The risks and benefits of opioids
Isaac McConnell
Opioids are a class of drugs including both natural and synthetic substances which can be derived from the opium poppy plant directly or by creating the same chemical structure in labs. Common examples include morphine, heroin, fentanyl, and oxycodone, which are primarily used in managing mild to severe pain, often being prescribed after surgeries, injuries, or for chronic pain conditions. The relaxing effects of the chemicals provide effective pain relief when prescribed appropriately, but these reactions are often exploited for recreational purposes, creating many risks through their highly addictive nature and danger of overdose. In this essay I will explore how opioids function in the body, the role chemists play in their production, and their benefits in pain management and the risks associated with their use.
How do opioids work?
Opioids work by travelling through the blood stream and binding to the opioid receptors found in brain cells, a process which ultimately blocks pain signals and enhances pleasure. Opioids are often categorized according to the specific receptor at which their effects are produced, of which there are three: DOP, KOP, and MOP (as per the 2000 classification, but also referred to as delta, kappa, and mu). The primary chemical interaction occurs when a molecule of the opioid, which typically contains a basic nitrogen atom, binds to the receptor’s active site, triggering a conformational change in the receptor leading to the inhibition of adenylate cyclases, which are enzymes that catalyse the conversion of ATP into cAMP and pyrophosphate. As a result of this inhibition, the intracellular levels of cAMP (cyclic AMP) reduce and consequently neuronal excitability is decreased and pain signals are suppressed, providing pain relief and often euphoric sensations.
Natural vs synthetic opioids
While the label ‘opioid’ is often used to describe all contents of this group of narcotic drugs, it is more carefully used to distinguish the chemically synthesized drugs (opioids) from those that are more naturally extracted, opiates, a naming system I will adopt in this paragraph when explaining the differences in their productions. As previously mentioned, opiates are chemical compounds that are achieved by extracting and refining natural plant matter from poppy sap and fibers. Common examples include heroin, codeine, and morphine. On the other hand, there are synthetic opioids, those chemical compounds that are synthesized in a lab are not generally derived from natural plant matter. Firstly, I will cover semi-synthesis, a process which starts from naturally occurring opioids alkaloids, such as thebaine (pictured below), which are extracted from the opium poppy.
Figure 1: Thebaine molecule diagram. (Source: Wikipedia, 2023: online)
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