The Dangers of Opiates - the Facts You Need to Know
Opiates are a group of prescription drugs, over-the-counter painkillers and illegal substances, derived from opium poppies. They include morphine, codeine and heroin. There are also synthetic opioids, produced in laboratories to mimic the effects of natural opiates - including fentanyl, tramadol, methadone, oxycodone and hydrocodone. Together, they are known as opioids.
Doctors routinely prescribe opioids for pain management but there are dangers of using opioid medications to treat chronic pain conditions. Recreationally, opioids are misused for their sedative, euphoric and pain-relieving effects. Whether you're taking them on prescription or buying from a pharmacy or drug dealer, all opioids can lead to addiction.
Statistically, opioids are the most common cause of death by drug poisoning. Every year since 2006, over half of all drug-related deaths have involved opioids. In 2018, this equated to 2,208 people (51% of all drug poisoning deaths). 
In this article, discover the facts about opiates and synthetic opioids - including how to spot the signs of opioid dependence.
How do Opiates and Synthetic Opioids Work?
Opiates and synthetic opioids affect central nervous system function, relieving pain and often inducing drowsiness or sleep. They are administered as tablets, capsules, liquids, skin patches or injectable solutions. They work by attaching to opioid receptors in the brain and spinal cord - the same receptors that are activated by natural neurotransmitters such as endorphins, which block pain signals in the body.
Opioids can also induce feelings of euphoria, due to their effects on the brain's reward system. They stimulate the release of dopamine, which plays a key role in human motivation. People who misuse opioids often chase heightened sensations of satisfaction or pleasure, which can lead to dependence and addiction.
Opioids for Managing Pain
Used short term with medical supervision, opiates and synthetic opioids are usually effective analgesics. They relieve pain associated with accidents, surgery, acute illness or childbirth. They can improve patients' health outcomes by allowing early mobilisation after trauma or surgery, reducing the risks associated with bed-bound patients such as blood clots. 
Longer term, opiates are routinely prescribed for patients with cancer and in end-of-life care, to relieve severe pain. However, the Opioids Aware resource (produced by the Faculty of Pain Medicine in collaboration with Public Health England), states that there is little evidence that opioids are helpful for long term pain. 
For this reason, caution must always be exercised with prescribing opioids for chronic pain conditions such as back or neck pain, fibromyalgia or nerve pain. Patients should always be informed by prescribers about the limitations of opioids for chronic pain - including the risks of addiction. The same applies if you're self-medicating pain, purchasing over-the-counter codeine or buying opioids online.
You can read more here about the dangers of using opioids for back pain, which is the most common cause of disability in the UK.  If you're on a repeat prescription for opioids or you regularly buy codeine, it's important to know the signs of dependence, as well as non-drug approaches for managing your pain.
Opioid Dependence - Spotting the Signs of Opioid Addiction
In 2018-19, 52% of all adults in England who received addiction treatment had problems with opioids - 139,845 people. Nearly three-quarters of these people were men. 
Jason Shiers, Psychotherapist at UK Addiction Treatment, explains: 'There's still a lot of stigma attached to opioid addiction, which is one of the reasons people don't ask for help when their drug use gets out of hand. Another problem is perception - if your doctor has prescribed you opioids for months or years, then it can be hard to accept they can cause you harm. If you're taking opioids regularly and your health is suffering, please don't suffer in silence. Speak to your doctor and get a second opinion from an addiction treatment advisor.'
Psychological signs of opioid dependence/ withdrawal
• Craving opioids
• Low motivation
• Anxiety of depression
• Mood swings
• Feeling hopeless
• Stockpiling opioids
• Feeling as if life isn't worth living
Physical signs of opioid dependence/ withdrawal
• Opioid cravings
• Muscular pain or fatigue
• Problems with sleep
• Stomach pains
• Sweating and fever
• Nausea or vomiting
• Feeling unusually cold
• Changes to heart rate and blood pressure
• Runny nose
• Headaches or migraines
Opioids - Further Information, Support and Addiction Treatment
The Opioids Aware resource is a useful set of guidance for patients and healthcare professionals, outlining good practice in opioid prescribing, based on available evidence.
The UK Addiction Treatment website provides detailed information about opioid abuse and addiction - including guidance on opioid detox and rehab.
Narcotics Anonymous offer face-to-face and online meetings across the country for people with drug addiction including to opioids.