As the crisis of opioid addiction has grown, so has the incidence of opioids overdose. More than 130 people die in the United States every day from some type of opioids overdose.
The epidemic of opioids addiction which has produced the opioids overdose problem is largely due to legitimately prescribed medications. This in conjunction with a general proliferation of illegal opioids has led to a dangerous situation.
In addition to the human cost of opioids overdoses, it is estimated that opioids abuse and opioids overdoses cost as much as 78.5 billion dollars a year in healthcare, loss of productivity, and criminal justice procedures.
The best way to prevent abuse and overdose is to be informed. Opioids overdoses can be prevented. In addition, there are effective treatments for opioid addiction, and medical interventions for opioids overdoses.
What are Opioids?
Opioids are a class of drugs derived from the opium poppy plant. These chemicals work in the brain and nervous system and produce a variety of effects. Since pain relief is one of the primary effects of opioid chemicals, they have found widespread use in medically treating pain.
Other effects can include a general feeling of ease and happiness—the so-called “high” people experience while using these drugs.
Side effects of using opioids include slow breathing, constipation, nausea, confusion, and extreme drowsiness. Opioids are also highly addictive.
Opioids include drugs made directly from the opium poppy. These include heroin and morphine. However, opioids also include newer synthetic chemicals derived from opioid substances. These include Oxycodone and Hydrocodone. Recently, a more powerful opioid derived synthetic called Fentanyl has been found in circulation. Fentanyl is 50- 100 times more potent than morphine.
All of these drugs are potentially dangerous and can cause a fatal opioid overdose. All of them are also highly addictive.
What Causes an Opioids Overdose?
The primary medical use for opioids is for the treatment of acute pain. Opioids reduce your perception of physical pain by binding to opioid receptors in the brain and central nervous system and inhibiting neurotransmission in the nervous system. Put simply, opioids inhibit the nervous system from its ability to perceive pain and other physical stimuli.
In order to achieve the desired effects, opioids also tend to produce feelings of euphoria, and this is why it is so frequently abused. However, opioids also reduce respiratory function, limit gastrointestinal function, and heart function.
As the respiratory function becomes diminished with increasing doses of opioids, people will experience hypoxia, or a loss of oxygen in the blood. The sedative properties of opioids can make it impossible for people to notice that this is happening. Effectively, people fall asleep due to the sedative effects of opioids and lose oxygen as their respiratory system stops functioning properly.
The problem of hypoxia becomes compounded as people develop a tolerance for opioids. People who have developed a tolerance for opioids require more of the chemicals to feel the desired effects. However, they never develop a tolerance to the effect of respiratory suppression and the hypoxia that results. Therefore, high tolerances for opioids can actually increase the likelihood of a fatal overdose.
How many Opioids does it take to Overdose?
The actual amount of any specific opioid that causes an overdose is difficult to calculate. Individual tolerances for the drugs, individual physical health, body mass index—all of these things will determine how much of a particular opioid a person can take before experiencing an overdose.
People who have developed a tolerance for opioids will require more of the chemicals to overdose. However, since so many illegal opioids, heroin, for example, have no regulated concentration, it is impossible to predict which dose, or how many doses will cause an overdose.
The minimum lethal dose (MLD) of Oxycodone is 95 pills of 4.5 mg each. But this is calculated from animal studies, and MLD is not a real indicator of an actual overdose.
Because an opioid overdose is most often unintentional, and just as often the result of a dose that cannot be predicted or properly determined, the amount of any specific opioid that causes an overdose is difficult to determine.
How to Avoid an Opioids Overdose?
Obviously, the best way to deal with an opioids overdose is to prevent it from happening in the first place. Educating people, providing proper care and medical oversight while taking prescribed opioids, and not abusing opioids will all ensure the safe use of opioid medications.
There are a number of strategies to prevent an opioids overdose.
Providers, high-risk users, and family members should be informed about the best practices for opioid use. They should also know the medically-based facts on avoiding and opioids overdose.
Access to treatment
Anyone using opioids, no matter the reason, should be aware of and have access to proper treatment for overdose. People using opioids should also have access to addiction treatment.
Anyone who is using opioids, prescription or otherwise, should have access to Naloxone. Family members and others close to a person using opioids should also have access to Naloxone. This is the first form of treatment in the event of an opioids overdose and can likely save a person’s life.
Everyone should be encouraged to call 911 in the event of an opioids overdose.
Drug Monitoring Programs
Prescribers should be informed of drug monitoring programs. These programs will check databases nationwide to see if a patient is obtaining prescription opioids from multiple sources. This can prevent access to opioid medications.
The epidemic of opioid overdoses has led to a number of measures designed to prevent overdoses. The drug monitoring programs and widespread distribution of Naloxone have arisen as a result of the opioid abuse epidemic.
Opioids Overdose Symptoms
Because an opioids overdose consists of a lack of oxygen and potentially a lack of heart function, the symptoms can be dramatic. An overdose will begin with general signs of extreme intoxication. An overdose will progress rapidly.
The following symptoms are indicative of an opioids overdose:
- Marked confusion, delirium, or acting drunk
- Frequent vomiting
- Pinpoint pupils
- Extreme sleepiness, or the inability to wake up
- Intermittent loss of consciousness
- Breathing problems, including slowed or irregular breathing
- Respiratory arrest (absence of breathing)
- Cold, clammy skin, or bluish skin around the lips or under the fingernails
It is absolutely critical to intervene immediately in the event of an opioids overdose. Call 911 and administer Naloxone when these symptoms are present.
Signs of Opioids Overdose
Before an actual opioids overdose, there are some signs of a potential overdose. Learning to recognize these signs can make it possible to get a person proper treatment before they have begun to experience hypoxia and other life-threatening conditions.
Some of the side effects of opioids will appear more pronounced as a person approaches a potential overdose. The inability to stay awake will become increasingly difficult for them to resist. Physical signs in the eyes will signal a potentially dangerous situation.
Things to watch for:
- Pupils will contract and appear small
- Muscles are slack and droopy
- They might “nod out”
- Scratch a lot due to itchy skin
- Speech may be slurred
- They might be out of it, but they will respond to outside stimuli like loud noise or a light shake from a concerned friend.
One or more of these signs means it is likely a person is about to experience an opioids overdose. Early and immediate treatment can prevent overdose.
Opioids Overdose Statistics
The epidemic of opioid abuse and overdose worldwide is staggering. There has been a combination of prescribed opioid medication and increased use of illegal opioid drugs which have combined to create a deadly situation.
Some of the statistics on opioids use and opioids overdoses are alarming:
- Approximately 275 million people around the world (5.6 percent of the global population between the ages of 15-64) used drugs at least once. Among this number, 34 million used opioids.
- An estimated 27 million people have lived with some type of opioids use disorder. The majority of these people used illegal opioid drugs.
- There were over 118 thousand deaths from opioid overdose in 2015.
- Although there are numerous effective treatments for opioid use disorder, only about 10 percent of the people living with opioids use disorders get help.
- 46 people die every day from prescription opioids overdose.
- The highest increase in opioids overdose deaths was in people 65 or older.
It is the combination of prescription opioids and illegal opioids which seems to have driven this overwhelming number of overdoses and overdose deaths. These numbers are alarming and getting worse.
Again, having a plan in place for an opioids overdose is the best way to prevent and opioids overdose fatality.
What to do in case of an Opioids Overdose Emergency?
The first thing to do in case of an opioids overdose emergency is call 911. Get help from medical professionals at the first sign of an opioids overdose.
Naloxone, or Narcan, is the primary medical intervention in the event of an opioids overdose.
Naloxone is an opioid receptor antagonist. It works by blocking the opioid receptors which bind with opioid chemicals, thus preventing them from working. Naloxone has been approved by the FDA to be administered by non-medical personnel. If you know someone who is prescribed an opioid medication you should have access to Naloxone.
Naloxone can be administered as a nasal spray. You do not need to inject the medication. It is also available to family members and caregivers.
Again, call 911. An opioid overdose is potentially fatal. Even after giving someone Naloxone they will still require medical treatment to completely stabilize their condition.
Opioids Overdose Treatment
Treating opioids overdose begins with the steps detailed above. Call 911 and, if possible, administer Naloxone.
Medical staff will stabilize a person once they are brought into an emergency room. Addiction interventions may be necessary to fully stop the progress of the overdose. This sometimes requires additional doses of Naloxone.
The most important step after a medical intervention is to get to some type of opioids abuse treatment program. There is now a wide array of treatment options. Some of these programs for treating opioid use disorder will provide medications designed to alleviate or altogether eliminate the pain of opioids detox and withdrawal.
Outpatient programs will work for people whose drug use and dependence are not too severe. These are generally people who have not been using opioids for long periods of time.
For those who are severely addicted to opioids, inpatient treatment will likely be necessary. These treatment programs will involve medical detox protocols and long-term recovery programs.
The treatment programs now available are scientifically based systems that provide one-on-one counseling combined with group counseling. These programs treat the underlying issues that may have led to addiction and teach people healthier coping skills.
Wrapping things up
The increase in prescriptions for opioids for pain over the last several years has inevitably led to an increase in opioids addiction and opioids overdose. The number of people who are addicted to opioids is now at epidemic levels.
Opioids overdoses can be fatal. Since opioids work in part by reducing respiratory function, it is easy to take too much of even prescribed medication. This will lead to respiratory failure and, if not properly treated, a fatal overdose.
It is important to bear in mind that any opioid can cause the types of overdose conditions described above. Even if you or someone you are close to is prescribed an opioid medication, the danger of overdose is just as immediate.
The first course of action for anyone taking opioids or who may be close to someone taking opioids is to be informed on the signs and symptoms of an opioids overdose.
If you are close to someone who is taking opioids, even if they are properly prescribed, you should have access to Naloxone in case of an accidental overdose.
Those who have experienced an opioids overdose should take the next step and get proper treatment for opioids use disorder and addiction.