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. 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.
Risk Factors for Prescription Opioid Abuse and Overdose
Research shows that some risk factors make people particularly vulnerable to prescription opioid abuse and overdose, including:
- Obtaining overlapping prescriptions from multiple providers and pharmacies.
- Taking high daily dosages of prescription pain relievers.
- Having a mental illness or a history of alcohol or other substance abuse.
- Living in rural areas and having low income.
Addiction and Overdose
Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.
Once addicted, it can be hard to stop. In 2016, more than 11.5 million Americans reported misusing prescription opioids in the past year.
Taking too many prescription opioids can stop a person’s breathing—leading to death.
Prescription opioid overdose deaths also often involve benzodiazepines. Benzodiazepines are central nervous system depressants used to sedate, induce sleep, prevent seizures, and relieve anxiety. Examples include alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®). Avoid taking benzodiazepines while taking prescription opioids whenever possible.
What is fentanyl?
Pharmaceutical fentanyl is a synthetic opioid pain reliever, approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine. It is prescribed in the form of transdermal patches or lozenges and can be diverted for misuse and abuse in the United States.
However, most recent cases of fentanyl-related harm, overdose, and death in the U.S. are linked to illegally made fentanyl. It is sold through illegal drug markets for its heroin-like effect. It is often mixed with heroin and/or cocaine as a combination product—with or without the user’s knowledge—to increase its euphoric effects.
An illegal, highly addictive opioid drug processed from morphine.
Today’s Heroin Epidemic
Heroin use has increased sharply across the United States among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes.
How is heroin harmful?
Heroin is an illegal, highly addictive opioid drug.
A heroin overdose can cause slow and shallow breathing, coma, and death.
People often use heroin along with other drugs or alcohol. This practice is especially dangerous because it increases the risk of overdose.
Heroin is typically injected but is also smoked and snorted. When people inject heroin, they are at risk of serious, long-term viral infections such as HIV, Hepatitis C, and Hepatitis B, as well as bacterial infections of the skin, bloodstream, and heart.
Who is most at risk of heroin addiction?
- People who are addicted to prescription opioid pain relievers
- People who are addicted to cocaine
- People without insurance or enrolled in Medicaid
- Non-Hispanic whites
- People who are addicted to marijuana and alcohol
- People living in a large metropolitan area
- 18 to 25-year-olds
What can be done?
Prevent people from starting heroin by reducing prescription opioid abuse
- Improve opioid prescribing practices and help identify individuals at high risk early.
- Among people presenting for treatment for addiction to opioids, and who initiated use of an opioid in 2015, about two out of three started with prescription opioids.
Ensure access to prevention services
Ensure that people have access to integrated prevention services, including access to sterile injection equipment from a reliable source, as allowed by local policy.
Ensure access to Medication-Assisted Treatment
Reduce heroin addiction by ensuring access to Medication-Assisted Treatment (MAT)
- Treat people addicted to heroin or prescription opioids with MAT which combines the use of medications (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.
- People who are addicted to prescription opioids are 40 times more likely to also be addicted to heroin.
Expand the use of naloxone
Reverse heroin overdose by expanding the use of naloxone
- Use naloxone, a life-saving drug that can reverse the effects of an opioid overdose when administered in time.
- From 1999 to 2017, the number of heroin overdose deaths has increased by 7 times.
Where to Get Help
Community Counseling Center http://www.cccohio.com/
Lake Area Recovery Center http://www.larc.cc/
Signature Health https://www.signaturehealthinc.org/