LIU Informatics

Signs of an opioid overdose include:

Not waking up or responding to voice or touch

Breathing that is very slow, irregular or has even stopped

Center part of the eyes become very small or “pinpoint pupils”

Fingernails and lips turn blue or purple

A slow heartbeat and weak pulse

Continue watching this video for more information on Naloxone- reversal agent for opioid overdoses.

Source: Youtube

The word opioid is derived from the word opium - opioids have been formulated to replicate the pain-educing properties of opium. 

When you take opioids they trigger the release of endorphins, these are brain neurotransmitters that cause a feel-good sensation. For those who are prescribed opioids for pain relief, perception of pain is altered and feelings of pleasure are increased. 

The problem starts with consistent use of these drugs, some may feel that they cannot go about their day without their daily dose. Users will ultimately realize that when you take opioids repeatedly over time, your body slows its production of endorphins. This means that the same dose os opioids stop producing those feel-good feelings the person was used to feeling. This is called tolerance. This is a reason that opioid addiction is so common amongst users- people who develop a tolerance  feel the need to up their doses in order to bring that flood of good feelings back. 

Doctors today understand the risk of addiction and the risks that opioids pose therefore they are not easily increasing doses, nor are they fast to renew prescriptions. Opioid users who think they need these drugs turn to illegally obtained opioids. This includes buying pills off street dealers, heroin, or fentanyl. 

It may seem a little backwards that the person who initially prescribed these medications is the same person that can help one facing addiction but, if you or anyone you know are having trouble talk to your doctor about treatment. It is not advised to stop opioid use abruptly, without the help of a doctor. 

One of the main ways of preventing an opioid overdose from occurring is through the recognition of the signs and symptoms. If you are trained in the use of Naloxone, it is important to recall what signs to look for with persons who may be experiencing an overdose.

According to the CDC, some signs include:

-       Pinpoint pupils- small and constricted pupils

-       Severe Lethargy or Loss of Consciousness

-       Slow, Shallow Breathing with a respiratory rate less than 10

-       Limp body

-       Pale, blue, or cold skin

If you suspect someone might be overdosing:

1.     Initiate the emergency response system by calling 911.

2.     Administer Naloxone, if available.

3.     Once administered, try to keep the person awake and breathing.

4.     Reorient the person as they might be unaware of their surroundings or that they overdosed in the first place.

5.     Lay the person in a side-lying position to prevent choking.

6.     Wait for arrival of first responders before leaving the patient.

- Saaeed U.

In order to decrease the amount of lives stolen by opioids and for those who have been affected to be compensated, attorneys have begun to sue the manufacturers of these drugs. According to the Drug Watcher Organization, "the drug makers and their associates purportedly downplayed the risks and overstated the benefits of these medications caring only to inflate their profits." These attorneys are asking for financial reimbursement from those who knowingly put individuals at risk with these prescription medications. This includes the drug companies, distributors of the drugs, and, in some cases, medical experts.

Some legal battles have already been won or settled:

Purdue Pharma agreed to pay a $19.5 million settlement over allegations of unlawful marketing of OxyContin (oxycodone) in 2009.

Insys Therapeutics were found guilty of illegally promoting their drug Subsys (fentanyl) in 2017. The drug maker settled for $4.45 million after the State of Illinois brought the case in front of a court.

In 2016, the United States Department of Justice found that Cardinal Health violated the Controlled Substances Act in Maryland, New York and Florida and forced it to pay $44 million. In 2017, the state of West Virginia filed a litigation accusing the wholesale distributor of flooding the country with painkillers, reaching a $20 million verdict shortly thereafter.

Illinois won a lawsuit against a drug maker after of unlawfully promoting the medication Subsys. In 2017, Cardinal Health paid $20 million after the state of West Virginia filed a litigation claiming the wholesaler flooded the state with narcotics between 2007 and 2012.

There are still currently hundreds of pending lawsuits involving opioids.

Source: Drug Watcher

The opioid epidemic is a crisis that is continuously affecting everyday lives and crippling individuals and families. Just this year on January 12, 2019 one man died and 12 people were hospitalized in Northern California. Authorities has deemed this incident as a mass casualty overdose of the powerful narcotic fentanyl. The incident took place early morning where officers received a 911 call to a house where the victims were found overdosed on a synthetic opioid. According to the fire department this exposure to the synthetic opioid is imported on the black market from Mexico and China and is used as a filler in heroin and other street narcotics.

The responding officers gave patients six doses of the opioid antidote naloxone while also administering CPR. Two of the responding police officers became ill and treated at the hospital. This mass overdose included victims from the age of 19 to 30; authorities say the incident took place due to the ingestion of fentanyl in combination with an unknown substance. The fire chief described it as a “large, mass casualty incident.” The police captain says that the residence where the incident took place is now being treating as a hazmat site and the narcotics task force is determining the source of the drug. This incident is unfortunate and heartbreaking to see the continuous tragedy of this epidemic, you can’t help but to also think about the police officers who responded and fallen ill shortly after. They did not ingest the drug but simply were exposed it. According to the National Institute of Drug Abuse, fentanyl is a very powerful synthetic opioid that is 50 to 100 times more potent than morphine. The focus on opioid overdose is imperative and requires strategic intervention that will help reduce fatal opioid overdoses.

Opioid use and overdoses have increased tremendously through the years, especially in New York City. Opioid overdose results in severe respiratory suppression that can be fatal if left untreated. Narcan works by reversing those symptoms. Studies show that when naloxone and overdose education are available to community members, overdose deaths decrease in those communities. We as nursing students believe that increasing the availability of Narcan and treatment is critical to ending the opioid epidemic. Luckily, we have the privilege  at our University to attend a training class, which we believe is amazing and beneficial to our communities . Anyone can get trained in administering Narcan, just check out your states DOH website for upcoming monthly class. 

Get trained!!  It only takes one person to save a life <3

By now we have all heard of the opioid epidemic that is currently taking our country by storm. Nobody is safe from its wrath, the use and abuse of drugs does not discriminate. It’s important that we understand how it all started.

1991: This is the first wave- Opioid involved deaths began to spike and for this we can blame the over prescribing of opioid and opioid-combination medications for the treatment of pain. Pharmaceutical companies were reassuring prescribers that the risk of addiction to these drugs were very low. With very little data to back up these claims 86% of patients being prescribed these drugs were suffering from non-cancer related pain.

2010: The second wave- Around this time there was a significance decrease in the prescribing of opioids, people were dependent upon them but unable to get  prescriptions from their doctors. Enter: Heroin. Cheap, potent, and readily available on the streets. Similar effects to the prescribed opioids users were getting from their doctors. Deaths related to heroin overdoses increased dramatically. 

2013: The third wave- Increased amount of deaths due to synthetic opioids like fentanyl. 50-100 times more potent than heroin. It is made illegally and cheaper than heroin- hence why so many users are finding it cut into their drugs.

Our country is in serious turmoil ... On average, 130 American die every day from an opioid overdose. Even more interesting is that 80% of people who are using heroin first misused prescription opioids. This is a serious public health crisis with unavoidable consequences. 

Photo Credit: Evdokimov Maxim | Shutterstock