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Opioid Resources

Frequently Asked Questions

Opioids are a class of highly addictive drugs that act on the nervous system to relieve pain. These drugs often give people a “high” by inducing feelings of pleasure and relaxedness. After use, users are at risk to develop opioid addiction disorder, or in other words, an opioid addiction.

Heroin is a commonly used illicit opioid. Some of the most commonly used prescription opioids include:

  • Codeine
  • Fentanyl
  • Heroin
  • Hydrocodone (Vicodin, Norco)
  • Methadone
  • Morphine
  • Oxycodone (Percocet, OxyContin)

Anyone who takes an opioid for a prolonged period of time is at risk of opioid use disorder, which amplifies the risk for overdose.

You are at risk for an opioid overdose if you…

  • have a history of substance abuse or non-fatal overdoses
  • have certain medical conditions like liver or lung disease, HIV or depression
  • mix opioids with alcohol or benzodiazepines like Xanax, Ativan or Valium that make you sleepy
  • take high doses of prescription opioids
  • inject opioids
  • smoke cigarettes or have a respiratory illness
  • do not know the strength and dosage of prescription opioids or the purity of street drugs
  • Recently completed a detoxification program or been released from
  • incarceration, which lowered your opioid tolerance

An opioid overdose has symptoms like…

  • Loss of consciousness
  • Non-responsive to outside stimulus
  • Awake, but unable to speak
  • Breathing is very slow and shallow, or has stopped completely
  • Choking sounds, or the “death rattle”
  • Blue or gray tint

If you think someone is overdosing, the best practice is to call 9-1-1 and administer naloxone.

Naloxone is a non-addictive prescription medication used to reverse an opioid overdose. Specifically, naloxone reverses the depression of the central nervous system and respiratory system, which allows an overdose victim to breathe. Naloxone has no downside, because the drug has no negative impact if opioids are not present, but will work immediately if opioids are present. It can be administered by anyone by injection into the muscle or vein, or by nasal spray.

Naloxone is available as prescription medication, and some states, including Texas, allow the reversal agent to be distributed to the public without a prescription from a physician via a standing order.

A naloxone rescue kit can be obtained from a community pharmacy or via community distribution and education programs. Pharmacies like Walgreens, CVS and Walmart have committed to stocking and providing kits. Most insurance plans including TX Medicaid will pay for naloxone rescue kits or you can pay cash.

Prevalence data on Opioid RX or deaths and articles on general impact 

  • Brady KT, McCauley JL, Back SE. Prescription Opioid Misuse, Abuse, and Treatment in the United States: An Update The American journal of psychiatry 2016;173:18-26. First published on 2015/09/05, 10.1176/appi.ajp.2015.15020262.
  • The Sentencing Project. Opioids: Treating an Illness, Ending a War. Washington, DC: The Sentencing Project, 2017

  • Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration., 2016

  • Reid MC, Henderson CR, Papaleontiou M et al. Characteristics of Older Adults Receiving Opioids in Primary Care: Treatment Duration and Outcomes Pain medicine (Malden, Mass) 2010;11:1063-1071. 10.1111/j.1526-4637.2010.00883.x.

  • Harbaugh C, Malani P, Solway E et al. Older Adults' Experiences with Opioid Prescriptions: Institute for Healthcare Policy and Innovation, 2018.

  • Centers for Disease Control and Prevention. Evidence-Based Strategies for Preventing Opioid Overdose: What’s Working in the United States. 2018.

  • Hedegaard H, Miniño AM, Warner M. Urban–rural Differences in Drug Overdose Death Rates, by Sex, Age, and Type of Drugs Involved, 2017. In. Vol 345. Hyattsville, MD: : National Center for Health Statistics; 2019.

  • Drug and Opioid-Involved Overdose Deaths- United States, 2013-2017 
  • Texas Health & Human Services Comission: Maternal Mortality and Morbidity: The Role of Drug Overdoses

Other Articles/Books/ Webinars 

  • Papaleontiou M, Henderson CR, Jr., Turner BJ et al. Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis Journal of the American Geriatrics Society 2010;58:1353-1369. First published on 2010/06/11, 10.1111/j.1532-5415.2010.02920.x.

  • Benson W, Aldrich N. Raising Awareness and Seeking Solutions to the Opioid Epidemic’s Impact on Rural Older Adults. Arlington, VA: Grantmakers In Aging, n.d.

  • Grantmakers In Aging. Heartache, Pain, and Hope: Rural Communities, Older People and the Opioid Crisis -An Introduction for Funders. Arlington, VA: Grantmakers In Aging, n.d.

  • Eccleston C, Fisher E, Thomas KH et al. Interventions for the reduction of prescribed opioid use in chronic non-cancer pain The Cochrane database of systematic reviews 2017;11:Cd010323. First published on 2017/11/14, 10.1002/14651858.CD010323.pub3.

  • Els C, Jackson TD, Kunyk D et al. Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews The Cochrane database of systematic reviews 2017;10:Cd012509. First published on 2017/10/31, 10.1002/14651858.CD012509.pub2.

  • National Academies of Sciences, Engineering, and Medicine. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington, DC: The National Academies Press; 2017.

  • National Academies of Sciences, Engineering, and Medicine. Integrating responses at the intersection of opioid use disorder and infectious disease epidemics: Proceedings of a workshop. Washington, DC: The National Academies Press; 2018.

  • National Academies of Sciences, Engineering, and Medicine. Advancing therapeutic development for pain and opioid use disorders through public–private partnerships: Proceedings of a workshop. Washington, DC: The National Academies Press; 2018.

  • National Academies of Sciences, Engineering, and Medicine. Pain Management and Prescription Opioid-Related Harms: Exploring the State of the Evidence: Proceedings of a Workshop in Brief. Washington, DC: The National Academies Press; 2016. 

  • National Paralysis Resource Center. Understanding Pain Medication. In. Pain Medication Education Series 1: Administration for Community Living; 2019
  • The American Institutes for Research. What I Want My Doctor to Know About How Arthritis and Chronic Pain Affect My Everyday Life. The American Institutes for Research; 2019
  • Practical Implications: Opioid-Affected Births to Rural Residents 

Medical Education 

  • Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2016.

  • Dowell D, Haegerich T, Chou R. Guideline for Prescribing Opioids for Chronic Pain - United States, 2016 Centers for Disease Control and Prevention, 2016.

  • The Vera Institute of Justice. Corrections-Based Responses to the Opioid Epidemic: Lessons from New York State’s Overdose Education and Naloxone Distribution Program. Fact Sheet. New York, NY: The Vera Institute of Justice, 2018.

  • Reid MC, Eccleston C, Pillemer K. Management of chronic pain in older adults BMJ (Clinical research ed) 2015;350:h532. First published on 2015/02/15, 10.1136/bmj.h532.

  • Association of American Medical Colleges. How Academic Medicine is Addressing: The Opioid Epidemic. Washington DC., 2019.

  • Dowell D, Haegerich T, Chou R. No Shortcuts to Safer Opioid Prescribing. New England Journal of Medicine. 2019. Accessed May 2, 2019

  • National Academies of Sciences Engineering and Medicine. Medications for Opioid Use Disorder Save Lives. In. Washington, DC: The National Academies Press; 2019.

Treatment Strategies

  • Agerwala SM, McCance-Katz EF. Integrating Screening, Brief Intervention, and Referral to Treatment (SBIRT) into Clinical Practice Settings: A Brief Review Journal of psychoactive drugs 2012;44:307-317.

  • Padwa H, Urada D, Antonini VP et al. Integrating Substance Use Disorder Services with Primary Care: The Experience in California Journal of psychoactive drugs 2012;44:299-306.

  • Center for Substance Abuse Treatment. Substance Abuse Treatment for Adults in the Criminal Justice System. Treatment Improvement Protocol (TIP) Series 44. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.

  • Rogers E, Mehta S, Shengelia R et al. Four Strategies for Managing Opioid-Induced Side Effects in Older Adults Clinical geriatrics 2013;21. First published on 2013/04/01.

Policy Statements

  • Carter M. Behavior Management of Justice-Involved Individuals: Contemporary Research and State-of-the-Art Policy and Practice. Washington, DC: National Institute of Corrections, 2015.

  • National Institute on Drug Abuse. Treating Opioid Addiction in Criminal Justice Settings. North Bethesda, MD: National Institute on Drug Abuse, 2017.

  • Brinkley-Rubinstein L, Zaller N, Martino S et al. Criminal justice continuum for opioid users at risk of overdose Addictive behaviors 2018. First published on 2018/03/17, 10.1016/j.addbeh.2018.02.024