What are Opioids?
Prescribed opioids are mainly used to help people feel less pain after surgery or accidents. When used illegally, people initially seek opioids for the “high” and "calm" they provide.
For years, doctors prescribed large amounts of opioids because researchers said patients in pain could not become addicted. We now know this is not true as tens of thousands of people in the U.S. became addicted to opioids while taking these medications.
Opioids include prescribed medications to treat pain, such as:
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Oxycodone (Percocet, Percodan, OxyContin)
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Hydrocodone (Vicodin, Lorcet, Lortab)
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Pethidine (Demerol)
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Hydromorphone (Dilaudid)
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Fentanyl (Duragesic)
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Tylenol with Codeine
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Morphine
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Tramadol (Ultram)
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Drugs used to treat addiction to opioids, such as methadone (Dolophine)
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Buprenorphine (Suboxone & Subutex)
Illegal opioids include heroin, fentanyl, opium. Prescription opioids become illegal when they are used by individuals other than the person whose name is on the prescription. It is also illegal for those who receive opioid prescriptions to take them for other purposes than the original reason for the prescription.
How do opioids affect people?
In addition to relieving physical pain, opioids can initially cause euphoria—feelings of well-being and intense pleasure, and mask emotional pain. People who regularly take substantial doses of opioids will develop tolerance, which means they must take larger and more frequent doses to feel pain-free or to feel good. In as few as 10 days, the regular use of opioids can lead to addiction—when your mind and body tell you to take opioids, even if you don’t have a medical reason to take them.
When people are addicted to opioids attempt to cut back or stop using them, they will go through withdrawal. These symptoms include intense muscle and bone pain, muscle spasms, cold flashes with goose bumps, vomiting, and not sleeping. While withdrawal is normal and difficult, a physician can help. Going through withdrawal without a plan or the aid of a doctor is called going “cold turkey.”
The problem:
People who become addicted to opioids may start taking opioids as prescribed to them by a physician and then develop a physical dependence on them. Other people may become addicted by taking opioids not prescribed to them. This is against the law and is dangerous. When prescription pills are no longer available, some may turn to illicit drugs, including street manufactured pills, or injecting heroin or fentanyl. Sharing needles and syringes to inject opioids can cause serious infections, and can spread HIV and Hepatitis C.
People who take opioids illegally are also at risk for overdosing. An overdose occurs when a large or powerful dose of opioids causes a person to stop breathing. People who take opioids with alcohol or benzodiazepines – like Valium, Xanax, and Klonopin – are at an even greater risk of an overdose because these medications and alcohol will lower their breathing rate.
Opioid overdose
A person who uses opioids and has one or more of these symptoms may be overdosing:
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Does not feel pain–they do not move when you pinch their ear or under their arm, or rub their breastbone or rub the space between their nose and upper lip with your knuckles, using pressure
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Passes out or becomes unconscious
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Cannot talk even when they are awake
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Breathes very slowly or stops breathing
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Has a heartbeat or pulse that is slow, not regular, or hard to feel
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Their body is limp
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Has a very pale, ashen or damp face or skin
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Their fingernails and lips turn blue or purple
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Makes choking sounds, or a gurgling noise
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Throws up
People overdosing may seem drunk, but don’t let them sleep it off. Take them to the Emergency Department or call 911. In North Carolina, the 911 Good Samaritan/Naloxone Access Law says people who overdose, or persons who get help for them, cannot get in trouble for having small amounts of drugs, drug supplies, or for underage drinking.
The person who calls 911 must give their name to 911, or the police, to get this protection.
A person who gets medical assistance for someone that overdoses cannot get in trouble for a parole, probation, or post-release violation, even if they are arrested. The person who overdoses is also protected.
Narcan, or naloxone, is a medication that can reverse an opioid overdose.
What is Narcan/Naloxone?
Narcan, or its generic name – naloxone – is a medication that removes opioids from sites in the brain that cause the body to stop breathing. It is completely safe, cannot cause addiction, and does not affect any body organs or systems. If it is given to a person by mistake, it will not cause them any harm.
Naloxone can be given to a person through the nose or through an injection. It typically takes two to three minutes to work and will last 20-40 minutes. When people experience overdoses due to large amounts of opioids or very strong opioids, may need a second or third dose of naloxone until the opioid leaves their bodies.
In North Carolina, there is a standing order for naloxone. This means anyone can purchase this medication at a pharmacy without a prescription. Some insurance companies cover the cost or a portion of the cost of naloxone. The cost varies by brand and whether you purchase a kit that gives naloxone through the nose or an injection.
We recommend for the families and friends of people with opioid use disorder keep naloxone at home, in the event their loved one experiences an overdose.
Anyone may administer Naloxone to a person they believe is experiencing an opioid overdose. You do not have to be a medical provider. All parties are immune from civil or criminal liability so long as they act in good faith. Naloxone is not addictive and is so safe you will not harm a person if you give them medication and it turns out they were not having an opioid overdose. Remember, Naloxone only reverses opioids, so if the person has alcohol or other substances in their system, more than likely they can wake up with the effects of that substance.