Although substance abuse of all types continues to affect the lives of individuals everywhere, opioid abuse, in particular, is a growing concern. According to the World Health Organization (WHO), “Worldwide, about 500,000 deaths are attributable to drug use.” Additionally, “More than 70% of these deaths are related to opioids, with more than 30% of those deaths caused by overdose.” We are living amidst an opioid epidemic, with opioid abuse contributing to thousands of overdoses and overdose deaths each year. As these numbers continue to grow annually, it is time to take a stand by understanding the severity of the opioid epidemic and advocating for harm reduction. Doing so will save lives.
At PCP – The Perry Clayman Project, we recognise that the opioid epidemic is stretching across the world. Further, we understand that if our nation does not take a stand against the growing opioid problem, it may certainly turn into a worldwide pandemic. Fortunately, at PCP, our staff members dedicate their lives to assisting individuals in healing from both substance and behavioural addictions. We are passionate about empowering individuals to achieve lasting healing and sobriety, free from any grips of maladaptive behaviour, to promote healthy and worthwhile living.
What Are Opioids?
The U.S. Centers for Disease Control and Prevention (CDC) explains that “Opioids are a class of drugs used to reduce pain.” They are both made directly from the opium poppy plant as well as chemically synthesised in laboratories. Most often, opioids are prescribed to individuals following surgery or injury or used to manage chronic health conditions such as cancer. However, over the last several decades, there has been a significant increase in both the acceptance and use of prescription opioid drugs for symptom management of chronic, non-cancer pain and other ailments, “despite serious risks and the lack of evidence about their long-term effectiveness,” says the CDC.
Examples of prescription opioid drugs include the following:
- Hydrocodone (Vicodin®) & Oxycodone (OxyContin®, Percocet®)
- Oxymorphone (Opana®)
- Morphine (Kadian®, Avinza®)
- Codeine
- Fentanyl
On the other hand, illicit fentanyl and heroin are examples of non-prescription opioid drugs.
When used on a short-term basis and taken exactly as prescribed by a doctor, opioid medications can be especially effective for pain management. However, the misuse or abuse of any prescription opioid or the use of any non-prescription opioid drug can pose serious risks to an individual’s health and well-being, as these drugs have incredibly high addictive potential. For this reason, it is necessary to identify warning signs of potential opioid misuse as well as learn how to identify opioid abuse and opioid use disorder (OUD).
Warning Signs of Prescription Opioid Misuse
The National Insitute on Drug Abuse (NIDA) explains that prescription drug misuse involves “taking a medication in a manner or dose other than prescribed.” In addition to using a prescription drug for a nonmedical purpose, other warning signs of prescription drug misuse include:
- Taking someone else’s prescription, even in an attempt to treat a legitimate medical complaint
- Forgetting to take a dose of a medication
- Stopping the use of a specific medication too soon
- Taking more medication than what was prescribed
Meanwhile, drug misuse becomes drug abuse when an individual uses a substance with the intent to get high.
Warning Signs of Opioid Use Disorder
According to the publication titled Opioid Use Disorder by authors Dydyk, Jain, and Gupta, “Opioid use disorder [OUD] is the chronic use of opioids that causes clinically significant distress or impairment.” OUD is a condition that affects over 16 million individuals worldwide. Furthermore, it is necessary to point out that addiction is the most severe form of any substance use disorder (SUD). Thus, OUD exists on a spectrum, with the most severe form often referred to as opioid addiction.
The CDC highlights the following warning signs of OUD and opioid addiction:
- Continuing to use opioids despite the problems it is causing on work performance, relationships, and daily life
- Multiple attempts to moderate or slow opioid use without success
- Using opioids to self-medicate
- Experiencing a growing tolerance to opioids
- Taking more opioids to treat withdrawal effects
- Stealing drugs or money to pay for more opioids
- Fearing the idea of running out of opioids
- Overdosing on opioids
Understanding the Opioid Epidemic In America
According to the CDC, America has experienced three distinct waves of opioid abuse and opioid overdose thus far – what is now known as the phases of the opioid epidemic. These waves informed undeniable ripple effects that have affected various countries across the globe, both directly and indirectly.
- First wave: 1990s – Began with increased prescribing of opioid drugs, contributing to an increased number of overdose deaths (involving both natural and semi-synthetic prescription opioids) in the late 1990s
- Second wave: 2010 – Another rapid increase in overdose deaths, specifically involving heroin
- Third wave: 2013 – “Significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl
It is also necessary to note that the COVID-19 pandemic created an optimal breeding ground for self-medicating practices, especially for the use of painkillers like opioid drugs. As a result, polysubstance use (the use of more than one drug at a time) became more common. Regardless of whether polysubstance use is intentional or unintentional, however, increased polysubstance use in and of itself is a call for concern. Moreover, some are characterising this post-pandemic era as “the fourth wave” of the opioid epidemic.
Is Europe Facing an Opioid Epidemic?
According to an article in European Psychiatry, “The opioid situation in Europe seems to be less problematic than in the US.” Contrary to this, however, the number of opioid prescription rates has still increased significantly since 2009. Regardless of whether or not the nation references the opioid epidemic specifically, there is an undeniable opioid crisis happening in Europe as well as the United States.
The article evaluated opioid use trends between 2010 and 2018, noting with-country and between-country comparisons as well as comparisons with data from the US. Despite considerable variations found between European countries, “Most countries showed increased [prescription opioid] consumption with the largest increase and the highest consumption in the United Kingdom (UK) compared to the rest of Europe and the US in 2018.” Further, Scotland had the highest rates of [high-risk] individuals who use opioids, opioid-related hospital admissions, OUD treatment admissions, and opioid-related deaths. The article also notes, “These rates were similar or even higher than those in the US in 2018.”
Possible Causes For the Opioid Epidemic
First, in reference to the first wave of the opioid epidemic, the increased prescribing of opioid medications has certainly contributed to increased opioid misuse, abuse, and addiction. In addition, as the American Journal of Public Health notes, “Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.”
One of the most common underlying drivers of drug use is general distress. Many individuals turn to alcohol and drugs like opioids in an attempt to manage, numb, treat, or cope with mental and emotional distress, often informed by trauma or stress. Moreover, socioeconomic disadvantages, mental health disorders, and more can all increase an individual’s vulnerability to self-medicate with substances.
Regardless of the initial reason why an individual was exposed to the effects of an opioid drug – either through a prescription or through experimentation with friends, for example – it is crucial to understand that their brain will quickly associate their drug experience(s) with euphoria and contentment. Thus, as the human brain is wired to seek out and motivate experiences of pleasure, they may experience urges to engage in recurrent opioid use, even when no opioid drug is available. In an attempt to ease any physical or psychological cravings, some individuals may seek out opioids illegally, such as through the street.
The Dangers of Obtaining Illicit Opioid Drugs
Those struggling with OUD and opioid addiction may see no other option than to seek out more opioids illegally. However, obtaining illicit street drugs poses immense dangers, many of which can be life-threatening. For instance, buyers can never be sure that what they are attempting to purchase is 100% pure. Most times, street drugs are contaminated or otherwise “cut” with other substances, which can affect the potency of the drug and increase profit for drug sellers.
Overdose and Overdose Death: The Silent Killer
As the CDC explains, “Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.” Referred to as the silent killer, fentanyl is undetectable by sight, smell, and taste.
When discussing the silent killer, we are not referring to the pharmaceutical fentanyl that is prescribed by doctors to treat severe pain. Rather, we are referring to illegally made fentanyl that is often added to other street drugs to make them “cheaper, more powerful, more addictive, and more dangerous,” says the CDC.
The Drug Enforcement Administration (DEA) has the following to say about contaminated street drugs, specifically those consisting of fentanyl:
There is significant risk that illegal drugs have been intentionally contaminated with fentanyl. Because of its potency and low cost, drug dealers have been mixing fentanyl with other drugs including heroin, methamphetamine, and cocaine, increasing the likelihood of a fatal interaction.
Furthermore, the DEA notes that two milligrams of fentanyl can be considered a lethal dose depending on factors such as an individual’s body size, tolerance, and past exposure to fentanyl. The CDC also notes, “Synthetic opioid-involved death rates increased by over 56% from 2019 to 2020 and accounted for over 82% of all opioid-involved deaths in 2020. Unfortunately, fentanyl is to blame for the majority of these overdose deaths.
With that said, it is also necessary to highlight that most overdoses that occur due to fentanyl or other substance contamination are considered unintentional. As more and more individuals continue to lose their lives as a result of consuming illicit street drugs, there is no better time than now to discuss the role of advocacy and harm reduction in fighting the opioid epidemic and overdose crisis.
Reducing the Risk of OUD and Opioid Abuse
It is important for all individuals to recognise the risks of using opioids – both prescription and non-prescription – as it can protect them and their loved ones from future substance misuse, abuse, and the potential development of SUD, including OUD. The CDC offers a variety of information on how to reduce any risks associated with opioid drugs. First and foremost, they note the following suggestions for preventing opioid misuse:
Taking and storing opioids properly:
- Consume medications exactly as prescribed by a doctor
- Inform doctors about any side effects or personal concerns when using opioids
- Avoid polysubstance use or taking opioids with other medications or drugs like alcohol
- Never share or sell prescription medications
- Store medications in a secure place, out of sight
- Dispose of any unused prescription opioids when treatment has concluded
Recognising signs of opioid overdose:
- Constricted pupils
- Losing consciousness
- Reduced motor coordination; limp body
- No breathing
- Discoloured skin, especially lips and nails
- Cold and/or clammy skin
- Choking or gurgling sounds
Knowing how to respond to an opioid overdose:
- Call 999 immediately
- Administer naloxone, if available
- Attempt to keep individual awake and breathing
- Lay the individual on their side to prevent choking
- Stay with the individual until emergency personnel arrive
Harm Reduction Advocacy: The Role of Naloxone In Reversing Overdose
NIDA explains, “Naloxone is a medicine that rapidly reverses an opioid overdose.” It does so by attaching to opioid receptors in the brain and blocking the effects of other opioids in an individual’s system. Further, “Naloxone can quickly restore normal breathing to a person if their breathing has slowed or stopped because of an opioid overdose.” Contrary to what some may believe, however, “naloxone has no effect on someone who does not have opioids in their system.” This medication is administered through a nasal spray, although it can also be injected into a muscle, under the skin, or into veins.
Despite naloxone becoming more widely available in the states through OTC (over-the-counter) means, it remains a prescription-only medicine in the UK. However, as gov.uk notes, “drug services can supply it without a prescription.” Said differently, Stop the Deaths highlights, “In the UK it is legal for anyone to administer naloxone to anyone for the purpose of saving a life, regardless of whether or not they have had training.”
Fortunately, there are many non-profit organisations that offer both in-person and online training for naloxone. For example, one resource known as naloxone.org.uk offers step-by-step guidelines for administering injectable naloxone. Additionally, Exchange Supplies offers a free, open-access UK training resource as a part of its “social mission to develop and improve the harm reduction response to drug use.”
PCP’s Efforts to Fight the Opioid Epidemic and Overdose Crisis
We at PCP – The Perry Clayman Project recognise the devastating reality of substance abuse and addiction, specifically when either is left untreated. For this reason, we have several treatment rehabilitation centres across the UK to help individuals recover from the challenging effects of substance and behavioural addictions. Moreover, we individualise our clients’ treatment plans to ensure that their unique needs and goals are met during treatment and throughout long-term sobriety. Some of the treatment programs we offer include:
- Primary alcohol and drug rehabilitation
- Secondary programme
- Third-stage supported housing
- Aftercare
- Support for families
In regard to the opioid epidemic and overdose crisis, we specialise in the treatment of OUD. More specifically, we are passionate about helping individuals restore their lives from the challenging harms of fentanyl, methadone, and heroin use, abuse, and addiction.
Furthermore, for loved ones working to support friends, family, and others in their addiction recovery journeys, we also provide various support in the form of 1-2-1 counselling, group counselling, and more. We are here to provide professional guidance and support, alongside peer support, as individuals and their families heal from the long-lasting impact of substance use and addiction. Moreover, we will continue to take a stand against the opioid epidemic by providing harm reduction and education to those who need additional assistance in their fight to secure lasting sobriety.
With overdose deaths reaching new annual highs this past year, it is more important than ever to recognise the severity and impact of the opioid epidemic and its impact on the lives of individuals everywhere. If you or a loved one has been exposed to opioid misuse and abuse, you are uniquely vulnerable to the harms of opioid use disorder and opioid addiction. Fortunately, treatment is available, and recovery is possible. We at PCP – The Perry Clayman Project offer a number of treatment programmes for individuals seeking recovery from substance and behavioural addictions. We are dedicated to fostering lasting sobriety in the lives of all the clients we serve. Call 08000 380 480 to learn more today.
