"ON THE NOD" - THE OPIOID OVERDOSE CRISIS
INTRODUCTION
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Each day hundreds of individuals in Canada and the U.S. die after overdosing on opioid drugs and medications. These drugs include a variety of prescription pain relievers such as morphine and oxycodone (i.e. Percocet) as well as street drugs such as heroin. They also include the synthetic opioid drug known as Fentanyl. The overall misuse of opioid medications has reached epidemic proportions in North America and the Center for Disease Control and Prevention (CDC) estimates that the issue cost the country of the United States roughly 78.5 billion dollars per year.
WHEN/HOW DID IT ALL START
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Though opioids have been arounds for hundreds of years, the overall systemic issue began in the U.S. and Canada in the late 90’s when pharmaceutical companies convinced medical professionals that opioid pain relievers were not addictive. With this in mind, doctors and other healthcare professionals began prescribing opioid medications and pain relievers to patients at greater and greater rates. However, as it turns out, opioid drugs are actually highly addictive, which has led to their widespread dependence and misuse. In 2015 approximately 2 million individuals became addicted to opioid pain relievers that were prescribed to them.
Furthermore, according to research, America has the highest rates of overdose on an international level and in 2015 an estimated 33 thousand Americans died of an opioid overdose. Overdose is now the leading cause of accidental death in the U.S. having surpassed deaths by motor vehicle accidents back in 2011.
FENTANYL
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Fentanyl is a synthetic opioid pain reliever that is fast acting and approximately 50 – 100 times stronger than morphine (some source even estimate that it is 10 thousand times stronger). Because of its potency, Fentanyl is typically prescribed as a skin patch that is meant to release the drug slowly over the course of several days. However, individuals who are looking to increase their high sometimes scratch off the drug from the patch and add it to other drugs like cocaine or heroin, a practice that is extremely dangerous. When even tiny particles of the drug are smoked, injected or ingested there is a serious risk of overdose.
“ON THE NOD”
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Opioids including fentanyl are depressant drugs in that they slow down the messages that are sent from an individual’s brain to their body. The opioid molecule binds receptors in the brain that regulate breathing. When this happens the individuals natural impulse to breathe becomes interrupted and inhibited. Taking higher doses than the brain or body can withstand can ultimately results in respiratory depression which is commonly referred to as an overdose. When overdose occurs and if actions are not taken immediately, sustained respiratory symptoms can quickly lead to brain damage or even death.
SIGNS OF AN OVERDOSE
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Other signs include: Muscles spasms or seizures and limp body or coma.
NALOXONE
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Noloxone, which commonly goes by the brand name Narcan and others, is a medication that can temporarily pull someone out of an overdose by blocking the effects of opioids molecules in the brain. Noloxone can be injected into a vein or muscle or sprayed into the nose if the individual is still breathing. It is relatively fast acting taking only 2 – 5 minutes (depending on its administration) and its effects lasts for approximately 15 minutes to a half hour.
It is important to note that once an individual regains consciousness they still need to get medical treatment immediately. This is because opioids can remain in the brain for up to 24 hours and they can rebind to the brains receptors once the effects of Naloxone wears off. If this happens it is possible for the individual to go directly back into an overdose state. Upon awaking, individuals may also be upset that their high has been interrupted or that it has worn off. As such, they may attempt to use more of the drug which creates an even greater risk of overdose. For these reason, an ambulance should be called prior to administering Naloxone to ensure that the overdosed individual receives the proper care as soon as possible.
How to Administer Naloxone
In Canada, Noloxone kits can be obtained for free with a health card from a pharmacy. Pharmacists will typically also provide brief training on how to use the kit and administer the medication.
WHAT DOES AN ADDICT LOOK LIKE?
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There is a common misconception that addicts and drug misusers are low life individuals who are criminals and that they are unemployed and a strain on society. However, the fact of the matter is that drug addicts can really be anyone. Individuals who misuse drugs come from a variety of backgrounds and socioeconomic statuses and they became addicted to drugs for any number of reasons. Some individuals turned to drugs to overcome distressing memories related to traumatic events. Other individuals become addicted to pain relieving prescriptions that were prescribed to them by doctors.
CONCLUSION
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Opioid drugs and prescriptions are not only highly addictive but they are also vastly prevalent within our society. This is in part because of how they are promoted by pharmaceutical companies and how often they are prescribed to individuals by healthcare professionals. I think that it is important to be aware of the opioid crises and to also realize that this is an issue that goes beyond the characteristics of the individual. It is a systemic issue prevalent in Western society that is largely perpetuated by the healthcare sector. I would also like to note that this article is not meant to scare but is meant to inform and also that at this point I myself do not have an answer to the problem. Hopefully though, greater awareness of the issue will result in further dialogue that will eventually lead to some sort of resolution.
As Always, Thanks For Reading
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Image Sources 1, 2, 3, 4, 5, 6, 7, 8, 9
References:
Alcohol and Drug Foundation. (2018). Fentanyl. Retrieved from Website
Center for Addiction and Mental Health. (2018). Opioid overdose. Retrieved from Website
National Institute of Drug Abuse. (March, 2018). Opioid overdose crisis. Retrieved from Website
Vakharia, S. P. (2014). Incorporating substance use content into social work curricula: opioid overdose as a micro, mezzo, and macro problem. Social Work Education, 33(5), 692-698.