1. Opioid Overdose Crisis
What to look for and how to help

2. Norma Holtz RPH
Pharmacist The Medicine Shoppe 217 S Main St. Farmer City, IL Thank you for inviting me to the parent Academy Children in crisis – what do I look for and how to help..

3. Opioid Overdose Crisis
July 2017 the FDA announced the biggest crisis in America is an Opioid Overdose Epidemic
In 2014, almost 2 million Americans abused or were dependent on prescription opioids.2
As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.3
Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids. 4

4. Illinois 2015 Opioid Overdose Crude Mortality Rate10 (per 100,000 population)
A measure of the number of deaths due to a specific cause in each county’s population, scaled to the size of that population, per unit of time.
Population
De Witt County
16,226 (2016)

5. Data from IL Department of Public Health Aug 2017
Data from 2013 to 2016
48.8% increase in all drug overdose deaths
76.2% increase in opioid overdose deaths.
Opioids were a contributing factor in 68% of drug overdose deaths in 2013 and 80% in 2016
Heroin deaths have nearly doubled since 2013
583 deaths in 2013
1,008 deaths in 2016
Opioid analgesic deaths has almost quadrupled
344 deaths in 2013
1,233 deaths in 2016

6. What is an Opioid?
One group of drugs that provides pain relief (analgesics), suppression of cough and can be used non-medically to produce euphoria
Opioid analgesics are prescription natural and semi-synthetic products such as morphine, codeine, oxycodone, hydrocodone, hydromorphone, oxymorphone, fentanyl AND non-prescription such as Heroin
opioids are addictive and cause death
taking opioids at high doses for extended periods of time increase the risk of Opioid Utilization Disorder (OUD) also referred to as addiction
OUD characteristics include developing a physical tolerance (meaning more of the opioid is needed to get the desired effect), a physical dependence therefore resulting in withdrawal symptoms when abruptly stopping use
Addiction can begin to develop as early as 2-3 days following continuous use5
There is a direct correlation to length of therapy for first time users of prescription opioids and the outcome of long term use.
One in five patients will become a long term user after an initial 10 day supply8

7. Who overdoses on opioids?
Not just an addict, a person with an acute pain flare up, a person in recovery
Anyone taking an opioid can overdose by:
Taking more units than prescribed by the doctor, misuse
Combining with other opioids, with other Central Nervous System depressants such as alcohol, and/or other medications, abuse

8. How does an opioid cause death?
Opioids slow the rate of breathing and if it slows too much it creates severe respiratory depression.
The breathing rate for most people normally ranges from 12 to 20 breaths per minute, but it varies from person to person.
If a person’s respiration rate slows to less than 12 breaths per minute, this is an indicator that something is wrong
The lack of oxygen causes a person to first pass out and then die.

9. What are the signs of opioid overdose?
There is no one certain sign of an opioid overdose. Just remember if a person appears to be in distress and exhibits one or more of the symptoms below which is not typical for that person, then call 911:
A respiration rate of less than 12 breaths per minute
Pinpoint pupils
Acting confused
Acting drowsy and having trouble staying awake
Asking just to be allowed to go to sleep

10. Signs of opioid overdose, cont’d
Sudden mood shifts, like from happy to sad
Acting as if nothing mattered anymore
Moving slowly if at all
Experiencing nausea
Not knowing where they are
Uncontrolled vomiting

11. What signs can you look for opioid abuse?
Physical signs
Noticeable elation/euphoria.
Marked sedation/drowsiness.
Confusion.
Constricted pupils.
Slowed breathing.
Intermittent nodding off, or loss of consciousness.
Constipation.

12. What signs can you look for opioid abuse?
Other Signs
Physically getting hurt/dental pain
Shifting or dramatically changing moods
Extra pill bottles turning up in the trash, missing opioid pain relievers or short
Social withdrawal or self isolation, social network
Sudden lack of money or missing valuables

13. Video Link
content/how-opioid-painkiller- abuse-can-lead-heroin-use

14. Prevent and how to help Secure all opioid medications
Turn in unused opioids at the local police or sheriffs department that has a Controlled Substance disposal receptacle.
Do not share prescription medications
Use with caution and less is better
Understand the risks of addiction
Ask for a non addictive alternative

15. Withdrawal symptoms Flu like symptoms Headache Nausea and vomiting
Diarrhea
Sweating
Fatigue
Anxiety
Inability to sleep
Fidgety or twitchy
Sudden mood change

16. Resource Guides
samhsa.gov Substance Abuse and Mental Health Services Administration
CDC.org Centers for Disease Control
drugabuse.org National Institute on Drug Abuse
prevent-protect.org Prevent to Protect

17. CDC Vital Signs, July 2017
Substance Abuse and Mental Health Services Administration, National Survey on Drug Use and Health, 2014.
Boscarino JA, Rukstalis M, Hoffman SN, et al. Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system. Addiction 2010;105:1776–82. org/ /j x
Substance Abuse and Mental Health Services Administration. Highlights of the 2011 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. The DAWN Report. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; Available from URL: DAWN-highlights.htm
Shah, A., Hayes, C., Martin, B., (2017). Characteristics of initial prescription episodes and likelihood of long-term opioid use – United States, MMWR Morbidity and Mortality Weekly Report, 66,
Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA , NSDUH Series H-51). Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from
Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Barometer: Illinois, 2015.
IL Department of Public Health,
State of Illinois Opioid Action Plan,