaths and increases in death rates related to fentanyl in 2016, and they included carfentanil in these numbers since it is technically an analog of fentanyl.
Summing Up—Understanding Synthetic Opioids
So what are synthetic opioids? Synthetic opioids in most general terms are substances made to replicate the effects of natural opioids like morphine. Many synthetic opioids are incredibly strong, however, including fentanyl. There are also illegally-made versions of these synthetic opioids that have significantly contributed to the soaring opioid epidemic death rates.
Many people who ultimately die from using synthetic opioids have no idea what they’re taking, and in some cases, even Narcan can’t reverse the effects of these ultra-powerful drugs.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. “Fentanyl.” December 19, 2018. Accessed April 27, 2019.
DEA Resource Guide. “Drugs of Abuse.” Accessed April 27, 2019.
Just Think Twice (DEA.gov). “Five Quick Facts: Carfentanil.” Accessed April 27, 2019.
NIH National Institute on Drug Abuse. “Fentanyl and Other Synthetic Opioids Drug Overdose Deaths.” May 2018. Accessed April 27, 2019.
Wamsley, Laurel. “Fentanyl Surpasses Heroin As Drug Most Often Involved in Deadly Overdoses.” NPR. December 12, 2018. Accessed April 27, 2019.