What Are “Opioids” Anyway?

According to the Center for Disease Control and Prevention, opioids are a class of drugs used to reduce pain. Prescription opioids can be prescribed by doctors to treat moderate to severe pain, but can also have serious risks and side effects. Common types are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. Fentanyl is a synthetic opioid pain reliever. It is many times more powerful than other opioids and is approved for treating severe pain, typically advanced cancer pain. (1) Illegally made and distributed fentanyl has been on the rise in several states. Heroin is an illegal opioid. Heroin use has increased across the U.S. among all genders, most age groups, and all income levels. (2) The number of drug overdose deaths has never been higher, and the majority of these deaths, 66% in 2016, involved opioids. (3)

References

  1. Algren D, Monteilh C, Rubin C, et al. Fentanyl-associated fatalities among illicit drug users in Wayne County, Michigan (July 2005-May 2006). Journal Of Medical Toxicology: Official Journal of the American College Of Medical Toxicology [serial online]. March 2013; 9(1):106-115.

  2. Centers for Disease Control and Prevention. Vital Signs: Today’s Heroin Epidemic – United States, 2012. MMWR 2015; 64(26);719-725.

  3. Seth P, Scholl L, Rudd RA, Bacon S. Increases and Geographic Variations in Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants with Abuse Potential – United States, 2015-2016. MMWR Morb Mortal Wkly Rep. ePub: 29 March 2018.

How Did We End Up With an Opioid Overdose Epidemic?

Drug overdose (poisoning) is the leading cause of unintentional injury death in the United States, causing more deaths than motor vehicle crashes. On average, 115 Americans die every day from an opioid overdose.(1)  Opioids – both prescription painkillers and heroin – are responsible for most of those deaths. The California Department of Public Health reports that the number of Californians affected by prescription and non-prescription opioid misuse and overdose is substantial, with rates varying significantly across counties, and even within counties.

  • From 1999-2016, more than 350,000 people died from an overdose involving any opioid, including prescription and illicit opioids.(2) This rise in opioid overdose deaths can be outlined in three distinct waves.

    • The first wave began with increased prescribing of opioids in the 1990s (3), with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.

    • The second wave began in 2010, with rapid increases in overdose deaths involving heroin.

    • The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids – particularly those involving illicitly-manufactured fentanyl (IMF). The IMF market continues to change, and IMF can be found in combination with heroin, counterfeit pills, and cocaine. (2,4)

According to the California Department of Public Health, California continues to face a serious public health crisis. The state has approximately 2,000 annual opioid overdose deaths (70% involving prescription opioids), and 8,000 hospital and emergency department admissions.  The California Opioid Overdose Surveillance Dashboard  indicates that Butte County experienced 16 deaths due to all opioid-related overdoses in 2017, the most recent calendar year of data available. This represents a 7% decrease from 2015. We believe we can drop opioid overdose deaths to zero with data-driven strategies.

References

  1. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2017. Available at http://wonder.cdc.gov.

  2. Seth P, Scholl L, Rudd RA, Bacon S. Increases and Geographic Variations in Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants with Abuse Potential – United States, 2015-2016. MMWR Morb Mortal Wkly Rep. ePub: 29 March 2018.

  3. Kolodny et al. 2015. The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559-74

  4. Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in Drug and Opioid Overdose Deaths – United States, 2000-2014. MMWR 2016, 64(50); 1378-82.

Learn How to Reverse an Opioid Overdoses with Naloxone (Narcan)

Drug overdose (poisoning) is the leading cause of unintentional injury death in the United States, causing more deaths than motor vehicle crashes. Opioids – both prescription painkillers and heroin – are responsible for most of those deaths. The number of Californians affected by prescription and non-prescription opioid misuse and overdose is substantial, with rates varying significantly across counties, and even within counties.

  • Naloxone is a medication that works almost immediately to reverse an opioid overdose. Naloxone is currently a prescription drug, but is not a controlled substance. It has few known adverse effects, no potential for abuse, and can be rapidly administered through intramuscular injection or nasal spray. While most professional first responders and emergency departments are equipped with naloxone, emergency service providers may not arrive in time to revive overdose victims. Trained and equipped bystanders such as friends, family and other non-health care providers (lay people) and drug users themselves can effectively respond and reverse an opioid overdose. Given the success of bystander naloxone programs, the CDC and the World Health Organization have recommended expanding the availability of naloxone to lay people. Watch this 11 minute video by CPDH to learn how to use naloxone or attend one of our short FREE trainings where you can go home with FREE NALOXONE.

  • Individuals and family members can obtain naloxone by: 1) obtaining a prescription for naloxone from their health care provider and having it filled at a pharmacy; or 2) purchasing naloxone from a pharmacist without a prescription from a health care provider (authorized by Business and Professions Code Section 4052.01). A pharmacist can determine if naloxone is covered by an individual’s health care insurance, and can bill for this cost as appropriate. 4) Staff of community organizations and other entities distributing naloxone under the statewide standing order are required to receive opioid overdose prevention and treatment training, and are also required to train individuals who receive naloxone from them. NVHRC’s work is covered under subsection 4.

TAKE HOME FREE NALOXONE AND LEARN HOW TO REVERSE AN OPIOID OVERDOSE: Providing overdose prevention, recognition, and response education to drug users and their neighbors, friends, families, and the service providers who work with them is a harm reduction intervention that saves lives.  We provide one-on-one or group trainings and distribute FREE NALOXONE to all who complete a short training. Check out our Opioid Overdose Prevention page to see when our next community training is happening or schedule your own.