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

Synthetic opioids: a historical and clinical review

In the 19th century, researchers began synthesizing and isolating poppy plant alkaloids, leading to the invention of morphine, codeine, heroin, oxycodone, and others. These highly addictive variants eventually gave rise to illicit use and a widespread underground market, laying the foundation for the current opioid crisis.

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.

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.

Opioids mimic naturally produced endorphins to dull pain.

From prescriptions to street drugs: Opioids trajectory across America

Exclusive data obtained by The Washington Post from the Centers for Disease Control and Prevention shows how individual counties moved through three waves of the opioid crisis, each wave paving the way for the next. Between 2011 and 2017, the drug responsible for the majority of overdose deaths shifted from prescription pills to heroin to fentanyl. Together, oxycodone, hydrocodone, heroin, and fentanyl have been major drivers in declining life expectancy in the US.

Evidence of opium use dates to as early as 5000 BCE

Archaeological evidence shows the use of the poppy plant for its pain-killing properties likely originated in the Mediterranean before making its way to the East and West via trade. It has since inspired two eponymous wars, and highly addictive derivatives of the naturally occurring substance have led to an ongoing overdose crisis.

The three waves of the opioid crisis: overprescription, heroin, and fentanyl

The US opioid crisis has unfurled in three distinct waves, each spiraling into an epidemic that's killed millions. The first crested in the 1990s with the overprescription of opioids for pain relief. The second manifested as heroin overdoses in the 2010s. The third began in 2013 with the rise of deaths related to tramadol and fentanyl.

Why are drug dealers putting fentanyl in everything?

A few grains of fentanyl, a synthetic opioid far more potent than heroin or morphine, are 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.

Why the human brain loves opioids

When opioids enter the brain, they dock in receptors, blocking electrical pulses such as those that communicate pain. They also trigger the release of dopamine, a neurotransmitter tied to motivation and associated with stress relief.

Overuse of opioids can lead to hypersensitivity to pain.

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.

Fentanyl can be up to 100 times more potent than morphine

A synthetic opioid, fentanyl is highly addictive and incredibly fast-acting—a fatal dose is equal to a few grains of table salt. Once it enters the body, fentanyl floods naturally occurring opioid receptors, which can cause the body to shut down its breathing reflex, leading to a fatal overdose.

Fentanyl is better at crossing the blood-brain barrier than other opioids

Among opioids, fentanyl is uniquely adept at crossing the blood-brain barrier—the brain's security fence against harmful substances. This enables a lightning-fast high. It ends just as quickly, sometimes within minutes (where a heroin high lasts hours), and still results in the same withdrawal symptoms.

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.

Methadone binds to the same receptors as heroin and other opioids

Methadone is a long-acting opioid agonist that works by binding to the same brain receptors as other opioids (like heroin or morphine), but without producing intense euphoria. It reduces withdrawal symptoms and cravings, helping people stabilize and avoid illicit opioid use.

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 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.

Opioid epidemic 101: lawsuits and settlements

State and local governments trying to address the opioid epidemic have sued organizations they believe started and supported the crisis. Companies that made, distributed, or contributed to sales of the highly addictive painkillers are expected to pay more than $50B in settlements. These settlements specifically state that at least 85% of settlement funds must be spent on addressing the epidemic, though where exactly the money is going is unclear.

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.

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.

Naltrexone blocks the reward effects of alcohol and opioids

Naltrexone is used to treat alcohol and opioid dependence, blocking opioid receptors in the brain, reducing cravings, and preventing the euphoric effects of alcohol or opioids. It is nonaddictive and works best as part of a comprehensive treatment plan, including counseling or therapy, to support long-term recovery.

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.

Psychoactive drugs found in 1,000-year-old bag made of fox noses

Archaeologists in Bolivia have uncovered an ancient bag filled with "amazing goodies" that suggests the owner or owners were well-versed in the properties of psychoactive substances and sourced goods from well-established trade routes. This article details the findings, which shed light on how ancient peoples in the region consumed and obtained psychoactive substances.

Watch the craziest ways cartels traffic drugs

The war on drugs has forced cartels to be increasingly creative when it comes to smuggling drugs. As police develop methods to catch smugglers, drug traffickers come up with new ways to get their products from producer to seller to buyer. This cycle...

Doctors ignored women's pain as a nurse replaced their fentanyl with saline

This five-part podcast series, produced by Serial Productions, focuses on the experiences of women undergoing fertility treatments at a Yale clinic where a nurse secretly replaced pain medication with saline solution. This led to women experiencing excruciating pain during procedures, but the clinic downplayed or ignored their complaints.

How the Myanmar coup fueled a rise in illegal drugs

According to the UN, Myanmar remains the world’s second-largest producer of heroin. Inside Myanmar, almost all the drugs come from one place: Shan state in the Golden Triangle region, south of China, where Myanmar meets Thailand and Laos. The...

The subjectivity of pain means that one person's kidney stones may be another's childbirth, but most sources of pain do have objective, underlying causes.

Researchers have investigated the benefits of extreme pain rituals, exploring how and why we engage in these events when humans generally naturally avoid pain and perceive it as a negative experience.

Over 28% of US adults use yoga for pain management.

Common hormone therapies to treat menopausal symptoms

While there is no cure for menopause, there are ways to treat some of the intense symptoms women experience during perimenopause. There are two main hormone therapies used, one in the form of a pill, gel, or patch to treat symptoms like hot flashes, and another in the form of a cream or ring to treat symptoms like vaginal dryness. Read this article to learn more about the different hormone therapies available for menopausal women.

Fame can trigger addictive, drug-like highs in the brain

Differences in the type of fame, such as movie stardom, sports, and internet virality, can produce varying degrees of dependence on individuals based on their age and background. Some individuals—particularly children—can develop drug-seeking behavior as they pursue continuous dopamine spikes if they lack an existing sense of fulfillment from elsewhere.

New drugs called Gepants have been shown to improve the quality of life of many sufferers.

Journalist Eva Wiseman has had migraines since childhood. Beginning with a yawn they segue into visual auras before turning into severe pain. As it so happened, she experienced a migraine during the course of her interview with Dr. Peter Goadsby, a pioneer in understanding and treating migraines as well as getting the world to treat them seriously.

Addiction is defined as chronic compulsive drug use despite adverse consequences

This resource from the National Institute on Drug Abuse provides a comprehensive look at addiction as a complex brain disorder. It explores why people initially take addictive substances and how continued use alters the brain’s reward system.

View a sample of objects surprisingly derived from crude oil, including chewing gum and lipstick

Crude oil processing produces a variety of fuels and the building blocks for plastics, but it also distills out the hydrocarbons used to make aspirin, Teflon, vinyl, crayons, candles, Tupperware, roofing shingles, asphalt pavement, hair dye, anesthetics, food-grade lubricants, polyester, synthetic rubber, and resins for items like dentures.

How the environmental diversity of coral reefs provides potential medical treatments for humans

As immobile animals, corals and the organisms that live on them have evolved a suite of chemical compounds to prevent disease and ward off predators they cannot outrun. These include antibiotics, antivirals, and powerful toxins that target the nervous system and are studied for applications involving pain management and neurological treatments.

How self-care led to Ozempic's success

Self-care has become a $1.5T economy that idealizes restraint and willpower, leaving behind those who can't shake off human nature. This article explores how Ozempic and similar weight loss medications pick up where self-care left off.

The World Anti-Doping Agency has banned many peptides

The global body has an entire section dedicated to banned peptide hormones, including ones that may stimulate growth hormones and testosterone. BPC-157 was added to the list in 2022.

Companies developing new weight loss drugs

In recent years, weight loss drugs made a tremendous amount of money for Novo Nordisk and Eli Lilly. Other companies are developing new drugs to break into the market. This piece is a concise overview of companies creating and testing new drugs, how far along they are, and what Novo Nordisk and Eli Lilly are doing to compete with these emerging rivals.

A 49-year-old American died at an ibogaine clinic in Mexico, underscoring its risks

The man had sought out the drug to help him overcome his substance abuse disorder. Though anecdotal reports indicate potential promise, there's been no large-scale clinical trials on ibogaine's safety and efficacy. The plant is derived from a root bark named iboga and has been used for centuries by indigenous communities in Gabon, but first entered scientific consciousness in 1901 after its alkaloid was isolated from Iboga.

Plant hormones and growth regulators guide growth stages and responses in plants

Plants naturally produce hormones like auxin and gibberellins, while humans apply synthetic or extracted growth regulators to control plant development. These substances influence processes like flowering, root growth, dormancy, and ripening—even in very small doses.

The word allergy is partly derived from the Greek word 'allos' for 'other'

For people with allergies, their immune systems recognize substances as a harmful "other"—cuing an inflammatory response. This podcast explores allergy details and related topics, including how scientists are interested in if the same allergic response mechanisms could underpin other health issues, including severe, painful symptoms around the time of menstrual cycles. Since estrogen acts on white blood cells called mast cells, which leads to the release of histamines—similar to what happens during allergic responses—an understudied question is whether the same process is fueling some of the uncomfortable symptoms around menstruation. An allergist guest notes this raises questions about if antihistamine medications like Pepsid might alleviate them, something that hasn't yet been explored in clinical trials.

The five most common chemicals found in modern food

Most modern processed foods rely on a number of preservatives to stay fresh from production to our plates. The most common include citric acid (preservative and flavor), sodium benzoate (preservative), xanthan gum (thickening and stabilizing), carrageenan (thickening), and red dyes 3 and 4 (for color).

Two-thirds of antibiotic classes were made between the 1940s and 1960s

The vast majority of bacterial treatments were developed during the "Golden Age of Antibiotics," an era of rapid innovation and drug discovery that led to the reduction of millions of deaths worldwide. Since 1970, only eight new antibiotic classes have been discovered.

Surgery before the dawn of anesthesia

The arc toward anesthetics was painfully slow, with early pain mitigation offerings ranging from analgesics—drugs that dim pain but don't block it—and numbing surgical sites with cold water to gassing patients with carbon dioxide or bashing or bleeding them unconscious. Such treatments and the torturous surgery they preceded led many to avoid even life-saving procedures, and those who survived often kept silent about the trauma.

Compounding pharmacies make custom drug formulations during drug shortages

Compounded semaglutide refers to customized versions of the medication prepared by pharmacies, especially during shortages of FDA-approved products like Ozempic and Wegovy. While compounded forms of brand-name medications can make it easier to access the drugs, the quality of such medications often varies.

Animal-to-human pathogens constitute 75% of emerging infectious diseases

Zoonotic diseases encompass more than 200 diseases transmitted from animals to humans, wherein humans are usually accidental hosts. Ranging from rabies to HIV to monkeypox, this overview lists some of the most common viral threats.

The negative effects of cannabis use

After decades of criminalization, cannabis is a legalized drug in an increasing number of countries around the world. This allows for accurate, robust research on the drug's effects on humans . While weed isn't as harmful as alcohol, regular usage has its negative effects. As strains of the drug become stronger, so does its consequences. Watch this video for a lucid look at the effects of cannabis on its users.

It seems like we shouldn’t have to say this: Cheese is not like crack

While news reports may claim cheese is addictive, the facts behind the research show cheese and crack have little in common. It appears that highly processed foods with high levels of sugars and fat, rather than cheese specifically, are most closely associated with addictive-like behaviors. In fact, cheese ranked lower than foods like pizza, chocolate, and fries in terms of its addictiveness.

Over-the-counter markets are used to bypass traditional exchanges while trading

Commodities are regularly traded via OTC markets so that buyers and sellers can bypass central exchanges and negotiate terms more directly. Before the advent of formal exchanges, most assets were traded OTC.

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...