The misuse and abuse of opioids — whether prescription opioids, heroin, or synthetic opioids like fentanyl — Is a serious national crisis, affecting public health and welfare. Many communities are looking for new tools to help them curb this growing and deadly problem.

One such tool is naloxone. This prescription drug can help reverse the effects of an opioid overdose in some patients.

How opioid overdoses cause death

Opioid overdoses are the result of ingesting so much of the drug that it affects the parts of the brain that regulate breathing. This slows breathing significantly — or even stops it altogether. That’s why people experiencing an opioid overdose generally lose consciousness and are unresponsive when you try to wake them. They may have slow or erratic breathing, and their lips and fingernails may turn a bluish color because their body isn’t getting enough oxygen.

If they remain in this state for too long, that lack of oxygen will cause the brain and other organs to shut down. However, the drug naloxone, if administered quickly enough, can restore regular breathing and reverse the overdose, at least temporarily.

How naloxone can be used to treat an overdose

Naloxone is a type of drug called an opioid antagonist. It works by attaching to receptors in the brain and body that would normally bind with opioid drugs. This effectively blocks the effects of these powerful narcotics.

Naloxone is available both as an injectable drug (Evzio) and as an easy-to-administer nasal spray known as Narcan. Today, many police officers, emergency medical technicians, and other emergency response personnel carry naloxone with them at all times so they can quickly resuscitate individuals who may experience an opioid overdose.

However, it’s critical to note that this drug only works for a short amount of time. According to the Substance Abuse and Mental Health Services Administration, naloxone is only a temporary treatment.

That’s why it is essential, even if you have administered naloxone to someone, that you immediately call 911 for further evaluation and treatment.

If the person has taken a large dose of opioid drugs, a single dose of naloxone may not be sufficient. Naloxone also typically wears off between 30 to 60 minutes after it’s administered, so the person may develop further trouble breathing if the opioid is still in their system.

How to get naloxone for yourself — or a loved one

Naloxone is a prescription drug. That means that, in many states, you need a prescription to get it. However, there are some addiction risk reduction programs that will provide Narcan to those diagnosed with an opioid misuse disorder — or even provide it to a person’s close friends or family members. Depending on the laws where you live, some pharmacies may even provide it without a prescription.

Many addiction experts recommend that people who live with someone struggling with an opioid addiction have Narcan nearby. The more quickly the drug can be given to someone who has overdosed, the more likely the person is to survive. Your doctor, pharmacist, or risk reduction specialist can show you how to properly administer it.

With the number of opioid overdoses on the rise, the Centers for Disease Control and Prevention now refers to the crisis as an epidemic. But some of these opioid overdose deaths might be preventable if someone nearby has naloxone on hand — and knows how to use it.

If you suspect someone may be experiencing an opioid overdose, call 911 immediately. Then administer naloxone, if you have it, and try to keep the person awake and breathing until help arrives.

According to the National Institute on Drug Abuse (NIDA), the U.S. is in the midst of an opioid crisis, with an estimated 130 people dying from opioid overdoses every day. The NIDA also estimates that approximately 1.7 million people suffer from a substance use disorder related to this class of drugs, which includes Percocet (oxycodone), codeine, morphine, Vicodin and Oxycontin — all drugs commonly prescribed by doctors to help manage pain. Anyone who takes these drugs, even those who do so under a physician’s supervision, could be at risk. This is true even if they are being used only for the short-term, such as the first few days after an outpatient surgical procedure.

That’s why it is important for patients to take a proactive role in their own pain management. If you are having surgery or are experiencing chronic pain, be sure to ask your doctor or pharmacist the following important questions about any medication treatment plan that includes opioids.

What are the common side effects and issues associated with opioids?

Although opioids can be effective at managing pain, even short-term use can come with some side effects, including slowed breathing, sleepiness, confusion, nausea and constipation.

But the biggest potential problems come with long-term use. For a long time, doctors were led to believe these drugs were not habit forming, so they started prescribing them more frequently for common chronic pain issues, such as back pain and migraines.

Unfortunately, it’s now apparent that long-term use of this class of painkillers, whether after surgery or to manage chronic pain, can lead to serious consequences, including muscle pain, lung infection, heart infection and perhaps most distressingly, lifelong addiction and even death.

What should I ask my doctor or pharmacist before taking an opioid?

Experts from the Food and Drug Administration, as well as other public health agencies, now recommend that upon receiving a prescription for an opioid medication, patients should ask their doctors some important questions.

Here are the key questions you should ask:

• I have a personal — or family — history of addiction. Is it safe for me to take this medication?
• How often should I take this drug? How much should I take? How long should I take it for?
• How can I best reduce the risk of side effects — including addiction?
• Could this drug interact with any of my other medications?
• Are there any safe, reliable non-opioid alternatives to help me manage pain?

Although opioid medications may often be used as the first line of defense for acute pain, they aren’t the only option available. According to American Addiction Centers, there are several non-opioid ways to deal with short-term pain, like after a surgical procedure or a broken bone, as well as long-term management of chronic conditions.

Nonsteroidal anti-inflammatory drugs (NSAIDs). Common over-the-counter and prescription medications like ibuprofen, acetaminophen, aspirin and steroids are often more than enough to quell the discomfort experienced after a bone fracture or minor surgical procedure. Tylenol and Advil can also play an integral role in the management of chronic conditions by helping to relieve inflammation and in turn, feelings of pain.

Physical therapy and exercise. Although moving around may be the last thing you want to do when you are in pain, moving can actually help bring short- and long-term relief, according to University of Utah Health, an academic healthcare system. Movement-based therapies help control pain by reducing inflammation and strengthening muscles that can provide added support to help avoid injury or strain. As an added byproduct, this kind of exercise can also reduce your body weight, improve your sleep and heighten your mood — all things that will also minimize pain.

Neuromodulation. Some doctors may recommend electrical or radio stimulation to help “short-circuit” pain signals in the body, especially for patients who are experiencing chronic pain. These newer high-tech neuromodulatory techniques modulate how pain signals are communicated in the body and may promote the production of endorphins and other feel-good chemicals to help keep pain at bay.

If you still have questions, ask your local Good Neighbor Pharmacy pharmacist for more information on the safe use of opioids.

Opioids are natural or synthetic chemicals that relieve pain. Common types include:

• Hydrocodone (e.g., Vicodin)
• Oxycodone (e.g., OxyContin)
• Morphine
• Methadone

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer.

Opioids and Chronic Pain

Many Americans suffer from chronic pain, which is a major public health concern in the United States. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness. The number of opioids prescribed and sold in the U.S. has quadrupled since 1999, but the overall incidence of pain reported hasn’t changed.

Risks and Side Effects

In addition to serious risks of addiction, abuse, and overdose, the use of prescription opioids can have many side effects, even when taken as directed:

• Tolerance, meaning you might need to take more of the medication for the same pain relief
• Physical dependence, meaning you have symptoms of withdrawal when the medication is stopped
• Increased sensitivity to pain
• Constipation
• Nausea, vomiting, and dry mouth
• Sleepiness and dizziness
• Confusion
• Depression
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching and sweating

Talk with your doctor or pharmacist about the risks and benefits of opioids before beginning opioid therapy. Learn more about opioids and how to protect yourself and your loved ones from abuse, addiction, and overdose by visiting CDC.gov/drugoverdose.

Source: CDC.gov

Misuse of Prescription Drugs

The misuse of prescription drugs is a serious public health problem in the United States. Although most people take prescription medications responsibly, an estimated 54 million people (more than 20 percent of those aged 12 and older) have used prescription medications for nonmedical reasons at least once in their lifetimes.

Misuse of prescription drugs means taking a medication in a manner or dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to feel euphoria (i.e., to get high). The reasons for the high prevalence of prescription drug misuse vary by age, gender, and other factors, but likely include ease of access.

Prescription drug misuse can have serious medical consequences. Increases in prescription drug misuse over the last 15 years are reflected in increased emergency room visits, overdose deaths associated with prescription drugs, and treatment admissions for prescription drug use disorders, the most severe form of which is addiction.

• ABOUT 21 TO 29% of patients prescribed opioids for chronic pain misuse them.
• BETWEEN 8 AND 12% continue opioid use despite clinically significant distress or impairment.
• AN ESTIMATED 4 TO 6% who misuse prescription opioids transition to heroin.
• ABOUT 80% of people who use heroin first used prescription opioids.

Tips to Prevent Prescription Drug Abuse

Ensuring proper use, storage and disposal of prescription drugs is important in reducing accidents, thefts, and the misuse and abuse of medications.

• STAY ALERT. Family, friends and visitors can get into your medicine cabinet without you even knowing it. Make sure your medications don’t wind up in the wrong hands.
• NEVER SHARE. Don’t let other people use your medications. Even if you think you’re helping to relieve their pain, it can result in serious, even fatal, consequences.
• DISPOSE OF THE EXTRA. Take advantage of your local drug take-back events, or safely discard medications at home with a drug deactivation pouch.
• KEEP IT SECURE. Take the proper precautions to store your medications in a safe and secure location.

Talk to your Good Neighbor Pharmacy pharmacist today to learn about steps you can take to keep your medications safe and out of the wrong hands. Additional tips for safe disposal of prescription drugs are available here.

Source: CDC.gov

Prescription drugs play an important role in treating many conditions and diseases, but when they are no longer needed it is important to dispose of them promptly and properly to help reduce the danger of accidental exposure or intentional misuse. Below, we list some options and special instructions for you to consider when disposing of expired, unwanted, or unused medicines.

Transfer Unused Medicine to Authorized Collectors for Disposal

Medicine take-back programs are a good way to safely dispose of most types of unneeded medicines. The U.S. Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events where collection sites are set up in communities nationwide for safe disposal of prescription drugs. Local law enforcement agencies may also sponsor medicine take-back programs in your community. Likewise, consumers can contact their local waste management authorities to learn about medication disposal options and guidelines for their areas.

Another option for disposing of unneeded medicines is to transfer unused medicines to collectors registered with the DEA. DEA-authorized collectors safely and securely collect and dispose of pharmaceuticals containing controlled substances and other medicines. In your community, authorized collection sites may be retail pharmacies, hospital or clinic pharmacies, and law enforcement locations. Some authorized collection sites may also offer mail-back programs or collection receptacles, sometimes called “drop-boxes,” to assist consumers in safely disposing of their unused medicines.

Visit the DEA’s website for more information about drug disposal and National Prescription Drug Take-Back Day events, or to locate a DEA-authorized collector in your area.

Disposal in Household Trash

If no medicine take-back programs or DEA-authorized collectors are available in your area, and there are no specific disposal instructions on the drug label, you can also follow the steps outlined below to dispose of most medicines in the household trash.

Source: FDA.gov

Opioid Overdose Basics

Prescription opioids (like hydrocodone, oxycodone, and morphine) and illicit opioids (like heroin and illegally made fentanyl) are powerful drugs that have a risk of a potentially fatal overdose. Anyone who uses opioids can experience an overdose, but certain factors may increase risk, including:

• Combining opioids with alcohol or certain other drugs
• Taking high daily dosages of prescription opioids
• Taking more opioids than prescribed
• Taking illicit or illegal opioids, like heroin or illicitly manufactured fentanyl, which could possibly contain unknown or harmful substances
• Certain medical conditions, such as sleep apnea or reduced kidney or liver function
• Being more than 65 years old

Signs and Symptoms of an Opioid Overdose

During an overdose, breathing can be dangerously slowed or stopped, causing brain damage or death. It’s important to recognize the signs and act fast. Signs include:

• Small, constricted “pinpoint pupils”
• Falling asleep or loss of consciousness
• Slow, shallow breathing
• Choking or gurgling sounds
• Limp body
• Pale, blue, or cold skin

What to Do if You Think Someone Is Overdosing

It may be hard to tell if a person is high or experiencing an overdose. If you aren’t sure, it’s best to treat it like an overdose—you could save a life.

• Call 911 immediately.
• Administer naloxone, if available.
• Try to keep the person awake and breathing.
• Lay the person on his or her side to prevent choking.
• Stay with him or her until emergency workers arrive.

Death from an opioid overdose happens when too much of the drug overwhelms the brain and interrupts the body’s natural drive to breathe. To learn more about opioids to protect yourself and your loved ones from opioid abuse, addiction, and overdose, visit these resources:

• Centers for Disease Control and Prevention Opioid Overdose
• Substance Abuse and Mental Health Services Administration
• Health Resources and Services Administration

Source: FDA.gov