Prescription Opioid Safety
Drug overdose continues to be the leading cause of adult injury death in the United States. The majority of overdose deaths involve prescription opioid medications. The number of overdose deaths involving opioids have nearly quadrupled since 1999, leading public health officials to declare a nationwide opioid overdose epidemic.
What Are Opioids?
Most opioids are narcotic medications used to treat pain. Opioid medications work by binding to specific opioid receptors in the brain, spinal cord, and gastrointestinal tract. In doing so, they minimize the body’s perception of pain. Opioids can also have an effect on parts of the brain and body that regulate mood, blood pressure, and breathing.
Common Opioid Medications
- Oxycodone (PERCOCET®, OXYCONTIN®, ROXICET®, etc.)
- Hydrocodone (VICODIN®, NORCO®, LORTAB®, etc.)
- Hydromorphone (DILAUDID®, EXALGO®, etc.)
- Codeine (TYLENOL #3, Cough syrups, etc.)
- Morphine (MS CONTIN®, KADIAN®, AVINZA®, etc.)
- Oxymorphone (OPANA®, OPANA® ER)
- Fentanyl (DURAGESIC®)
- Methadone (METHADOSE®)
- Buprenorphine (SUBOXONE®, BUTRANS®, SUBUTEX®, ZUBSOLV®, etc.)
Common Side Effects from Opioids
- Tolerance - needing more medication to get pain relief
- Physical dependence - withdrawal symptoms when the medication is stopped
- Increased sensitivity to pain
- Dry mouth
- Itching and poor wound healing
- Hormone imbalances
Not all opioids are prescription pain relievers. Heroin is also an opioid drug made from morphine and has the same effect on the brain and body as opioid medications used to treat pain. Heroin use is associated with many health risks, including overdose and death. It is usually inhaled or injected and rapidly enters the brain. Once in the brain, heroin is converted back into morphine.
What Is an Opioid Overdose?
Opioids, like all medications, can have adverse reactions. Opioids can cause harmful and severe reactions that slow or even stop breathing. This can happen when a person takes too much of the opioid medication or when a person mixes an opioid with another substance, like alcohol or other sedatives. Because opioids slow or even stop breathing, opioid overdoses can be fatal.
Opioid Overdose Death Is Preventable
Factors that Increase Risk for Overdose:
- Previous non-fatal overdose.
- Mixing opioids with other medications like benzodiazepines (Xanax®, Klonopin®, Valium®, etc.) or mixing opioids with alcohol.
- Opioid doses greater than 90 mg of morphine per day or 60 mg of oxycodone per day.
- Obtaining overlapping prescriptions from multiple providers and pharmacies.
- History of mental illness or history of substance use disorder.
- When opioids are discontinued and then restarted after a period of abstinence. For example, individuals who have been incarcerated or individuals returning home from substance abuse treatment are at especially high risk for overdose if opioids are restarted.
- Living in rural areas and having low income.
How to Prevent Overdose:
- Talk to your health care provider and pharmacist about all prescription and non-prescription medications.
- Do not mix opioids with alcohol, benzodiazepines, or other drugs.
- Do not take opioids more often or in higher quantities than prescribed.
- Talk to your health care provider or pharmacist about naloxone.
What is Naloxone?
- Naloxone is a safe medication that reverses and blocks the effects of opioids and can be used by anyone to treat a known or suspected opioid overdose.
- Naloxone is easy to use and available in many pharmacies in New Mexico. Ask your pharmacist how to obtain and use naloxone.
- Naloxone only reverses the effects of opioids. It will not have an effect on an overdose caused by another substance (e.g. alcohol, benzodiazepines, stimulants, etc.).
- Naloxone is usually not self-administered. Tell others about the possible need to use naloxone, how to use it, and where it’s kept in case of overdose. Ask your pharmacist how to obtain and use naloxone.
Are There Any Adverse Effects From Naloxone?
- Naloxone may cause opioid withdrawal symptoms such as: nausea/vomiting, diarrhea, chills, sweating, anxiety, and combative/disorientation. People who take opioids chronically are more likely to experience these effects.
- Opioid overdose complications, such as brain damage or death from lack of oxygen, are more alarming than potential side effects from naloxone administration.
- If naloxone is given to a person who has not taken opioids, it will not have any effect on that person.
- Governor Announces Grant to Fight Drug Overdose Fatalities (February 7, 2017)
- Substantial Improvement in National Ranking for Overdose Deaths (December 29, 2016)
- National Prescription Drug Take-Back Day (October 21, 2016)
- Opioid Epidemic: By the Numbers (Substance Abuse)
- Naloxone User Guide (Guide)
- Naloxone Dispensing Guide for Pharmacists (Guide)
- Naloxone Letter to Pharmacists (General)
- Naloxone Statewide Standing Order (Rules, Regulations & Protocols)
- Naloxone Statewide Standing Order for Schools in New Mexico (Rules, Regulations & Protocols)
- Checklist for Prescribing Opioids for Chronic Pain (Help)
- Guidelines for Prescribing Opioids for Chronic Pain (Help)
- How to Administer Intranasal Naloxone
- Substance Abuse & Mental Health Services Administration
- Prescribe to Prevent
How to Administer Intranasal Naloxone
This video provides information on overdose recognition, overdose response, and naloxone administration. Watch the How to Administer Intranasal Naloxone video for more details.