Opioids, Stimulants, Depressants, and Inhalants

Christy Bazan; Brandi Barnes; Ryan Santens; Emily Verone

6 Opioids, Stimulants, Depressants, and Inhalants

Introduction

Opioids, stimulants, and depressants are the top three drugs that have shown to cause addiction in the user. They are the most widely used and prescribed medications today. The impacts on the central nervous system make the use of these drugs concerning for the user and communities and families that are impacted when these drugs are used or misused. Your familiarity and knowledge about these drugs can help advocate and educate for change and prevention that is needed to stop the crisis that is arising around these drugs.

Learning Objectives

Understand and describe what opioids are.
Understand and describe what stimulants are.
Understand and describe what depressants are.
Understand the implications of use and misuse of opioids, stimulant and depressants.
Explain how opioids, stimulants, depressants, and inhalants work in the brain and body.
Understand how opioids, stimulants, depressants, and inhalants are used and misused.

Image 6.1 – Syringe with Brown Liquid

Photo by Raghavendra V. Konkathi, Unsplash, Unsplash License

Learning Content

Opioids

History Of Opioids

1911 to 1990s: Federal Drug Administration (FDA) allowed opioids to be used to treat acute pain and cancer pain.
1995: FDA approves Oxycontin.
1998: FDA approves Fentanyl.
2003: FDA sends warning letters to “Big Pharma” about misleading opioid information.
2014: Naloxone is approved to help address opioid overdose concerns.
2016 to present: FDA responds to concerns around the opioid crisis/epidemic.(USFDA, Timeline of Selected FDA Activities and Significant Events Addressing Opioid Misuse and Abuse, 2021)

Opioid Forms and Types of Use

Opioids are a class of drugs that include legally prescribed pain relievers, illegal drugs, and synthetic opioids. Most prescribed opioids are used to treat moderate to severe pain but can also be prescribed for coughs and diarrhea. Other opioids can make people feel relaxed or euphoric, causing the drugs to be used for nonmedical reasons. Opioids can be taken orally, by suppository, injected via a needle, inhaled, applied dermally on the skin.

Critical Thinking

Review one of the fact sheets from the pain reliever category and both fact sheets in the illegal and synthetic opioid category. What do you notice about these drugs? What risks are you more aware of when it comes to using these drugs?

Opioids’ Effects on the Body

Opioids interact with opioid receptors on nerve cells in the brain and body. The opioids bind to opioid receptors in the brains, spinal cord, and other organs in the body. Opioids block pain signals by releasing large amounts of dopamine throughout the body encouraging the desire to take more to repeat the dopamine high or drug high. Opioids make you feel happy and relaxed. The feeling of euphoria that users get when taking opioids is something that opioid users desire. There are adverse effects with opioid use. They include drowsiness, confusion, nausea, constipation, slowed breathing, overdose, or death. It is important to understand all of the risks associated with use of these drugs, and, if prescribed, to use them under the guidance of a medical professional.

Use, Misuse, and Overuse

Having a mild headache or a muscle pain or ache can often be managed with over-the-counter pain relievers (acetaminophen or ibuprofen), but when your pain becomes more severe, you may need something stronger. An opioid prescription obtained from your doctor can help with the pain. Prescription use is generally safe when taken for a short time. When opioids are taken in a way other than prescribed—if a person takes another person’s prescription or takes the opioid to get a “high”—concerns arise with use. Unfortunately, prescription opioid use can lead to addiction concerns.

Opioids can be misused because the euphoria they create—along with the pain relief they provide—may cause individuals to want to use the drug more. Therefore, it is critical to understand that using opioids, even prescribed medically, can lead to dependence, addiction, overdose, and other harmful incidents, and even death.

Critical Thinking

Look at the graphs below. What do you notice about the rise of Opioid deaths? Look back at the fact sheets above to gain more information on why the U.S. is seeing the increase in use and deaths associated with opioid use, misuse, and addiction.

Table 6.1 – Three Waves of the Rise in Opioid Overdose Deaths

A chart from the CDC (2021) outlining three different waves of opioid overdose deaths tracked from 1999-2019. — “Three Waves of the Rise in Opioid Overdose Deaths” by the Centers for Disease Control and Prevention, Overdose Graphics, Public Domain

Table 6.2 – National Drug-Involved Overdose Deaths 1999-2019

Chart shows overdose deaths from 1999 to 2019 from different drugs. Demonstrates a large jump beginning in 2015 in synthetic opioids other than methadone (primarily fentanyl) that continues in a large upwards trend through 2019 outpacing all other drug related overdose deaths. — “National Drug-Involved Overdose Deaths, Number Among All Ages, 1999-2019” by National Institute on Drug Abuse, Overdose Death Rates, Public Domain

Watch the following video related to the opioid crisis:

Video 6.1 – Addicted to Death

Critical Thinking

After watching this video, what thoughts come to your mind about drug use and addiction risk? Why in the United States do we hear so much about the Opioid Crisis?

Lifespan Considerations

Opioid use remains a concern throughout your life. Accidental misuse can happen at any age, but as you age, the risk increases—you may be taking more multiple prescriptions and there is risk with misuse.

If you are using opioids by injection, sharing of needles is a concern. HIV risk from unprotected sex is a concern with opioids injection users. Treatment can be long-term, costly, and necessary to recover from opioid addiction. The most concerning with use of opioids is risk of death from overdose. The long-term implications and concerns will take a toll on the life of a user.

Image 6.2 – Pills and a Spoon

Photo by Michael Longmire on Unsplash, Unsplash License

Stimulants

History and Background

Amphetamines were the first synthetic stimulant discovered in the 1930s. They were first used to treat nasal congestion. Eventually they were used to treat other conditions, such as alcoholism, obesity, depression, hyperactivity, and more.In the 1960s crystal methamphetamine (crystal meth) came on the scene, followed by widespread amphetamine misuse. In the 1970s methamphetamine use was prevalent with few, if any, laws in place to regulate the amount prescribed or used illegally.

Stimulant Forms and How they are Used

Stimulants are administered orally, by injection, or through inhalation. They are generally used to treat ADHD (Attention Deficit Hyperactivity Disorder), uncontrolled issues with deep sleep; these drugs can increase alertness, attention ,and energy, and are often used by college students at the end of the semester to help them stay awake.

Below is a list of legal and illegal stimulants.

Legal Stimulants:

amphetamines Amphetamines
methylphenidate Methylphenidate
diet pills/diet aids Office of Dietary Supplements (ODS)
dietary supplements for weight loss
caffeine

Illegal Stimulants:

methamphetamine 10 Facts About Methamphetamines
cocaine; 10 Facts About Cocaine
spice/K2 Synthetic Cannabinoid Fact Sheet
bath salts Fact Sheet: Synthetic Cathinones

Critical Thinking

Which of the above stimulants (if any) do you use the most? Review the factsheet for that stimulant. Then look at one that you know is being used in your community. What concerns you about the use of that stimulant?

Stimulants’ Effects on the Body

Stimulants increase the chemicals and in the brain. Stimulants provide a “rush” in the body that activates the central nervous system and speeds up communication. Stimulants, in general, activate or excite the nervous system. They also increase energy in the body. Stimulant drugs work by increasing the release of neurotransmitters in the body. Stimulants tend to create effects that can be mild to intense, depending upon the stimulant being used. Individuals taking stimulants have an increased sense of well-being, high energy levels, increased confidence, concentration, and alertness along with a reduced need for sleeping and eating. Stimulants provide that “adrenaline” rush that one might get naturally from winning the big game, climbing a mountain, riding a roller coaster, but unfortunately, with continued use, that rush is harder to achieve when using drugs.