Opioids are a class of drugs including fentanyl, heroin, oxycodone, and more.

Synthetic opioids: a historical and clinical review

In the 19th century, researchers began synthesizing and isolating poppy plant alkaloids, leading to the invention of morphine, codeine, heroin, oxycodone, and others. These highly addictive variants eventually gave rise to illicit use and a widespread underground market, laying the foundation for the current opioid crisis.

Opium is a milky liquid substance extracted from unripe poppy plant seeds

It's been used for ages to reduce pain and induce euphoria, both of which are side effects of the plant's alkaloids—nitrogen-based compounds with pronounced physical effects. Isolating and synthesizing derivatives of these naturally occurring chemicals enabled the invention of morphine, heroin, and other opioids.

Morphine, heroin, codeine, and more were derived from opium

Opium reached the US at about the time early colonists were itching for ways to soothe aches and pains. The active ingredient in the substance was isolated in the early 19th century, eventually leading to the manufacture and commercial sale of morphine, heroin, and other opium-based drugs.

Opioids mimic naturally produced endorphins to dull pain.

From prescriptions to street drugs: Opioids trajectory across America

Exclusive data obtained by The Washington Post from the Centers for Disease Control and Prevention shows how individual counties moved through three waves of the opioid crisis, each wave paving the way for the next. Between 2011 and 2017, the drug responsible for the majority of overdose deaths shifted from prescription pills to heroin to fentanyl. Together, oxycodone, hydrocodone, heroin, and fentanyl have been major drivers in declining life expectancy in the US.

Evidence of opium use dates to as early as 5000 BCE

Archaeological evidence shows the use of the poppy plant for its pain-killing properties likely originated in the Mediterranean before making its way to the East and West via trade. It has since inspired two eponymous wars, and highly addictive derivatives of the naturally occurring substance have led to an ongoing overdose crisis.

The three waves of the opioid crisis: overprescription, heroin, and fentanyl

The US opioid crisis has unfurled in three distinct waves, each spiraling into an epidemic that's killed millions. The first crested in the 1990s with the overprescription of opioids for pain relief. The second manifested as heroin overdoses in the 2010s. The third began in 2013 with the rise of deaths related to tramadol and fentanyl.

Why are drug dealers putting fentanyl in everything?

A few grains of fentanyl, a synthetic opioid far more potent than heroin or morphine, are enough to kill a typical adult human. It's made its way into other, less lethal street drugs, where it may be used to increase the highs experienced by unknowing users, increasing their likelihood of addiction and overdose.

Why the human brain loves opioids

When opioids enter the brain, they dock in receptors, blocking electrical pulses such as those that communicate pain. They also trigger the release of dopamine, a neurotransmitter tied to motivation and associated with stress relief.

Overuse of opioids can lead to hypersensitivity to pain.

Why is fentanyl poisoning street drugs?

A few grains of fentanyl, a synthetic opioid far more potent than heroin or morphine, is enough to kill a typical adult human. It's made its way into other, less lethal street drugs, where it may be used to increase the highs experienced by unknowing users, increasing their likelihood of addiction and overdose. This 39-minute podcast episode is the first half of a two-part series exploring fentanyl's rise.

Opioid prescription rates by states and counties

The origins of the US' ongoing opioid crisis are typically traced to the more than 1 billion prescription pain pills that flooded medicine cabinets between 2005 and 2019. This prescription opioid epidemic resulted in more than 210,000 fatal overdoses and set the stage for the ongoing crisis fueled by heroin and fentanyl.

Opium's history traces from religious use to mass-market commercial products

Religious or medical use of opium was present across Europe and Asia as early as 5000 BCE. By the 16th century, humanity had come to see opium as more than medicine: It was a marketable product. This perspective also defines today's relationship with opioids, highly addictive painkillers at the heart of an ongoing drug crisis.

Fentanyl can be up to 100 times more potent than morphine

A synthetic opioid, fentanyl is highly addictive and incredibly fast-acting—a fatal dose is equal to a few grains of table salt. Once it enters the body, fentanyl floods naturally occurring opioid receptors, which can cause the body to shut down its breathing reflex, leading to a fatal overdose.

Fast, cheap, and deadly: How fentanyl replaced heroin and hooked America

This interactive article details how fentanyl has largely replaced heroin in the drug trade, with fatal results. Fentanyl was first developed in 1959 as an anesthetic for pain relief, but the drug took hold in the US black market in 2014 and has since exploded in the intervening decade.

Fentanyl is better at crossing the blood-brain barrier than other opioids

Among opioids, fentanyl is uniquely adept at crossing the blood-brain barrier—the brain's security fence against harmful substances. This enables a lightning-fast high. It ends just as quickly, sometimes within minutes (where a heroin high lasts hours), and still results in the same withdrawal symptoms.

One person dies from opioids every 7 to 8 minutes

This collection of infographics by the National Institute for Health Care Management helps put the crisis into perspective. The opioid epidemic has had three waves. Opioid-related deaths increasingly involve synthetic versions of the drug class, contributing to 83 percent of all opioid-related deaths in 2020. Use these infographics to learn more about the crisis.

Methadone binds to the same receptors as heroin and other opioids

Methadone is a long-acting opioid agonist that works by binding to the same brain receptors as other opioids (like heroin or morphine), but without producing intense euphoria. It reduces withdrawal symptoms and cravings, helping people stabilize and avoid illicit opioid use.

Drugs 101: An interactive guide

What's the difference between opioids and psychedelics? This guide details specific drugs and their various associated effects. Drugs in this wheel fall into seven categories: stimulants, depressants, empathogens, psychedelics, dissociatives, cannabinoids, and opioids.

The body produces its own opioids that act on several receptor types throughout the body, triggering the release of dopamine and suppression of noradrenaline, neurotransmitters associated with reward and alertness, respectively.

The story of the Sackler empire behind highly addictive OxyContin

This investigative report examines how the Sackler family built its fortune through Purdue Pharma’s aggressive marketing of OxyContin, a highly addictive painkiller. Through 2017, the drug had generated more than $30B in sales for Purdue Pharma, controlled by the Sacklers.

Opioid epidemic 101: lawsuits and settlements

State and local governments trying to address the opioid epidemic have sued organizations they believe started and supported the crisis. Companies that made, distributed, or contributed to sales of the highly addictive painkillers are expected to pay more than $50B in settlements. These settlements specifically state that at least 85% of settlement funds must be spent on addressing the epidemic, though where exactly the money is going is unclear.

Narcan is an opioid antagonist that can rapidly reverse overdoses

Naloxone, also known by the brand name Narcan, is an opioid-overdose reversal medication that typically begins working within a few minutes. An opioid antagonist, the treatment attaches to opioid receptors without activating them, forcing opioid molecules out of their respective receptors and allowing users' breathing rates to normalize.

Learn about the US opioid crisis in this free course

Where did the US opioid crisis come from, and how did it spread? Learn this and more in this free, online Harvard University course. Learn about the disease model of addiction treatment and management, and get up-to-date with public health and law enforcement's current harm reduction practices. This free resource gives users a greater understanding of opioid addiction and the epidemic still haunting the US.

Naltrexone blocks the reward effects of alcohol and opioids

Naltrexone is used to treat alcohol and opioid dependence, blocking opioid receptors in the brain, reducing cravings, and preventing the euphoric effects of alcohol or opioids. It is nonaddictive and works best as part of a comprehensive treatment plan, including counseling or therapy, to support long-term recovery.

A workplace back injury and the opioid prescription that followed set one Texas father on the path the Washington Post's video profile calls his rise to fentanyl 'kingpin.'

The Cincinnati Enquirer's Pulitzer-winning look at the opioid epidemic

Synthetic opioids kill someone in the US every 16 minutes. Communities across the country have been ravaged by deaths, overdoses, jail time, and babies born with drug-related medical problems as opioid abuse became a typical feature of many American towns. This seven-part exposé provides an inside look at the effect in southern Ohio and northern Kentucky.

See how DOJ prosecutors took down a pharmaceutical company's executives over the opioid crisis

This FRONTLINE documentary follows federal prosecutors as they used anti-racketeering laws to convict executives at Insys Therapeutics, a pharmaceutical company that bribed doctors to overprescribe a fentanyl painkiller.

Addictive drugs can cause dopamine levels to become ten times higher than normal.

Aspirin was the first synthesized anti-inflammatory drug

Once used by the ancient Sumarians—extracted from willow bark—but now synthesized in the lab, the active ingredient of this popular medication has been used to treat headaches and pain for thousands of years.

Psychoactive drugs found in 1,000-year-old bag made of fox noses

Archaeologists in Bolivia have uncovered an ancient bag filled with "amazing goodies" that suggests the owner or owners were well-versed in the properties of psychoactive substances and sourced goods from well-established trade routes. This article details the findings, which shed light on how ancient peoples in the region consumed and obtained psychoactive substances.

Learn about the point of the physical and emotional experience of pain, which has three broad categories that help determine treatment approaches.

Addiction develops when the pleasure circuits in the brain get overwhelmed

Normal pleasure circuits become overwhelmed by addictive substances, triggering dopamine floods many times stronger than those induced by everyday reward experiences. The understanding of addiction as a brain disease has led to treatments pairing medication and counseling.

Drug tolerance and withdrawals are consequences of overloading dopamine circuits

Addictive substances or behaviors will typically flood our brains with more dopamine than usual. In response to the overstimulation, our brains will decrease the number of available dopamine receptors. This results in the need for more stimulus for the same response (tolerance) and a rise in negative feelings when the stimulus is absent (withdrawal).

As immobile animals, corals and the organisms that live on them have evolved a suite of chemical compounds to prevent disease and ward off predators they cannot outrun.

Watch the craziest ways cartels traffic drugs

The war on drugs has forced cartels to be increasingly creative when it comes to smuggling drugs. As police develop methods to catch smugglers, drug traffickers come up with new ways to get their products from producer to seller to buyer. This cycle...

The story of Marie Nyswander, the woman who co-discovered methadone maintenance

Methadone, an opioid with distinct effects from heroin, revolutionized heroin addiction in the 1960s. Marie Nyswander was a psychoanalyst who helped discover the treatment process which is still in use today. Here's a podcast episode examining her life and role in the field of addiction treatment.

Doctors ignored women's pain as a nurse replaced their fentanyl with saline

This five-part podcast series, produced by Serial Productions, focuses on the experiences of women undergoing fertility treatments at a Yale clinic where a nurse secretly replaced pain medication with saline solution. This led to women experiencing excruciating pain during procedures, but the clinic downplayed or ignored their complaints.

How the Myanmar coup fueled a rise in illegal drugs

According to the UN, Myanmar remains the world’s second-largest producer of heroin. Inside Myanmar, almost all the drugs come from one place: Shan state in the Golden Triangle region, south of China, where Myanmar meets Thailand and Laos. The...

Your favorite music can minimize physical pain, according to a 2025 study on how music can bring solace and address pain.

The subjectivity of pain means that one person's kidney stones may be another's childbirth, but most sources of pain do have objective, underlying causes.

Researchers have investigated the benefits of extreme pain rituals, exploring how and why we engage in these events when humans generally naturally avoid pain and perceive it as a negative experience.

Explore a database of generic drugs to trace their origins and identify any safety concerns.

Drug trafficking in the MENA

The Middle East and North Africa is a major source, transit point, and consumer of illicit drugs. Despite having some of the harshest penalties for drug-related crimes, the region both influences and is negatively impacted by illicit substance abuse...

The US FDA defines peptides as being 40 amino acids or less.

Over 28% of US adults use yoga for pain management.

An eye-opening interactive journey into the global drug trade

POPPY Interactive reveals how drug money destabilizes entire countries, fuels global conflicts, and allows a worldwide illegal economy to grow. Navigating the site involves diving into three major routes—the Northern Route, the Balkan Route, and...

Common hormone therapies to treat menopausal symptoms

While there is no cure for menopause, there are ways to treat some of the intense symptoms women experience during perimenopause. There are two main hormone therapies used, one in the form of a pill, gel, or patch to treat symptoms like hot flashes, and another in the form of a cream or ring to treat symptoms like vaginal dryness. Read this article to learn more about the different hormone therapies available for menopausal women.

Anesthetics slow brain activity by promoting inhibitory neurotransmitters

Drugs like propofol and isoflurane increase activity at the GABA receptor, which opens chloride channels. These ions enter neurons and hyperpolarize them, making them less likely to fire. Dexmedetomidine instead blocks norepinephrine receptors in the brainstem to sedate patients.

A video showing how drug dealing really works

What motivates people to sell drugs? The "News on Drugs" series asks how people get drawn into the drug trade, unpacking the different goals and aims involved in dealing drugs. While there is a lot of focus on cartels, traffickers, and gangs...