“As I see it, India has an epidemic of opioid drug use and an epidemic of pain,” Dr. Atul Ambekar of the National Drug Dependence Treatment Centre and Department of Psychiatry told FRANCE 24, speaking of opioid drugs — which often skew the line between extraordinary palliative medicine and dangerous, addictive drugs.

Ever since the Indian government significantly loosened narcotics laws to allow opioid painkillers like morphine, fentanyl, methadone, oxycodone, codeine, and hydrocodone into the market in 2014, the country has become a booming market for painkillers. The main driver of this legislative decision was intense lobbying by doctors involved in palliative care — in order to provide relief for patients of critical illnesses. However, in 2018, Tramadol, an opioid painkiller’s sales had to be severely regulated in Punjab, due to reports of abuse — setting off alarms about a potential U.S-style opioid addiction problem in India

“… What began as a populist movement to bring inexpensive, Indian-made morphine to the ill has given rise to a pain management industry that promises countless new customers to American pharmaceutical companies facing a government crackdown and mounting lawsuits back home,” wrote Sarah Varney, while covering India’s growing affinity for pain medication and American pharmaceuticals’ affinity for India.

Here’s all you need to know about opioids and what they can do to the body.

What are opioid painkillers?

Opioids are derived from the opium poppy plant and they produce a variety of effects in the brain when injected or ingested, including pain relief. Opioids exist as both street drugs, like heroin, and prescription pain medication like morphine, fentanyl, and codeine. They are generally safe when prescribed for a short period of time, but long-term prescriptions can cause the patient to develop a tolerance to the medicine.

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How do opioid painkillers work?

Opioid painkillers attach themselves to and activate opioid receptors found on cells located in the brain, spinal cord, peripheral neurons, and even the digestive tract. After they bind with these receptors, they block pain signals that the brain sends to the body. They also release large amounts of dopamine, which is a neurotransmitter that contributes to feelings of pleasure and satisfaction.

Why are opioid painkillers dangerous?

The combined feeling of no pain and pleasure can make a user crave the experience of taking the drug again. According to Johns Hopkins Medicine, “Regular use of these prescribed medications can increase your tolerance and dependence, requiring higher and more frequent doses. In some cases, longer-term use can lead to addiction (or what doctors will call ‘opioid use disorder’). In addition, opioids can restrict your ability to breathe when taken at a higher dose, and when misused, can lead to a fatal overdose. The risk of respiratory depression (slowing or even stopping your breathing), increases if you have never taken an opioid before or if you are taking other medications/drugs that interact with the opioid. Opioids, which can interact with diseases, too, should only be used if needed for pain, including if alternatives for pain control are not effective.” Other side effects that accompany opioid drug use can include drowsiness, nausea, confusion, and constipation.

What does an addiction to prescription opioids look like?

A number of factors play a part in the development of addiction, mainly, environmental, psychological factors, or even the genetic make-up of an individual. However, here are a few basic ways in which an addiction to opioids manifests and can be recognized:

• Using opioids daily, either without a prescription or not in the way a doctor’s prescription intended (that is, increased quantity)
• Using the opioids even when not in pain; craving opioids
• Frequently requiring more prescriptions from the doctor due to various excuses, and even going to multiple doctors for the same prescription
• Engaging in self-harm to receive opioid prescriptions from a hospital
• Sourcing opioids from ‘other’ sources (online/street)
• Odd sleep and eating patterns
• Not fulfilling home, school or work obligations
• Withdrawl from social groups and activities
• Experiencing withdrawal symptoms like diarrhea, moodiness, rage and sweating when not taking opioid drugs regularly

What to do if you are addicted?

Knowing that you are addicted is the first and most important step towards seeking recovery. A good plan of action is to inform loved ones and check into an opioid addiction rehabilitation facility. With professional, familial and social support, addiction can be overcome.