Drug abuse is a pervasive problem that saw a meteoric rise in the past few decades. Due to the abuse of prescription opioids as well as the use of illegal narcotics, opioid overdose deaths have tremendously increased to the point of ushering in a healthcare crisis.
Although most opioid overdoses don’t cause death, they can still have life-altering complications that cause severe health problems in the future. That’s why understanding opioids and their mechanism of action can better explain the risk factors associated with their use.
What Are Opioids?
Opioids are potent analgesics (painkillers) that can be natural, synthetic, or semi-synthetic. They include morphine, codeine, tramadol, fentanyl, and the illegal narcotic, heroin.
In a healthcare setting, opioid analgesics are prescribed in cases of severe pain caused by injury or disease, or after major surgery.
Synthetic opioids, like fentanyl, are much stronger than natural opiates, like morphine. They are often used for palliative care in terminal illnesses for pain relief or as an anesthetic.
These drugs act on special opioid receptors in the brain and other organs, which respond to chemicals produced by the body, taking control of their natural pathways. Their action results in a diminished sense of pain and a state of euphoria that can cause opioid use disorder (OUD).
What Is Opioid Use Disorder?
This disorder describes the misuse of one’s prescription opioids by altering the dosage, using someone else’s prescription opioids, or using illegal opioids, such as heroin. It’s a chronic illness, marked by recurrent relapses, and can increase a person’s chance of suffering an opioid overdose, leading to death.
How Can a Person Overdose on Opioids?
An opioid overdose is the result of one of the following scenarios:
- Using illegal opioids, like heroin, recreationally and accidentally taking too much.
- Taking high doses of prescription opioids, like oxycodone, either accidentally or intentionally.
- Mixing opioids with other substances, such as alcohol or other prescription medications. This is especially dangerous in the case of anxiety medications (Xanax or Valium) as they contain Benzodiazepines. These combinations can have an additive effect and, hence, increase the risk of overdose.
- Taking prescription opioids meant for someone else. A common reason for accidental overdoses is children reaching for and consuming opioids prescribed for one of their family members.
- Overdosing on methadone, a drug used in heroin addiction treatment.
How Does an Opioid Overdose Happen?
Opioids have a common side effect of slowing down and depressing the breathing mechanism, which can lead to low oxygen to the brain, resulting in brain injury and death. This usually doesn’t take too long.
The window of time between a drug overdose and loss of consciousness depends on multiple factors, which include:
- The type of opioid that caused the drug overdose, with fentanyl being one of the worst offenders
- The dose taken by the person
- Their tolerance to the drug
- Whether other substances were involved in the drug overdose.
Symptoms of an Opioid Overdose
The following symptoms occur when there’s a suspected opioid overdose:
- Tiny, pinpoint eye pupils
- Slow, shallow breathing
- Difficulty in walking, talking, or moving limbs
- Inability to stay awake
- Vomiting, gurgling, or choking sounds
- Pale, clammy face with cold sweat
- Blue or purple lips and fingernails
How to Respond to an Opioid Overdose
- You should call 911 immediately if you see someone exhibiting any of the previous symptoms. Opioid overdoses are life-threatening and can be fatal if not addressed immediately.
- If the person is still responsive, try to keep them awake and alert.
- Avoid letting them lie down on their back to keep their airway supported so they can breathe more easily.
- If the person is vomiting, rest their body on its side to prevent choking.
- Monitor their breathing and heart rate while emergency medical services arrive.
- If you’re trained, begin CPR to restore breathing.
- Administering naloxone, if available, can reverse the effect of the opioid overdose. You can administer naloxone via a nasal spray, an intramuscular (into a muscle), intravenous (into a blood vessel), or subcutaneous (under the skin) injection.
Risk Factors for Opioid Overdose
Although all unsupervised opioid use can result in overdose, some people are at a higher risk due to the following factors:
- Injecting opioids.
- Resuming the use of opioids after a period of abstinence, especially after release from incarceration (within the first 4 months) or completing a detoxification program.
- Being over 65 years old.
- Combining opioids with other substance use, like alcohol, barbiturates, benzodiazepines, anesthetics, or analgesics.
- Having a concurrent health issue, like chronic liver or kidney problems, HIV, or mental illness.
- Coming from a disenfranchised background, not having health insurance, and being unable to afford treatment for opioid abuse.
Drug Overdose Deaths
Drug overdose deaths have increased at an alarming rate from 1999–2021, with deaths involving synthetic opioids increasing 97 times and those related to prescription opioids increasing 4.9 times.
Compared to overdose deaths involving cocaine, which increased 6.4 times, and overdose deaths involving psychostimulants (primarily methamphetamine) increasing 59 times, the highest increase is in opioid overdose deaths.
The rise in drug overdose deaths related to opioids can be attributed to:
- Over-prescription of potent opioid analgesics with high abuse potential, which might lead to dependency.
- Inability to source prescription opioid drugs and resorting to illegal opioids, like heroin or fentanyl.
- Using illegally-sourced drugs that have been laced with fentanyl or one of its analogs. This is a common issue nowadays as illegal drug manufacturers do this to increase the potency of their drugs.
- The COVID-19 pandemic and its detrimental effects on mental health.
How to Prevent an Opioid Overdose
You can avoid an opioid overdose if you:
- Take prescription opioids as instructed by your healthcare practitioner.
- Have physical reminders of whether you took your pills, like pill boxes, to avoid duplicate doses.
- Have chronological reminders, like alarms, for your dose times.
- Never combine opioids with other substances, like alcohol, anxiety medication, or sleep medication.
- Never take someone else’s prescription drugs.
- Have Naloxone on your person and teach family and friends how to respond to a potential opioid overdose if you’re at a higher risk of overdose.
You can prevent opioid overdose in other people by:
- Storing all prescription medication away from the reach of children or pets.
- Keeping all medication stored in a safe place where no one can get to it and steal it if it goes unnoticed.
- Disposing of expired and unneeded drugs safely by dropping them off at a drug take-back site, flushing them down the toilet (if appropriate), or mixing them with coffee grounds, cat litter, or dirt, and throwing them in the trash.
Opioid Overdose Treatment
Treatment of opioid overdose starts by administering a drug called Naloxone, which acts as an antidote to the depressive effects of opioids.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the sooner the drug is given to the person overdosing, the less long-term damage their body might suffer.
Naloxone is also completely harmless if given to someone who’s experiencing another kind of drug overdose, so administering it is always advised if available.
The patient remains under the supervision of health care providers until their condition stabilizes. Then, they might be transferred to an in-patient rehab facility to complete their treatment program.
The treatment includes detoxification from the opioids and could involve the use of Methadone, Buprenorphine, or Naltrexone to manage withdrawal symptoms and reduce cravings for opioids.
After being discharged from the rehab facility, the person who experienced the opioid overdose should be involved in therapy with a professional. This step allows for a better understanding of their reasons to abuse opioids, and reduces the chances of a relapse.
Wrapping Up
The opioid crisis has claimed many lives through drug overdose deaths in the past three decades. This is, in part, due to the over-prescription of opioids and the rise of potent synthetic opioids, like fentanyl, in the illegal drug market.
Knowing the symptoms of an opioid overdose can be life-saving. If you see someone experiencing shallow breathing, inability to move or stay awake, and unusual pallor, call 911 immediately.
For people struggling with opioid abuse, taking the first step in seeking treatment can be intimidating. You or your loved one can rest assured that at CuredNation.com, you’ll receive the utmost care from licensed clinicians through our telemedicine services. Book an appointment today.
