What is opioid overdose prevention?
Opioids are highly addictive narcotics that induce numbness and cause feelings of euphoria. They are effective at suppressing pain in the short term but are also very addictive.
The widespread practice of prescribing opioids for pain has contributed to a meteoric rise in opioid use disorder, or opioid addiction. One tragic impact of the increase in the number of opioid-addicted people is overdose death.
An opioid-related overdose can occur when a toxic amount of an opioid, or a combination of opioids with other substances, including alcohol, is ingested into the body.
Overdoses are a leading cause of death in the United States. Fentanyl, a lab-made super-opioid considered about 50 times stronger than heroin, is the leader in overdose deaths. However, other opioids and, frequently, opioids in combination with other substances, such as benzodiazepines like Klonopin, are contributing to out-of-control numbers of drug deaths as well.
The opioid epidemic has led to a greater need for opioid overdose prevention. Opioid overdose prevention refers both to emergency interventions in the moment of an overdose transpiring, as well as strategies for preventing opioid abuse in the first place.
How is opioid overdose preventable?
Education as to the presence and lethality of fentanyl in illegal drugs being sold is a key factor in opioid overdose prevention.
Although many overdoses happen due to misuse of prescribed opioids, the majority of people who develop addiction to opioids will eventually purchase illegal knock-off pills for cost reasons, as well as to bypass restrictions like being unable to get a doctor to give them another prescription. These knock-off pills, as well as other street drugs, are more and more likely to contain some portion of fentanyl, as fentanyl is rising in popularity on the street.
Testing Substances for Fentanyl
One bandaid measure to help with the ubiquity of fentanyl is the distribution of fentanyl test strips which can be used to detect the presence of fentanyl in other drugs, such as cocaine, heroin, and methamphetamine.
Street drugs and illegal pills that contain fentanyl as an ingredient are not always labeled as such, and users may ingest these unintentionally. Due to fentanyl’s extreme potency, accidental overdose is a risk when a person takes a substance without knowing fentanyl is an ingredient.
Naloxone
A critical, life-saving measure is to make sure that naloxone is widely available in places where an overdose is reasonably likely to occur. Naloxone is an opioid antagonist (it reverses the effects of opioids, which can halt an overdose death from happening while it is underway if administered in time). Naloxone injections are used during emergencies to quickly interrupt an overdose in progress.
Overdose Emergency Protocol
It can be helpful to spread awareness of emergency protocols for responding to an overdose in progress. If you think an overdose may be happening, it’s best to treat it as an overdose even if you’re not sure (better safe than sorry).
If you suspect an overdose, call 911. Keep the person breathing and awake, and lay them on their side to prevent choking. Stay with them until responders arrive. If the person is having a seizure, move anything that can harm them away. Do not restrain them and do not put anything in their mouth. If they lose consciousness and are not breathing, start CPR if you are trained.
Avoid Using Opioids (Even When Prescribed by A Doctor)
Emergency measures are important, but they are a late-stage tactic. Better would be better if people weren’t abusing opioids in the first place.
Education about the risks of using any opioids, even as prescribed, is a key part of ending the epidemic. If opioids don’t get into human bodies at all, people will not end up addicted to them, which would lead to zero risk of opioid-related overdose death and injury. While many people realize that street drugs are very dangerous, still too many are unaware of the potential risks of prescribed opioids.
Everyone needs to decide for themselves, but here at Villa Kali Ma, as addiction professionals, we are against the use of opioids if at all possible. We understand that in exceptional cases opiates like morphine can be used in hospital settings. In the case of palliative care, it might be argued that super-opioids are appropriate, in a context in which there is no life expected to resume after the opioid use. If life is expected to resume after all, then the patient needs to be prepared for the reality of the effects of powerful opioid exposure.
We hope to share with these extreme examples that in general, opioids are not a good choice for most people, even though we know that physical pain is one of the hardest things to endure! But opioid addiction is worse.
The dictum generally believed among opioid proponents and doctors who still prescribe opioid drugs, is that they are safe if used as prescribed. The counterweight to that thought is that millions of people who were exposed to opioids for the first time through these prescriptions ended up struggling with overwhelming cravings and chemical dependence that made it nearly impossible to use only as prescribed.
Finally, it’s important to grasp that even if opioids are used strictly as prescribed, underlying pain remains uncured, and will need to be faced once opioid use ends again.
All in all, our recommendation to any person would be to stay away from opioids even when prescribed, if at all possible.
What is opioid use disorder?
Opioid Use Disorder is the diagnostic name for addiction to opioids.
The word opioid is a broad term referring to any substance, whether synthesized in a laboratory or natural, that affects the brain through binding to opioid receptors. The related term opiate refers only to naturally-occurring opioids, derived from opium poppies, such as morphine and codeine.
Semi-synthetic opioids are produced in laboratories using a chemical process but still rely on the active ingredients of the opium poppy. Semi-synthetic opioids include heroin and oxycodone. Finally, some opioids are fully lab-made, such as fentanyl.
Whenever there is chemical dependence on any of these substances, it is classed as opioid addiction, and the person will be given a diagnosis of opioid use disorder.
What is the stigma of opioid use disorder?
Like all addictions, opioid use disorder is widely misunderstood and broadly stigmatized. Those without any experience with addiction may have little understanding or ability to empathize, particularly with the ways that the addiction drives a person into extreme selfishness, self-destruction, and illegal behavior. It is truly difficult to understand without having been through it.
The problem with stigma is that it interferes with treatment and amplifies shame. The presence of shame is tied to all addiction and makes getting help harder. If the stigma of opioid addiction could be lessened, it would help heal the epidemic.
In our opinion, there is no reason to apply shame to opioid addiction, only compassion. Opioid addiction is truly widespread at this point, pointing to a problem not particularly in people’s characters and wounded psyches (at least, not only that), but actually to something extremely malevolent present in the drugs themselves. Ideally, the blame for the opioid epidemic should be lifted from the shoulders of sufferers.
What are opioids?
Opioids are a class of drugs that bind to opioid receptors in the brain, having a narcotic, or numbing effect. Opioids are highly effective at lessening pain in the immediate moment, making them helpful for medical situations like emergency surgeries and palliative care, when extreme physical pain is a factor. Opioids also have a euphoric effect, bringing powerful feelings of well-being and relaxation, in the short term. Opioids are extremely addictive.
There are three different kinds of opioids, synthetic, semisynthetic, and opiates.
Synthetic opioids are fully lab-made substances that mimic the effects of the natural active chemicals found in the opium poppy. Fentanyl is a synthetic opioid.
Fentanyl is not legally available for personal use even by prescription, but it is nevertheless widely distributed on the black market. It is exceedingly addictive and represents a very high risk of overdose. It is estimated to be at least 50 times more powerful than heroin.
Semisynthetic opioids are a class of pain relievers that are legal when prescribed by a doctor. Semisynthetic opioids are also made in a lab but include the natural ingredient found in opium poppies. Examples of brand-name semisynthetic opioids are Vicodin and OxyContin. Heroin is also a semisynthetic because it is synthesized from morphine and other ingredients.
Finally, opiates are the least-processed versions of the substance found naturally in opium poppies. This category includes morphine and opium, which are taken from poppy resin.
The role of fentanyl and benzodiazepines
Fentanyl is the number one killer, but the opioid crisis is driven not only by people who are using opioids alone but very commonly, opioids in combination with other substances.
Overdose deaths caused by the use of street drugs or knockoff pills come about because these substances are not pure opioids, but also include other ingredients, some of which are lethal when taken in the wrong combination.
One common source of lethal overdose is the pairing of an opioid with another central nervous system depressant, such as benzodiazepines. Benzodiazepines are another very dangerous class of drugs regularly prescribed despite strong addictive properties. Examples of name-brand benzodiazepines are Xanax, Valium, and Klonopin. Benzodiazepines are prescribed for anxiety disorders and sleep problems, but they are also widely abused and sold on the black market.
Fentanyl has the most overdose deaths
The biggest contribution to overdose deaths is owed to fentanyl.
Estimates of overdose deaths in the United States are currently around 100,000 people a year, according to the CDC.
Fentanyl is believed to be responsible for about two-thirds of those deaths. Deaths by fentanyl overdose have risen by almost 30% since 2020, according to an analysis of data conducted by the New England Journal of Medicine.
Fentanyl death is affecting all sections of the population, including older adults and people of all socioeconomic backgrounds. Rural and urban areas are both affected.
Opioid overdose deaths in San Diego County, California
According to the San Diego County Overdose Surveillance and Response Program Quarterly Report, opioid overdose deaths are on the rise regionally in San Diego.
The number of overdose-related emergency room visits increased by a greater percentage (13%) in the category of opioid overdose as compared with other drug overdose, which rose also but by a lesser percentage (7%) over 3 years.
In preliminary data collected in the first half of 2023, 75% percent of overdose deaths were related to opioids. The numbers of opioid overdose emergency room visits are around 3 times higher for male users, and the ages most affected are between 25-44.
Overdose facts
According to the National Center for Injury Prevention and Control, per the Web-based Injury Statistics Query and Reporting System, overdoses are the leading cause of death by injury in the United States.
According to a data brief entitled Drug Overdose Deaths in the United States, 2002-2022, 107,941 people died from drug overdoses in 2022 (almost 300 people a day). Of those overdose deaths, about two-thirds were opioid-related.
According to a 2018 article, Risks of Fatal Opioid Overdose during the First Year Following Nonfatal Overdose, people who have had at least one overdose are more likely to have another.
Finally, the Substance Abuse and Mental Health Services Administration’s findings from 2022 report that around 50 million Americans are estimated to qualify for substance use disorder treatment. Of those 50 million, less than 15 million were able to receive treatment in that year.
Signs of an opioid overdose
When it comes to recognizing an overdose, it can be tricky to identify and it’s best to follow the rule, “better safe than sorry”. If you think an overdose might be underway, call 911 and stay with the person until medical personnel arrive. Turn the person on their side so that they do not choke and if CPR trained, be ready to administer CPR if the person stops breathing.
Signs that an overdose might be underway are:
- Unconsciousness (you can’t wake the person up)
- Choking and gurgling, slow shallow breathing, or snoring sounds from someone who won’t wake up
- Skin discoloration, especially in nails and lips
- Pinpoint pupils that don’t react to light
What is International Overdose Awareness Day?
International Overdose Awareness Day is a day set aside to remember those who have passed by overdose, and to rededicate ourselves to raising awareness of the dangers of drug overdose.
When is International Overdose Awareness Day?
International Overdose Awareness Day is acknowledged every August 31st.
Promising prevention strategies
- Stop prescribing opioids
- Improve communication and prescription tracking among doctors and clinics to prevent opioid abuse through prescriptions
- De-incentivize opioid prescription (make kick-backs for doctors illegal)
- De-stigmatize opioid addiction, and provide treatment for all affected by opioid use disorder
- Increase awareness among active drug users of the severe dangers of fentanyl and other opioids
- Distribute fentanyl strips
- Share the message that full recovery from opioid addiction is possible
- Expand and fund research into natural, non-addictive healing solutions and alternative methodologies for physical pain disorders, injuries, and mental health struggles (treat the underlying pain in a better way)
How to recognize someone experiencing an overdose?
Opioid-related overdose is recognizable when a person is unconscious or nonresponsive and appears to have difficulty breathing or is not breathing at all.
Other signs and symptoms include:
- Limpness of the body
- Clammy, cold skin
- Discolored, bluish skin
- Small, constricted pupils that don’t respond to light
- Unable to stay awake
- Slow, shallow breathing
- Gurgling or choking sounds
Other bad signs, indicating another kind of drug overdose, can include tremors, nausea, vomiting, drooling or frothing at the mouth, uncontrollable jerking and twitching, sudden falling, and other more dramatic signs. It is best to call 911 if there is any suspicion of a drug overdose, opioid or otherwise.
We Offer Opioid Addiction Treatment in San Diego County
Villa Kali Ma is a San Diego County facility that helps women heal from addiction through compassionate and integrative approaches to recovery.
Our programs for women who suffer from substance abuse and co-occurring disorders facilitate healing and transformation of women’s lives at the deepest core so that they are fully free to discover the truth of who they are. Opioid addiction is a nightmare, but it’s possible to wake up from that nightmare and live a tender, precious human life again, in recovery. We’d love to help you do just that.
