Facts on opioid
Many people have used opioid medications without problems. However, these medications have several risks and side effects, even when taken as directed.
Use of opioid medications puts patients at risk for:
- Tolerance – needing more medication to achieve the same effects
- Hyperalgesia – Increased sensitivity to pain
- Physical dependence – Having physical withdrawal symptoms when a medication is stopped
- Addiction – A chronic disease where a person cannot control use despite the harm caused
- Unintentional overdose, or death
Risk of opioid overdose increases with:
- Aging
- Living Alone
- Taking additional medications
- Higher doses of opioids
- Having multiple chronic diseases
- Getting a lung infection
- Having sleep apnea
The ability to drive or operate machinery may be impaired.
Pregnant women who are using opioids may put their children at risk.
Avoid the following while using opioids: (Unless advised by your health care provider)
Alcohol, Hypnotics (Ambien, Lunesta), Muscle relaxants (Flexeril, Soma), Sedatives/Anti-Anxiety (Valium, Xanax), Other opioid pain relievers.
- Do not take your medications in larger amounts or more often than prescribed.
- If you would like to stop your medication, talk to your doctor to get a proper tapering schedule. Stopping the medicine at once can make you feel sick.
- Many opioid medications and over-the-counter products also contain acetaminophen. Do not exceed a total of 3 gm acetaminophen daily.
- Never share or sell your medications or use someone else’s.
- Ask about Naloxone or Narcan, a medication to reverse the opioid-related overdose.
- Discuss with your health care provider:
- Your full medical and substance use history
- The medicines you are taking (prescribed, over-the-counter, herbal and alternative).
- Concerns, and medication side effects
- If you still need the medication or can take a lower dose.
- A plan for pain control, especially if you need opioids for more than 1-2 weeks.
- Non-opioid options. Some may work better and have fewer side effects.
To help prevent accidental ingestion, misuse, or overdose by others, especially children:
- Store your medications in a locked box or cabinet.
- Dispose of all your unused, expired, or unwanted medications properly. Do not flush them down the toilet.
To find disposal locations near you:
Call the Santa Clara County Health Department:(408) 792-5040
Go online:
https://dontrushtoflush.org
What are Opioids?
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Watch videoLearn to Taper - Patient Resource A
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Alternative pain management
Each year, over 200 million opioid prescriptions are given out in the US. However, recent studies have suggested that opioids may not effectively treat some types of acute or chronic pain.
An estimated 39 to 100 million Americans are experiencing chronic pain at any time. Chronic pain is defined as at least three months or more past the normal time of tissue healing. It can be intermittent, or persistent. The most common conditions that cause chronic pain are arthritis and spine conditions of the back and neck. Other common causes of chronic pain include cancer, fibromyalgia, migraines, trauma or post-surgical pain, and endometriosis.
There are many different options available for the treatment of chronic pain. Talk with your doctor about different ways to treat your pain and remember, there are 5 P's to pain treatment:
- Physical therapy and activity.
Stiffness from inactivity is a huge contributor to the cycle of chronic pain. - Personal care.
Daily meditation, gentle stretching or yoga, getting a good night’s sleep every night (without using sedatives, which can increase your risk when used in combination with opioids), setting realistic goals for yourself all contribute to the reduction of pain. - Pharmacology
This includes: topical medications (creams/patches), non-steroidal anti-inflammatory agents such as ibuprofen, acetaminophen, anti-depressants, and anti-seizure medications among others. - Psychology
Chronic pain causes many subconscious changes in the brain, affecting our thoughts and emotions and self-concept. Visiting a pain psychologist can be very helpful. - Procedures
Local injections and other minimally invasive procedures performed by a specialist physician can also be very helpful in your path to getting better pain relief.
Properly storing and disposing of your opioid and other controlled prescription medications (such as stimulants, sedatives, and sleep aids) in a locked box or cabinet can help prevent your child or loved one from recreational drug use o accidental overdose.
If you have unused, expired, or unwanted medications and need a way to safely dispose of them, you can contact the Santa Clara County Health Department, or drop them off at a medication drop-off site. Here is a list of medication drop-off sites in the area.
If you represent an organization that is interested in partnering to host a prescription drug Take-Back event, contact us.
For more information on safe disposal, go to dontrushtoflush.org.
Healthcare providers
Physicians and other healthcare providers can contribute to reducing the toll of opioid overdose through careful prescribing of opioid analgesics and monitoring patient’s response, and through identifying and effectively addressing opioid use disorder and opioid overdose.
Buprenorphine is an opioid medication approved by the Food and Drug Administration for the treatment of opioid dependence and for acute and chronic pain. Treatment with buprenorphine has been proven effective in opioid addiction, decreasing mortality by approximately 50%. Patients treated with buprenorphine show improved social functioning with increased retention in treatment (67% at one year) compared to drug-free treatment (7-25% at one year), reduced criminal activity, lower rates of illicit substance use, and reduced risk of HIV and hepatitis infection.
The Drug Addiction Treatment Act of 2000 (DATA 2000) requires waivers to prescribe buprenorphine for the treatment of opioid use disorder. This includes completing eight hours of required training and applying for a physician waiver. The Comprehensive Addiction and Recovery Act of 2016 (CARA 2016) required 24 hours of certified training for nurse practitioners and physician assistants to prescribe buprenorphine treatment.
Clinicians are capped at 30 patients the first year and 100 patients each year after, and physicians board-certified in addiction or who meet certain qualifications (24-hour call coverage, use of health information technology, registration with CURES, acceptance of third-party insurance) have an increase to 275 patients. Using buprenorphine for pain relief and not addiction treatment is not included in federal cap requirements.
Click here for more information on Buprenorphine use.
To apply for a DATA 200 waiver to prescribe Buprenorphine go to SAMSHA’s website on physician trainings.
SCCOOPP provides buprenorphine waiver trainings for any practitioner interested in obtaining a waiver. Please Contact Us for more information.
Community partners - family and friends
Watching someone you love struggle with opioid use disorder is difficult. Supporting their treatment and recovery is a huge help in overcoming opioid use disorder. Here are some tips to help if your loved one is misusing opioids:
The best way to help is to understand what they are going through. Go to our Prevention and Education to learn more about opioids and click here to learn about opioid use disorder.
Tell them you care and show support. It’s not easy to talk about addiction, but it’s important. Approach the situation with love – you probably feel angry and disappointed with their choices, but they most likely already feel the same way with themselves. Tell them you want to support their treatment and recovery, and encourage them to seek treatment at a time when they are receptive.
Go to our treatment services page or to the Santa Clara County Substance Use Treatment Services for more information on finding treatment in the area. Work to find the best treatment for them.
It’s easy to forget about self-care when you’re supporting someone with an addiction. Make sure you have a support system and look into seeing a counselor or joining a family support group.
Community partners - first responders
First responders are often the first people to assist at the scene of an emergency and include police officers, firefighters, paramedics, EMTs, rescuers, deputy sheriffs, and volunteer first responders. In an event of an overdose, it is essential that first responders are trained to look for the signs of an overdose and respond effectively. Five essential steps for first responders:
If the First Responder is not an emergency medical personnel, it is essential to get EMS or other trained professionals on the scene.
Signs of overdose include:
- Face is pale and/or clammy to the touch
- Body is limp
- Fingernails or lips have a blue or purple cast
- The patient is vomiting or making gurgling noises
- He or she is extremely difficult to arouse or is unable to speak
- Breathing is very slow or stopped
- Heartbeat is very slow or stopped
Ideally, individuals experiencing an overdose should be ventilated with 100% oxygen before naloxone is administered to reduce the risk of acute lung injury. When oxygen is not available, rescue breathing can be effective and involves the following steps:
- Check to see that nothing is inside the mouth or throat that could be blocking the airway
- Placing a hand on the person’s chin, tilt their head back, and pinch their nose closed
- Place your mouth over the person’s mouth to make a seal and give 2 slow breaths. You can use a shirt or fabric to act as a barrier between your mouth and theirs.
- The person’s chest should rise (but not the stomach)
- Follow up with one breath every 5 seconds
- Naloxone (Narcan) should be administered to any person who shows signs of opioid overdose, or when an overdose is suspected
- Go to the Rescue & Training page to learn more about naloxone administration
- Most patients respond to naloxone by returning to spontaneous breathing with minimal withdrawal symptoms
- It is essential to get the person to an emergency department after naloxone administration. Naloxone will work for 30-90 minutes. After that, overdose symptoms may return.
- Stay with the patient to monitor for signs or symptoms of overdose recurrence
Why the human brain loves opioids
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Watch videoThis is what happens to your brain on Opioids
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