Synthetic Opiate Overdoses On the Rise

Depressed addict is sitting on top of the roof

One of the top news items regarding the opiate crisis is that overall opioid-related drug overdoses fell from 2017 to 2018. (We don’t have overdose death tallies for 2019 yet, so the 2017 and 2018 data is the most recent data available). Some celebrate the slight reduction of opiate deaths in 2018 because they see it as a sign that the opioid crisis is coming to a close.

Indeed, a drop in overdose deaths is something to be excited about. But no one should rest on their laurels or celebrate prematurely. It's important not to forget that opioid overdoses are still several times higher than they were in the 1990s and the early 2000s. Furthermore, certain types of opiate overdoses are rising considerably.

Case in point, while the CDC heralded a drop in both prescription painkiller overdoses and heroin overdoses, the CDC also mentioned that synthetic opioid overdoses, driven mainly by the fentanyl epidemic, were up 10% in 2018. Not only is this not at all a time for celebration, but certain aspects of the opiate crisis are actually getting worse, not improving.

Definitions — Understanding the Different Types of Opiates

Opiates refer to both the psychoactive chemicals that occur naturally in the poppy plant's resin and to the mind-altering drugs made synthetically in laboratories. Opiates work by binding to the opioid receptors in the central and peripheral nervous systems, as well as in the gastrointestinal tract.

Opiates are not just one type of drug; rather they are a class of drugs. There are several types of opioids. They all share some similarities, but they each have their differences, too. When learning about the opiate crisis and the public health emergency it has created, it’s essential to understand the different types of opiates involved.

  • Naturally-occurring opioids. Natural opiates are the base chemical compounds that are found in plants like the opium poppy. These plants are harvested to make natural opiates such as morphine, codeine, and thebaine.
  • Semi-synthetic opiates. These drugs are made in labs, but they are made while using natural opiates as the basic structure for the semi-synthetic drug. Semi-synthetic opioids include hydromorphone, hydrocodone, and oxycodone. Heroin is also technically a semi-synthetic opiate, as it is made from morphine.
  • Fully synthetic opiates. Fully synthetic opioids are entirely man-made without using any plant-based opium products. Such drugs include fentanyl, pethidine, levorphanol, methadone, tramadol, and dextropropoxyphene, to name a few.
Making drugs in a lab

Understanding the different types of opiates can be confusing because the terminology that’s used isn’t always precise. For example, the term “synthetic opiates” is usually used to refer to any man-made opiate drug. That could mean legal opiate pain relievers made by pharmaceutical companies, or it could mean illegal fentanyl made in clandestine laboratories operated by foreign drug cartels.

However, when the CDC and other institutions comment on an increase in synthetic opiate deaths and at the same time they comment on a reduction in prescription opiate deaths, it’s essential to understand that the CDC is referring to the rise in deaths from illicit synthetic opiates like fentanyl or other illegal, lab-made opioids, as well as the reduction in deaths from legal, pharmaceutical opiate pain relievers such as oxycodone.

A Look at New Overdose Data

From 2017 to 2018, overall opioid-related deaths in the United States went down slightly. Deaths involving prescription opiate pain relievers (oxycodone, hydrocodone, etc.) fell by 13.5%. At the same time, heroin-related deaths dropped 4%. Meanwhile, fatal overdoses involving synthetic opioids (mostly fentanyl) were up 10%.

In 2018, about 46,000 people died from opioid-related overdoses. Synthetic opiates were responsible for a little over 31,000 of those deaths. That means synthetic opioids are the most significant contributor to opiate-related fatalities. And it means that synthetic drugs alone accounted for almost half of the full drug-related death toll for 2018!

Some people might be celebrating the reduction in overall opiate deaths, but doing so is a bit premature. Experts estimate that much of the decrease in heroin-related and prescription drug-related deaths is simply because more addicts are now switching to synthetic opiates such as fentanyl as their main drug of choice instead of heroin or pharmaceutical painkillers.

“Decreases in overdose deaths involving prescription opioids and heroin reflect the effectiveness of public health efforts to protect Americans and their families.”

The director of the CDC, Dr. Robert Redfield, provided his commentary on the findings, touching on the importance of addressing all aspects of the opiate crisis: “Decreases in overdose deaths involving prescription opioids and heroin reflect the effectiveness of public health efforts to protect Americans and their families. While we continue work to improve those outcomes, we are also addressing the increase in overdose deaths involving synthetic opioids. We must bring this epidemic to an end.”

Dr. Debra Houry, the director of CDC’s National Center for Injury Prevention and Control, also commented, touching on the need for all members of communities, not just health professionals, to come together to halt the fatal epidemic of opiate addiction in America. She said: “To sustain decreases and continue to prevent and respond to drug overdoses, specifically those involving synthetic opioids, it is critical to have a coordinated response. Medical personnel, emergency departments, public health and public safety officials, substance abuse treatment providers, community-based organizations, and members of the community all play a role in addressing this complex and fast-moving epidemic.”

Getting Help for a Loved One Who is Addicted to Opiates

helping loved one

If you know someone addicted to opiates, you must help them get into a drug and alcohol treatment center as soon as possible. It doesn’t matter what type of opioid they are using or if they think they have their addiction under control. All opiates have the potential for being lethal, and all such drugs have the potential for being harmful and addictive.

Residential drug rehab programs offer a clear pathway to freedom from addiction. Drug rehabs can help opiate addicts with the physical, psychological, emotional, and behavioral aspects of opiate addiction. Do your best to connect with a drug rehab today if you know someone struggling with an addiction to opiates.




After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.