Opioids 101

Opioids are a class of drugs often called pain killers. Opioids differ by class, some are natural, semi-synthetic or fully synthetic. The strength of these medications can also differ.

For example, fentanyl (a fully synthetic opioid) is 50-100x stronger than morphine (a natural synthetic opioid).

Opioids can be obtained through prescriptions or purchased on the street.

Prescription opioids are prescribed for pain management. However, there are serious risks to taking these medications even when prescribed. Anyone who takes opioids can become addicted. As many as 1 in 4 people prescribed opioids will struggle with opioid addiction. Anyone who takes opioids is at risk for overdose.

The increased rate of non-prescribed use can be linked to the feelings of euphoria opioids. People tend to like the way opioids make them feel, even though some do not.

Taking prescription opioids in higher doses or for longer periods of times than how prescribed increases the risk of addiction, overdose and death.

Patients and providers should discuss the risks of opioid use and alternative therapies. If they must be used, fewer days with a lower dose is typically a safer option.

*The research article mentioned from the lecture video about teenage overdose rates doubling is here. This is not the specific study I am thinking of in the video, and Joseph has a different idea about the cause of the rate increasing so much. I did misspeak and say 2017 & 2020, instead of 2019 & 2020. There is an edit on the screen but I want to put it here as well. This research is mentioned by Joseph as well. However, I think that in reality a lot of factors are contributing to the spike in the teenage overdose rate. Joseph does an amazing job of breaking down different research to understand the spike in the rate, and I want to share that with you.

Fentanyl + Xylazine 101

Fentanyl has been used since 1968 when it was primarily prescribed as post-surgical pain management. Illicit fentanyl is the primary driver of the overdose public health crisis today. It is cheap to make, easy to acquire, and highly concentrated. It comes in a variety of colors, shapes and sizes. It is usually found in other illicitly-made drugs.

Fentanyl must be introduced to the bloodstream for someone to overdose on it.

You cannot overdose on fentanyl simply by touching it.

Fentanyl exposure can occur through inhalation, ingestion, by being introduced to the mucous membranes of the eyes, nose or mouth, or via needle stick.

Xylazine is a non-opioid central nervous system depressant. The effects of xylazine are much like those of opioids. However, because it is not an opioid, naloxone will not reverse an overdose. There has been a recent increase in overdoses related to xylazine.

Xylazine is often taken unknowingly within other drugs. It can increase the duration of the effects of other drugs. It is linked to painful skin ulcers and abscesses.

Since xylazine is typically co-injested with opioids, naloxone should still be administered. In part, this is why it is essential to call 9-1-1 when you suspect an overdose is occurring.