Opioids

What are Opioids?

Opioid Drug Names

Current Trends and Statistics

• • According to the MN Department of Health (MN DoH), the largest concern among national opioid experts is the emergence of illicit fentanyl and other synthetic opioids.

  • Compared to other states, deaths involving fentanyl and fentanyl analogs in MN are substantially lower than those involving prescription opioids and/or heroin.

  • In Massachusetts, there were 900 opioid overdose deaths involving fentanyl in 2015. In 2016, that number increased to 1500.

  • In Anoka County in October of 2016, 6 overdoses and 2 deaths within a 12 hour period were linked to carfentanyl. Carfentanyl is a substance derived from fentanyl and one of the most potent opioids known and used. It’s an odorless white powder with potency that’s 10,000 times higher than morphine. Its high potency makes it unsafe for human use under any circumstance.

  • In 2017 in MN: total opioid overdose deaths were rising and cases of nonfatal overdose were also rising, but prescribing practices appeared to be improving.

Social Impact

The total economic burden of prescription opioid overdose, abuse, and dependence in the US was estimated to be $78.5 billion in 2013. Around one third of this amount is due to health care and substance abuse treatment costs.³

Myths and Facts

• Myth #1:

  • Most people get opioids from illegal sources

  • In fact, most opioids are diverted from legal sources, such as family and friends who have a prescription for opioids or from forged or fake prescriptions

• Myth #2:

  • All opioid drugs have the same risks

  • However, each opioid drug varies in potency (how strong they are), onset (how quick they work), duration of action (how long they work), and how addictive they can be

• Myth #3:

  • All opioid overdoses are reversible

  • Unfortunately, not all overdoses are reversible, and people still die every day from opioid overdoses

• Myth #4:

  • Taking an opioid as directed by a doctor may not lead to addiction

  • In fact, any long term use of an opioid can cause dependence and addiction

• Myth #5:

  • Only certain people can become addicted to opioids

  • However, there are many risk factors that exist that can make a person more likely to experience addiction

Risk Factors

• • Some risk factors make people especially vulnerable to prescription opioids abuse and overdose²

  • Nearly 80% of heroin users reported using prescription opioids prior to heroin

  • Obtaining overlapping prescriptions from multiple providers and pharmacies

  • Taking high daily doses of prescription pain relievers

  • Having a mental illness

  • History of alcohol or other substance abuse

  • Living in rural areas

  • Having low income

How Teens are Getting Access to Opioids

• Taking legally prescribed medications in ways other than what is prescribed (e.g., higher dose, longer duration, or in a different form such as crushing pills and inhaling them)

• Taking prescription medications from a friend or relative without asking

• Given to them for free by a friend or relative

• Buying them from a friend or relative

• Buying them from a drug dealer or unknown person

• Buying on the internet from online pharmacies ¹²

How Opioids Work

Opioids work on the same part of the brain where natural endorphins work. Natural endorphins are what cause exercise-induced “high.” They also have roles in determining our natural pain threshold and response to addictive substances. High blood levels can occur within minutes when these substances are smoked or injected.

Use and Abuse

How People are Using/Abusing Opioids

According to the NIH National Institute of Drug Abuse, the most common way opioids are taken are injected, smoked, snorted, or pills taken by mouth. Highly pure heroin can be snorted or smoked while “black tar” heroin is more common and has impurities. "Black tar" heroin is dissolved, diluted, then injected into the veins or muscles.

How to Detect Abuse and Overdose

From the National Institute of Drug Abuse, drug addiction is a chronic, relapsing neurologic disease where individuals compulsively seek and use drugs despite knowing the harmful consequences.

Signs and symptoms of addiction include:

• Behavioral changes such as lack of personal hygiene

• Decreased connection with others

• Erratic spending

• Stealing

• Health-related changes such as sudden weight loss and/or flu-like symptoms (nausea, vomiting, severe headache and weakness)

• According to users, fentanyl and carfentanyl smell sweet when smoked.

An opioid overdose is identified by the “opioid overdose triad”: pinpoint pupils, unconsciousness, and respiratory depression.

Safety Concerns