What are opioids?: Medications that reduce pain signals to the brain. These drugs include oxycodone (OxyContin and Percocet), hydrocodone (Vicodin), meperidine hydrochloride (Demerol), hydromorphone (Dilaudid), codeine and morphine – all available by prescription – and heroin. Fentanyl, a powerful opioid used in cancer treatment, is 25 to 50 times more potent than heroin and 50 to 100 times more potent than morphine, according to the U.S. Drug Enforcement Administration. (Music star Prince died from an accidental overdose of Fentanyl in April.)
“The illicit production and sale of this drug used to mix with heroin or even sold on its own has played a role in the increased mortality,” says Dr. Craig Allen, Rushford’s medical director. “Because it’s more potent than heroin, a user can be surprised and overwhelmed when their brain is exposed to this drug.”
What’s the difference between opioids and opiates?: Opiates are alkaloids derived from the opium poppy. Opioids are synthetic, or at least part synthetic, manufactured with similar molecules that mimic opiates.
What causes dependency/addiction?: Changes in the brain’s chemistry when opioids attach to tiny receptors on nerve cells. These opioid receptors are found in the brain, gastrointestinal tract, spinal cord and elsewhere in the body. It’s a treatable medical condition, though cravings and withdrawal can be particularly intense and often require professional treatment.
Medications used in the treatment of opioid dependency/addiction:
Narcan (Nalaxone): A powerful drug known as the opioid overdose antidote. It’s a liquid administered through a syringe or nasal spray. In 2015, when more than 60 percent of the 723 deaths in Connecticut attributed to accidental drug overdose involved opioids, state legislators passed a law allowing third parties – usually a parent or sibling of some with an opioid dependency – to get a Narcan prescription.
Opioids, while relieving pain and releasing euphoria, also slow the body. Excessive amounts, an overdose, slow breathing and heart rate to life-threatening levels. Narcan works rapidly, in 2 to 5 minutes but sometimes within 30 seconds, by blocking the opioids’ access to the nerve cells.
Narcan’s effects weaken after about 30 minutes and usually last no longer than 90 minutes. Someone who has taken massive amounts of opioids or has used methadone or other long-lasting opioid might need another Narcan dose.
Suboxone: Opioid dependency is typically treated with this drug or Methadone, supplemented by counseling and treatment programs. Suboxone (active ingredient: buprenorphine) is a partial opiate agonist, which means its effects are limited in large doses. That makes it more difficult to abuse and thus “safe” enough for patients to take home. It is not an effective treatment, however, for opioid withdrawal symptoms.
Methadone: A full opiate agonist used in cases of serious addiction. Though it may be prescribed to manage an opioid addiction, it is not a substitute for prescription opioids or heroin. Both Suboxone and Methadone activate the same neurological receptors as heroin while preventing withdrawal and relapse. Methadone, taken once a day by mouth or injection, has some of the same risks as other opioids, including abuse.
Naltrexone: Some studies, most recently in randomized trial results at the University of Pennsylvania published online in the New England Journal of Medicine, suggest this drug (Vivitrol) might be more effective than Methadone. Sold as ReVia for opiate addiction, it attaches to the opiate receptors in the brain but does not activate them. By blocking the receptors, it also neutralizes the presence of other opiates. Someone who takes naltrexone and heroin simultaneously will not get high.
For information on Rushford’s Medication Assisted Treatment Close to Home (MATCH) program that treat’s opiate dependence and drug addiction, click here.
