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end youth opioid abuse

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The facts

 

what you need to know:

You have probably heard a lot about the “opioid overdose crisis” in the news lately. But what are opioids? And why are they such a problem?

 

You might not realize this, but if you have had a sports injury, dental work, or surgery, it is possible you're doctor gave you a pain reliever that was actually an opioid medication. While opioids can be very effective at treating pain, they can be very addictive and should only be used under a doctor’s careful watch.

 

In addition to opioids given to you by a doctor, they're is another kind of opioid you have probably heard about called heroin. Heroin is a very dangerous drug that is usually used by injecting it directly into a vein with a needle. The chemical makeup of heroin is the same as that of pain relievers and both can be very addictive and cause deadly opioid overdoses. In fact, 2.14 million people ages 12 and older had an opioid use disorder in 2016, including 153,000 12- to 17-year-olds.

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What are opioids?

Opioids are naturally found in the opium poppy plant. Some opioid medications are made from this plant while others are made by scientists in labs. Opioids have been used for hundreds of years to treat pain, cough, and diarrhea.

The most commonly used prescription opioids are oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, and morphine. Heroin is an opioid, but it is not a medication. Fentanyl is a powerful prescription pain reliever, but it is sometimes added to heroin by drug dealers, causing doses so strong that people are dying from overdoses.

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SAFE OPIOID PRESCRIBING

Medical professionals play a key role in facilitating the proper use of opioids. The following resources promote the responsible and effective use of these medications in the treatment of pain.

 

Proper Use of Opioids

 

Improving Opioid Prescribing
Opioid prescribers can play a key role in stopping the opioid overdose epidemic. Assessing risk and addressing harms of opioid use can save lives.

 

Clinical Guidance for Selected Common Acute Pain Conditions
Evidence-based clinical practice guidelines, available for selected common acute pain conditions, and can assist clinicians and patients in making safer, effective pain management decisions.

 

CDER Conversation: Pediatric pain management options
Physicians often must rely on their own experience to interpret and translate adult data into dosing information for pediatric patients. However, the manufacturer of the pain management drug OxyContin conducted a study to obtain pediatric-specific information on the safe use of drugs in pediatric patients.

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Opioid overdose

 

Opioid use can lead to death due to the effects of opioids on the part of the brain which regulates breathing. An opioid overdose can be identified by a combination of three signs and symptoms:

  • pinpoint pupils;

  • unconsciousness; and

  • difficulties with breathing.

 

Worldwide, about 0.5 million deaths are attributable to drug use. More than 70% of these deaths are related to opioids, with more than 30% of those deaths caused by overdose. According to WHO estimates, approximately 115 000 people died of opioid overdose in 2017. Opioid overdoses that do not lead to death are several times more common than fatal overdoses.

 

The number of opioid overdoses has increased in recent years in several countries, in part due to the increased use of opioids in the management of chronic pain and increasing use of highly potent opioids appearing on the illicit drug market. In the United States of America the number of people dying from opioid overdose increased by 120% between 2010 and 2018, and two-thirds of opioid-related overdose deaths in 2018 in the USA involved synthetic opioids, including fentanyl and its analogues.3

 

Fentanyl is a potent synthetic opioid that is used as a pain reliever and as an anaesthetic. It is approximately 50-100 times more potent than morphine. Fentanyl in various formulations is on the WHO Model List of Essential Medicines. However, fentanyl and its chemically-similar analogues (including carfentanil, acetylfentanyl, butyrfentanyl, and furanyl fentanyl) have been associated with a spike in deaths from opioid overdose. There is evidence that drug dealers may be adding fentanyl to increase the potency of their products (such as heroin) and selling fentanyl as counterfeit tablets, created to look like authentic prescription medications. Therefore, many users who test positive for fentanyl and its analogues do not realize that they took the substance.

 

Risk factors for opioid overdose

 

There are a number of risk factors for opioid overdose. These include:  

  • having an opioid use disorder;

  • taking opioids by injection;

  • resumption of opioid use after an extended period of abstinence (e.g. following detoxification, release from incarceration, cessation of treatment);

  • using prescription opioids without medical supervision;

  • high prescribed dosage of opioids (more than 100 mg of morphine or equivalent daily).

  • using opioids in combination with alcohol and/or other substances or medicines that suppress respiratory function such as benzodiazepines, barbiturates, anesthetics or some pain medications; and

  • having concurrent medical conditions such as HIV, liver or lung disease or mental health conditions.

 

Males, people of older age and people with low socio-economic status are at higher risk of opioid overdose than women, people of young age groups and people with higher socio-economic status.

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what are Prescription Opioids

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness.

Side Effects

In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of side effects, even when taken as directed:

  • Tolerance—meaning you might need to take more of the medication for the same pain relief

  • Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped

  • Increased sensitivity to pain

  • Constipation

  • Nausea, vomiting, and dry mouth

  • Sleepiness and dizziness

  • Confusion

  • Depression

  • Low levels of testosterone that can result in lower sex drive, energy, and strength

  • Itching and sweating