The effects of opioids on the brain result in euphoria, reduced pain, and suppressed breathing. These symptoms occur as opioids attach to and activate opioid receptors in brain nerve cells.

Long-term opioid use can cause opioid use disorder. It may also produce changes in the brain that harm cognition, the ability to think. Treatment of opioid misuse may involve medication-assisted therapy using drugs that bind to the same opioid receptors in the brain.

Keep reading to learn more about opioids and their short- and long-term effects on the brain, as well as treatment options for opioid use disorder and how to seek help.

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Opioids are a class of drugs that attach to opioid receptors in the brain and other parts of the body. The different types include natural, synthetic, and semisynthetic. Some opioids have medical uses, while others do not.

Natural opioids

Natural opioids are derived from the opium poppy plant. These include morphine, a treatment for pain, and codeine, a treatment for pain and coughs.

Synthetic opioids

Synthetic opioids are those that people and pharmaceutical companies manufacture. Prescription ones include:

  • fentanyl (Sublimaze), a treatment for severe pain
  • methadone (Dolophine), a treatment for opioid use disorder
  • tramadol (Ultram), a treatment for moderate to moderately severe pain

Semisynthetic opioids

Semisynthetic opioids are those that people and pharmaceutical companies manufacture in a lab, but while also using natural opioids. Prescription examples are for pain relief following surgery or an injury. They include:

  • hydrocodone (Vicodin)
  • oxycodone (OxyContin)
  • oxymorphone (Opana)
  • hydromorphone (Dilaudid)

Opioids and dangerous usage

While all of the above medications are prescription opioids for medical uses, some opioids are manufactured, sold, and used illegally. These can be very dangerous. One of these is heroin, a highly addictive drug made from morphine.

There are also synthetic opioids that have chemical structures similar to fentanyl. A few examples include:

  • acetyl fentanyl
  • butyryl fentanyl
  • furanyl fentanyl
  • beta-hydroxythiofentanyl

Learn more about opioids here.

Opioids have short- and long-term effects on the brain.

Short-term effects

These include the following:

  • Pain relief: They attach to opioid receptors in nerve cells in the brain and other parts of the body. This blocks pain messages sent to the brain from the body, which reduces the perception of pain.
  • Euphoria: They affect the part of the brain called the “reward circuit,” which produces a feeling of euphoria, or an emotional high. Additionally, they flood the brain with dopamine, a chemical that affects the reward circuit in such a way that produces pleasure. This makes a person want to continue taking the drugs.
  • Suppressed breathing: They suppress parts of the brain stem that control breathing rate. This makes breathing slow and shallow, which can be very dangerous. Suppressed breathing can cause too little oxygen to reach the brain, which can lead to permanent brain changes, coma, and death in some cases.
  • Drowsiness and dizziness: These are common side effects of opioid use.
  • Suppressed conscious reasoning and awareness: For example, a person who is having breathing problems due to opioid use would not be aware of their own respiratory distress, so they would not know that they need emergency help.

Long-term effects

The National Institute on Drug Abuse notes that long-term use of opioids, even those that a doctor prescribes, can cause:

  • Tolerance: This is the need to take larger or more frequent doses to get the desired effect.
  • Dependence: Repeated use of opioids causes nerve cell activity to change in ways that can make a person feel as though they are temporarily alleviated by taking the drug. Consequently, when someone stops using the drug, they experience withdrawal reactions.
  • Behavioral changes and impaired decision making: These are effects of long-term use as well as short-term use.
  • Addiction: This is an uncontrollable desire to continue to use drugs despite adverse effects. It can result in long lasting brain changes that can lead to harmful behavior.

The Brain Injury Association of America states that long-term use of opioids causes changes in the frontal brain region, which results in impairments in cognition, the ability to think.

In fact, brain scans show a reduced volume in this part of the brain. There are reports that cognitive impairments persist several years following recovery.

An estimated 2.7 million people in the United States who are age 12 and older have experienced opioid use disorder within the past 12 months. Treatment includes medications and behavioral therapy.


Medication-assisted treatment options include methadone (Dolophine) and buprenorphine (Sublocade), which bind to the same opium receptors in the brain as opioids. This results in decreased cravings and withdrawal symptoms.

A third option, naltrexone (Revia), blocks opioid receptors, which prevents opioids from producing an effect.

The Substance Abuse and Mental Health Services Administration (SAMHSA) notes that medication-assisted treatment can:

  • increase treatment retention
  • improve survival
  • raise the likelihood of gaining and maintaining employment
  • reduce opiate misuse
  • improve birth outcomes among individuals with substance misuse disorders who are pregnant

Behavioral therapy

Behavioral therapy is another treatment option. It can help people:

  • develop healthy life skills
  • change behaviors and attitudes that affect drug misuse
  • continue with other treatment, such as medications

One type is cognitive behavioral therapy. This can help people manage stress and triggers, as well as change their drug use expectations.

Another type is multidimensional family therapy, which targets adolescents with drug misuse problems. It involves identifying and reducing family and personal influences on drug use behavior. The intent is to increase overall functioning.

SAMHSA lists the following resources for people seeking help for misuse or addiction:

Seeking help for addiction may seem daunting or even scary, but several organizations can provide support.

If someone believes that they or someone close to them is dealing with addiction, they can contact the following organizations for immediate help and advice:

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Opioid effects on the brain can reduce the perception of pain, which is why doctors prescribe some opioids for pain relief. The effects also include euphoria, which can lead to opioid use disorder.

Other effects of opioid use, such as slow, shallow breathing, can lead to coma or death. Overdose can also lead to death.

Treatment has an array of benefits, such as reducing misuse, increasing survival, and encouraging the likelihood of gainful employment, states SAMHSA.