Last updated : May 12, 2025
Our nation has battled an addiction crisis caused by opiates for two decades now—it still rages out of control. Physicians prescribe opiates to manage pain, but users run the risk of addiction. They’re readily available on the black market and have taken the lives of hundreds of thousands of Americans over the past decade alone.
We divide opiates into three classifications.
- Natural
- Synthetic
- Semi-synthetic
Natural opiates
There are four natural opiates, however, physicians only prescribe three of them for medical use.
Heroin
Heroin is classed as a Schedule 1 drug by the DEA (Drug Enforcement Agency), which means it is never used for medical purposes. It is highly addictive and there is a very high risk of overdose.
People who use heroin experience a strong feeling of euphoria. The feeling is often accompanied by drowsiness and lethargy. “Nodding” is a term used to refer to someone who has recently used the drug. They are almost entirely out of control of their bodily functions and, sadly, they may be very close to never regaining consciousness.
Morphine
Doctors prescribe morphine to treat extreme pain. Often prescribed for patients suffering in the last stages of cancer, its injected, taken in pill form, or used as a suppository.
Morphine can produce a large number of unwanted side effects. The DEA classed morphine as a Schedule 2 narcotic.
Codeine
Prescription cough syrups often contain codeine, however, it comes in pill form too. It is classed as a Schedule 2 or 3 controlled substance depending on its use. Interestingly, some states allow low doses of codeine to be sold over the counter in cough syrups such as Robitussin AC or Cheratussin AC.
Codeine can be habit-forming even if used as directed.
Synthetic opiates
Synthetic opiates are completely manmade. Their chemical structure is very similar to the natural opiates but they are manufactured using chemicals.
Methadone
This is the most commonly prescribed synthetic opiate. It is often prescribed to reduce the withdrawal symptoms of someone who is trying to kick their heroin addiction. It may also be prescribed as a pain reliever.
The Drug Enforcement Agency classified methadone as a Schedule 2 controlled substance.
Fentanyl
Fentanyl is extremely potent—in fact, just 2 or 3 milligrams of the stuff can prove fatal. That is why the DEA classified fentanyl as a Schedule 2 prescription drug. Fentanyl comes in patch form to treat moderate to severe chronic pain around the clock.
Fentanyl has been showing up on the black market—but drug users don’t have to ask for it by name. Drug dealers use it to “cut” into other drugs such as cocaine or methamphetamine. Because users aren’t aware of that fact, they are at high risk of overdose.
Semi-synthetic opiates
Semi-synthetic opiates are where we find the most commonly used prescription narcotics. Partially derived from natural opiates, they include chemicals as well. Physicians used to freely prescribe them for pain management—until they discovered that they are extremely addictive.
Our bodies build up a tolerance to them fairly quickly and addicts are at a high risk of overdose. Therefore, physicians prescribe them very cautiously today, but addicts easily obtain them on the black market.
The abuse of semi-synthetic opiates has reached epidemic proportions in the United States. For that reason, the Department of Transportation (DOT) added these Schedule 2 drugs to the safety-sensitive workforce drug test in January 2018.
Oxycodone
Used to treat moderate to severe pain, oxycodone should only be taken as prescribed. Even then, patients are at risk of forming an addiction to the drug. Physicians mainly reserve use for cancer-related pain.
Oxymorphone
Oxymorphone treats moderate to severe pain. Once heavily prescribed, physicians seek other forms of treatment when possible due to the high potential for addiction and dependence.
Hydromorphone
Hydromorphone, a morphine-like pain reliever, manages severe pain. It carries a high risk of respiratory depression which is greatly intensified when combining it with other drugs or alcohol.
Hydrocodone
Doctors prescribe hydrocodone mixed with Tylenol to treat mild to moderate pain. However, it’s still habit-forming and carries a high risk of addiction and dependence.
Opiates in the workplace
Drug addicts don’t always refrain from using on the job. Common side effects of opiate drugs include decreased coordination and motor function. Users often become drowsy and lethargic causing decreased reaction time.
Using opiates on the job puts both the user and everyone around them at a higher risk of being involved in an accident. For that reason, many employers include opiates and the extended panel to detect semi-synthetic opiates on the employee drug test.
The length of time that drug tests identify opiates depends on the individual test.
- Urine drug test—two to seven days
- Mouth swab drug test—forty-eight hours
- Hair follicle drug test—90 days
Moreover, the amount of time that opiates remain in urine and saliva depends on several factors.
- Individual metabolism
- Frequency of use
- Type of opiate
- Overall health
- Age
The hair follicle drug test identifies all types of drugs for a 90 day period. That’s because the drug metabolites actually grow out into the center of the hair shaft and become trapped there.
Serious business
The number one reason that we drug test employees is to provide the safest workplace possible.
It’s also a known fact that employers who drug test benefit from decreased absenteeism, higher production levels, and a lower rate of employee turnover.
If an employee tests positive for opiate use—or any other drug—it’s an opportunity for us to point them in the direction of help. Undoubtedly, the pleas of family and friends to stop using drugs falls on deaf ears. A positive drug test result could be the catalyst that finally makes the difference.
