Synthetic opioids: a historical and clinical review

Opioids are a class of drugs including fentanyl, heroin, oxycodone, and more

Since the dawn of pain, living things have sought ways to mitigate this evolutionary warning signal. One of nature's most effective painkillers is opium, a highly addictive, milky latex extracted from poppy plants. This forms the basis of one of the most prescribed classes of modern drugs.

Morphine, heroin, codeine, and more were derived from opium

Opium reached the US at about the time early colonists were itching for ways to soothe aches and pains. The active ingredient in the substance was isolated in the early 19th century, eventually leading to the manufacture and commercial sale of morphine, heroin, and other opium-based drugs.

Opium is a milky liquid substance extracted from unripe poppy plant seeds

It's been used for ages to reduce pain and induce euphoria, both of which are side effects of the plant's alkaloids—nitrogen-based compounds with pronounced physical effects. Isolating and synthesizing derivatives of these naturally occurring chemicals enabled the invention of morphine, heroin, and other opioids.

Opium's history traces from religious use to mass-market commercial products

Religious or medical use of opium was present across Europe and Asia as early as 5000 BCE. By the 16th century, humanity had come to see opium as more than medicine: It was a marketable product. This perspective also defines today's relationship with opioids, highly addictive painkillers at the heart of an ongoing drug crisis.

Opioid prescription rates by states and counties

The origins of the US' ongoing opioid crisis are typically traced to the more than 1 billion prescription pain pills that flooded medicine cabinets between 2005 and 2019. This prescription opioid epidemic resulted in more than 210,000 fatal overdoses and set the stage for the ongoing crisis fueled by heroin and fentanyl.

Overuse of opioids can lead to hypersensitivity to pain

Opioid misuse can lead opioid-induced hyperalgesia, where the body becomes increasingly sensitive to pain. The body produces its own opioids as a way to temporarily block pain signals. When met with external opioid use, the body ratchets up pain sensitivity to ensure it senses the pain necessary to trigger its own response.

Why is fentanyl poisoning street drugs?

A few grains of fentanyl, a synthetic opioid far more potent than heroin or morphine, is enough to kill a typical adult human. It's made its way into other, less lethal street drugs, where it may be used to increase the highs experienced by unknowing users, increasing their likelihood of addiction and overdose. This 39-minute podcast episode is the first half of a two-part series exploring fentanyl's rise.

The story of the Sackler empire behind highly addictive OxyContin

This investigative report examines how the Sackler family built its fortune through Purdue Pharma’s aggressive marketing of OxyContin, a highly addictive painkiller. Through 2017, the drug had generated more than $30B in sales for Purdue Pharma, controlled by the Sacklers.

One person dies from opioids every 7 to 8 minutes

This collection of infographics by the National Institute for Health Care Management helps put the crisis into perspective. The opioid epidemic has had three waves. Opioid-related deaths increasingly involve synthetic versions of the drug class, contributing to 83 percent of all opioid-related deaths in 2020. Use these infographics to learn more about the crisis.

The Cincinnati Enquirer's Pulitzer-winning look at the opioid epidemic

Synthetic opioids kill someone in the US every 16 minutes. Communities across the country have been ravaged by deaths, overdoses, jail time, and babies born with drug-related medical problems as opioid abuse became a typical feature of many American towns. This seven-part exposé provides an inside look at the effect in southern Ohio and northern Kentucky.

Learn about the US opioid crisis in this free course

Where did the US opioid crisis come from, and how did it spread? Learn this and more in this free, online Harvard University course. Learn about the disease model of addiction treatment and management, and get up-to-date with public health and law enforcement's current harm reduction practices. This free resource gives users a greater understanding of opioid addiction and the epidemic still haunting the US.

Drugs 101: An interactive guide

What's the difference between opioids and psychedelics? This guide details specific drugs and their various associated effects. Drugs in this wheel fall into seven categories: stimulants, depressants, empathogens, psychedelics, dissociatives, cannabinoids, and opioids.

The story of Marie Nyswander, the woman who co-discovered methadone maintenance

Methadone, an opioid with distinct effects from heroin, revolutionized heroin addiction in the 1960s. Marie Nyswander was a psychoanalyst who helped discover the treatment process which is still in use today. Here's a podcast episode examining her life and role in the field of addiction treatment.

Aspirin was the first synthesized anti-inflammatory drug

Once used by the ancient Sumarians—extracted from willow bark—but now synthesized in the lab, the active ingredient of this popular medication has been used to treat headaches and pain for thousands of years.

Narcan is an opioid antagonist that can rapidly reverse overdoses

Naloxone, also known by the brand name Narcan, is an opioid-overdose reversal medication that typically begins working within a few minutes. An opioid antagonist, the treatment attaches to opioid receptors without activating them, forcing opioid molecules out of their respective receptors and allowing users' breathing rates to normalize.

How Western psychedelics research fell to the wayside

Psychedelics' modern era began when LSD was discovered in the 1930s. By the 1950s, clinical trials were underway. US user experimentation outside of medical settings (and high-profile violence, like the Manson murders) inspired negative attitudes toward psychedelics, leading to use restrictions that prohibited companies from patenting psychedelic compounds. This strangled psychedelics' profitability until the 1990s when the government loosened its grip and psychedelics research began seeing a resurgence.

The pharmaceutical industry evolved, in part, from the discovery of synthetic dyes

In 1856, a chemist accidentally discovered mauveine, the world’s first synthetic dye, while trying to make quinine to treat malaria. The synthetic dyes that followed helped reveal germs under microscopes, paving the way for modern imaging techniques and breakthrough treatments, such as antibiotics.

Read the FDA's statement on concerns over compound pharmacies

GLP-1 drugs popularity for weight loss and treating diabetes, led to a significant supply shortage and the rise of compound pharmacies, which produce customized drug formulations but lack formal approval from regulators. The drugs are ostensibly the same, but manufacturing methods lead to variations in concentration, filler compounds, and more.

Multiple sugar substitutes were accidental discoveries when lab workers didn't wash their hands

Saccharin, aspartame, and cyclamate all have origin stories from lab workers tasting something sweet on their hands. A Johns Hopkins University worker in the late 1800s, for example, tasted something sweet on his (unwashed or poorly washed) hands during dinner, prompting him to then taste everything on his lab bench in order to identify that the sweetness was a compound derived from his overheated coal tar—a substance he later named saccharin. (Some users may encounter a paywall.)

Early peptide research focused on isolating the substances from animal tissue

In the first half of the 20th century, peptides including insulin and adrenocorticotropic hormone were isolated from animals to provide life-saving medicines. ACTH was isolated from the pituitary glands of cows and pigs and insulin was isolated from the pancreas of dogs and cows.

The federal government allowed toxic chemicals into alcohol during Prohibition

Industrial alcohol was still legal during Prohibition, and was often used by bootleggers. In an attempt to disrupt the black market, the government required toxic additives to be included in industrial alcohol, leading to more than one death.

Trauma is a primary risk factor for substance use disorder later in life

Studies indicate 75% of people with substance use disorder have experienced at least one traumatic experience in their life. These experiences alter brain function, leading to heightened stress and emotional pain. Substances offer temporary relief, but this often results in dependency.

In 2025, researchers in the UK began working on developing artificial DNA

The Synthetic Human Genome Project aims to one day construct human DNA, molecule by molecule, in the hopes of creating disease-resistant cells and synthetic chromosomes for study. However, critics warn it may be misused to create enhanced or modified humans.

Plastic's history began with an inventor seeking a $10,000 prize offer

In 1869, the first synthetic polymer—celluloid—was created as a substitute for ivory in billiard balls. It became the historical catalyst for the eventual manufacturing of plastics everywhere as an alternative to the depletion of other natural resources, including tortoiseshell and horns.

Did people domesticate plants or did plants domesticate us?

Humans rely on plants to survive, and many plants have come to rely on humans. This 14-minute video explores how agriculture was simultaneously a building block of civilization and a trap that captured humanity. Plant types that may not have...

Read a deep dive on the 'all-purpose healing' peptide BPC-157.

Telehealth demand for GLP-1s for weight loss is booming as consumers seek easier access.

The hormonal disorder PCOS was renamed PMOS in 2026, a move designed to improve care and research by shifting the focus to the hormonal causes of this condition that affects 1 in 8 women.

At the beginning of the 20th century, a group of young men ate standard American food—replete with food additives like borax and formaldehyde—as part of government research to better understand food safety.

Hear 50 years of iconic hip-hop samples, the genre's foundational looped tracks

Poison ivy's characteristic rash is caused by an allergic response to an oily compound in the plant called urushiol.

The first line of 'immortal' human cells, which can divide indefinitely and are used in scientific research, was nonconsensually taken from a Black woman.

Some researchers have labeled nomophobia, the fear of being without your phone, as 'the phobia of the 21st century.'

For centuries, it was common to sleep in two shifts: a few hours at the beginning of the night, and a longer period beginning around midnight

When a Paris department store hesitated to sell Estée Lauder's perfume, she 'accidentally' broke a bottle, causing the smell to spread throughout the store and shoppers to start asking to buy the scent.

Roughly 43 million US borrowers owe roughly $1.7T in student debt, the second-largest source of consumer debt behind mortgages.

Explore the archaeological treasures of Pompeii, the city buried under volcanic ash when Mount Vesuvius erupted in 79 CE.

See images of medical cases of firework injuries shared on this 'Instagram for doctors.' (Warning: Graphic content)

Memecoins are a type of cryptocurrency—a form of digital currency with a wide variety of uses—created around popular 'memes,' or viral internet jokes.

The story of Dollree Mapp, whose legal challenge over her 1957 conviction for possessing "obscene material" led to a major strengthening of the Fourth Amendment

Long before Major League Baseball began allowing instant replay for balls and strikes, an umpire reluctantly used the technology to determine whether a hit was a home run, a move that inadvertently ushered in a new era for the sport.

See how Ebola tore through Guinea, Sierra Leone, and Liberia in 2014-2016.

Domino's Pizza's 30-minute delivery guarantee was responsible for the chain's 1980s surge, but it was discontinued after the company was found liable for delivery driver accidents.

This site reaches millions of visitors who are tired of AI chatbots and seeking human connection. Pretend to be an AI chatbot and ask questions, provide answers, and draw for people in real time.

The 19th-century painters of the Hudson River School were among the first American romantics, with portraits that displayed the natural beauty of the young country.

Some renewable energy sources may weaken the resiliency of electric grids by removing outage buffers provided by coal- and natural gas-fired plants, which provide the system with more time to find a new power source if a plant goes down.

The term 'algorithm' originated from the Latinized name of al-Khwārizmī, a 9th-century mathematician whose works introduced Arabic numerals and the decimal-based numeral system to Europe and whose treatise 'Al-Jabr' gave algebra its name.

Artificial coral reefs have been 3D printed from nontoxic, biodegradable terracotta clay, which coral polyps have used as a foundation for rebuilding marine ecosystems.

An initial public offering or 'IPO' is the process of a private company becoming public by putting shares of the company on the stock market for purchase.