Opioids

Opioids are the single most common drug involved in fatal poisonings. You may have seen the terms opiates and opioids being used interchangeably. Opiates are substances or drugs made directly from the poppy plant or opium and found naturally. Opioids are the larger class encompassing all drugs that work on our opioid receptors. This class includes both illegal and legal drugs such as heroin, fentanyl, oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others.

Types of opiods

Prescription opioids are often used to treat chronic and acute pain and, when used appropriately, can be an important component of treatment. However, serious risks are associated with their use, and it is essential to carefully consider the risks of using prescription opioids alongside their benefits. These risks include misuse, developing opioid use disorder, overdose and death.

Almost half of all opioid deaths in the US now involve a prescription opioid. People often assume prescription pain relievers are safer than illicit drugs because they are medically prescribed. However, when these drugs are taken for reasons or in ways or amounts not intended by a doctor or taken by someone other than the person for whom they are prescribed, they can result in severe adverse health effects, including substance use disorder, overdose and death, especially when combined with other drugs or alcohol.
Heroin is an illegal, highly addictive drug made in various forms, used in several different ways such as snorting, smoking or injecting. Many people who become addicted to opioid medications, such as oxycodone or hydrocodone, will eventually use heroin when they can no longer obtain these drugs from a doctor or other sources.
Synthetic opioids are substances that are synthesized in a laboratory and act on the same targets in the brain as natural opiates (morphine and codeine) to produce pain relief effects. One of the most common synthetic opioids is fentanyl.

Fentanyl is one of the most potent forms of opioid painkillers and used to treat patients with severe pain, especially after surgery. Fentanyl sets itself apart from other opioids due to the strength of its effects as well as the increased rates of overdose related to fentanyl use. Fentanyl comes in several forms, such as lozenges, tablets, mouth sprays, nasal sprays, patches and injectable solutions.

Illegally manufactured fentanyl is sold in powder form, dropped onto blotter paper, put in eye droppers and nasal sprays or made into phony pills that copy other prescription opioid pills (Perc 30 tablets). Fentanyl can deceptively be mixed into other drugs, like heroin, cocaine, methamphetamine and MDMA (ecstasy). You may not even realize that the drugs you are taking contain fentanyl, which increases the chances of overdose or death.

Many of these illicitly produced synthetic opioids are more potent than morphine and heroin and thus have the potential to result in a fatal overdose. Other synthetic opioids include tramadol, methadone, meperidine, carfentanil, acetylfentanyl, butyrylfentanyl, furanylfentanyl, 3-methylfentanyl and U-47700.

Who is at risk for opioid overdose

Unfortunately, when we hear “opioid overdose”, we think of someone who was using an opioid illegally to get high. There are many reasons for opioid overdose emergencies, and most often, these emergencies are accidental and unintentional. In fact, opioid overdose emergencies can even occur when opioids are used as directed. Sometimes patients who have chronic pain can overdose on their prescription medications by accident, and sometimes people without chronic pain overdose simply because they had a poor reaction to opioids.

Those at highest risk:

Take moderate to high doses of opioids
Consume other sedating medications or alcohol
Have a history of substance abuse or have recently been released from treatment or incarceration
Have access to unlocked or unsecured prescription opioids

The bottom line is that anyone who uses opioids for pain control or for recreational purposes is at risk for an opioid emergency, and any household that has opioids may be at risk.

Symptoms of an opioid overdose

An overdose occurs if you take too much of a medication, intentionally or accidentally, and begin to develop potentially life-threatening symptoms. Symptoms of opioid overdose include:

Shallow or stopped breathing
Unresponsive or found “down”
Pinpoint pupils
Lips or fingernails turning blue or purple

Call the 24-Hour Poison Help Line for Additional Support:

1-800-222-1222

Responding to an opioid overdose

An overdose constitutes an emergency that requires immediate medical attention. If you suspect an overdose and cannot wake the person, call 911. An opioid overdose can be reversed with the drug naloxone when given right away. Both emergency medical responders and members of the public can administer naloxone during an opioid overdose.

Hand holding a package of Narcan on a pink background.

Naloxone (Narcan) nasal spray

DCCCA is providing free naloxone (Narcan) nasal spray and training to community organizations and any Kansas resident: Naloxone Program - dccca.org

It is important to know there are Kansas legislation and regulations surrounding naloxone and Narcan intervention. Kansas legislation allows any patient, bystander, first responder agency or school nurse to be able to purchase naloxone from a participating pharmacy without a written prescription from a doctor. In Kansas, if naloxone is administered in good faith, the person shall not be subjected to civil liability or criminal prosecution.

Resources for substances abuse treatment

Call the SAMHSA National Helpline at 1-800-662-HELP or visit the SAMSHA’s Behavioral Health Treatment Services Locator
Obtain naloxone/Narcan to have in case of a suspected overdose.
Refer to inpatient and outpatient treatment options available in Kansas:
- Substance Use Disorder hotline: 866-645-8216
  Addiction helpline. Detox, inpatient and outpatient options including multiple programs.
- FindTreatment.gov
  Confidential and anonymous resource for persons seeking treatment for mental and substance use disorders.
- DCCCA.org
  Residential and outpatient addiction treatment programs.
- Substance Abuse and Mental Health Services Administration - SAMHSA

Poison prevention tips

Take your medicine as directed. Do not take it more frequently or in higher quantities.
Always tell your healthcare provider about all prescription and over-the-counter medications you are taking to avoid harmful combinations.
Avoid alcohol use when taking prescription opioids, as this can increase your risk of overdose.
Do not share your medicine, and only use medicine that is prescribed to you. It is against the law to share your controlled substance medication with anyone.
Store all medicines locked up, away and out of sight, especially if small children are around.
Properly dispose of medications if they are no longer needed.
Purchasing drugs online can be dangerous. They may be the wrong drug, expired or the wrong dosage. It is illegal to buy controlled substances online without a valid prescription.
Tell your family if you are taking opioids. They can be prepared with naloxone or help emergency responders understand the situation if you experience an overdose.

If you suspect a poisoning or have questions, call 1-800-222-1222.