What’s an opioid?

Correct! Wrong!

Opioids are drugs that mask pain. They do this by reducing the brain’s ability to perceive pain signals.

Since opioids are so effective at doing their job, they’re commonly prescribed in cases of moderate-to-severe pain. The body sends a message to the brain that it’s hurting, but an opiate temporarily keeps the message from getting through. For the most part, opioids do a great job in this respect. The downside is that they can have other side effects users may find enjoyable — like euphoria, extreme happiness, or a release from anxiety.

Opioids come with a high risk of developing a substance use disorder.

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Prescription opioids are most often prescribed

  • post-surgery,
  • after an injury, or
  • for serious ongoing health conditions like cancer.

Despite serious health risks to the community (and a startling lack of evidence about long-term effectiveness), there’s been a dramatic increase in the acceptance and use of prescription opioids to treat non-cancer pain. Conditions like osteoarthritis and chronic back pain are prime examples of this.

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Which of the following is NOT an opioid?

Correct! Wrong!

Adderall is a prescription amphetamine, and it works as a stimulant. A stimulant has the opposite effect on the nervous system from an opiate. It works to elevate a user’s blood pressure, increase alertness, and speed up the heart rate. Stimulant misuse can cause extreme restlessness and agitation. So does withdrawal.

While Adderall benefits many, it also has the potential for developing a substance use disorder.

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Oxycodone, Percocet, and heroin are all opioids.

Which of these is true about people with a substance use disorder?

Correct! Wrong!

Most medical associations, including the American Medical Association and the American Society of Addiction Medicine, define substance use disorder as a disease.

Diseases most of us are familiar with are things like diabetes, cancer, and heart disease. We know that a combination of factors causes each of those:

Behavioral
How did the person who got sick live pre-illness? Did they eat well, get enough sleep, and exercise?

Environmental
Did they have access to good food, shelter in a safe environment, and basic medical care?

Biological
What is their family makeup and medical history? Are they genetically predisposed to being sick? 

Substance use disorders don't differ from any other disease. Behavioral, environmental, and biological factors come into play. Genetic risk factors only account for about half the odds of someone developing a substance use disorder.

Early decisions to use drugs typically reflect an active choice on the user’s part. The brain of someone with a substance use disorder doesn’t allow the luxury of choice, though. Substance use disorder changes the way a user’s brain and body functions.

Untreated substance use disorder often leads to other health problems — both mental and physical — that get worse without attention. Long-term substance use disorders can be severe, disabling, and life-threatening. 

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Just like other chronic diseases, a substance use disorder may involve cycles of remission and relapse. Substance use disorders are progressive, and can lead to disability or premature death. It’s a disease that causes the sufferer to pursue the substance that rewards the brain and brings relief no matter what.

If that substance doesn’t show up, everything goes haywire. Biological, psychological, social, emotional, and spiritual systems are impaired until the person with a substance use disorder can either beat the craving or satisfy it.

Substance use disorders shows themselves via

  • the inability to consistently abstain,
  • issues with behavior control,
  • overwhelming cravings,
  • little self-awareness,
  • ongoing use despite negative results,
  • rocky relationships, and,
  • irregular emotional responses. 

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Which of the following is NOT a sign of opioid use?

Out of all the signs to look for, one of the most obvious and reliable is pinpoint pupils.

Pupil constriction is a common side effect of medication. Small pupils in normal levels of lighting could indicate narcotic misuse.

(For reference, the average adult pupil measures 2–4 mm in bright light and about 4–8 mm in the dark.)

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Show hint
Correct! Wrong!

Which is a sign of opioid overdose?

Correct! Wrong!

Opioid overdose causes a condition called cyanosis where the fingers and lips turn blue. Cyanosis happens when a victim loses the drive to breathe and oxygen levels in the blood drop dangerously low. 

If oxygen starvation continues, it eventually stops other vital organs like the heart and the brain, which leads to unconsciousness. Within 3–5 minutes without oxygen, brain damage begins, followed by coma and death.

With opioid overdoses, surviving or dying depends wholly on breathing and oxygen. 

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Opioids are known as depressants because they inhibit the central nervous system. In an overdose situation, the body goes overboard on suppressing the central nervous system. Everything slows way, way down: breathing, heartbeat, awareness. The body has the potential to relax itself right into death.

There’s also potential for Toxic Brain Injury.

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The powerful synthetic opiate Fentanyl is how many times stronger than heroin?

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Fentanyl is 25–50 times more potent than heroin.

Pharmaceutical fentanyl was developed as a pain-management patch for cancer patients. Word got out that it’s the strongest opioid out there, so now fentanyl is often diverted for street use. Much of the fentanyl being used on the street is manufactured in China and sent to the US as a street drug, it is not the fentanyl that is used in hospitals.

Dealers add it to heroin to bump its potency, or to con buyers into thinking they’re getting a purer grade of heroin. Users don’t know they’re getting product laced with fentanyl. As a result, fentanyl-related deaths are on the rise.

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What drug is used to revive people from an opioid overdose?

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NARCAN® isa medication that can temporarily stop or reverse the effects of an opioid or heroin overdose. It’s the FDA-approved nasal spray version of naloxone hydrochloride, is approved for use in adults and children, and is easily administered.

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Most accidental overdoses occur in a home setting. NARCAN® was developed with that in mind, and specifically for situations where little to no medical training exists. Friends, family, and caregivers can deliver life-saving treatment while waiting for first responders. 

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Over time your brain develops a tolerance for opioids so you have to take more for the same effect.

Correct! Wrong!

An opioid can make your brain and body believe the drug is necessary for survival. As your body becomes accustomed to the dose you’ve been prescribed, it ‘learns’ to make the pain signal louder. You may find that you need even more medication to relieve the pain or achieve well-being, which can lead to dependency. 

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Opioids change the chemistry of the brain. Taking them over a long period of time produces dependence, so that when you stop using, you experience physical and psychological symptoms of withdrawal. 


Dependence and substance use disorders aren’t the same thing. Everyone who takes opioids for an extended period will become dependent, while only a small percentage also experience the compulsive, continuing need for the drug that equals a substance use disorder.

It’s perfectly legal to share your opiate prescription with someone else.

Correct! Wrong!

Of course not. Your prescriptions are only for you, especially the ones that are controlled substances. 

Federal and state law prohibits the sharing of controlled substances (which is what opioids are).

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(a)Schedule II substances

Except when dispensed directly by a practitioner, other than a pharmacist, to an ultimate user, no controlled substance in schedule II, which is a prescription drug as determined under the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 301 et seq.], may be dispensed without the written prescription of a practitioner, except that in emergency situations, as prescribed by the secretary by regulation after consultation with the Attorney General, such drug may be dispensed upon oral prescription in accordance with section 503(b) of that Act [21 U.S.C. 353(b)]. Prescriptions shall be retained in conformity with the requirements of section 827 of this title. No prescription for a controlled substancein schedule II may be refilled.

21 U.S. Code § 829.Prescriptions, https://www.law.cornell.edu/uscode/text/21/829

People who take opiates report getting their supply most often via

Correct! Wrong!

Most people — adolescent and adult — admitting to recent nonmedical use of opioid medications get them via family or friends.

The underlying intent is usually good: A survey of people who shared their opioids found that the majority wanted to help someone manage pain. 

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A study based on young, urban heroin users interviewed in 2008 and 2009 saw similar results. The study found that 86% had used opioid pain relievers recreationally or nonmedically before their IV drug use. The reported sources of those opioids?

  • family
  • friends
  • personal prescriptions

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As of the2017 National Survey on Drug Use and Health, 6 million Americans misused controlled substances in the form of prescriptions. According to the study, we can trace most of those prescription misuses straight to the home medicine cabinets of friends and family members.

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You will have withdrawal symptoms if you take opiates for a long period of time and stop.

Correct! Wrong!

Withdrawal from opiates can occur any time long-term use is stopped or cut back. That’s because opioids cause physical dependence. 

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Opiate drugs like prescription painkillers and heroin can cause withdrawal symptoms within hours of the last dose. Those symptoms can last upwards of a week (sometimes longer). While unassisted withdrawal isn’t typically life-threatening, it can lead to relapse. 

A medical detox is supervised and can make relapse less likely. The overall goal is to implement new behaviors in place of learned substance use disorder behaviors. Things that a medical detox provides — like medication and therapy — give someone with a substance use disorder the tools and time to heal. 

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Which of these is not a common symptom of opioid withdrawal?

Correct! Wrong!

One early symptom of withdrawal is insomnia. Other early symptoms that may also interfere with sleep include:

  • agitation
  • anxiety
  • muscle aches
  • watery eyes
  • runny nose
  • sweating

Later withdrawal symptoms can include:

  • abdominal cramping
  • diarrhea
  • dilated pupils
  • goosebumps
  • nausea
  • vomiting

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Other symptoms include depression, persistent anxiety, and opiate cravings.

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Which of the following is a safe disposal method for prescription pain pills?

Correct! Wrong!

Drug Take Back Day events provide the opportunity for Americans to get rid of expired or unneeded prescription drugs.

They also serve as an opportunity to prevent substance use disorders and overdose deaths. 

The 2017 National Survey on Drug Use and Health tells us that 6 million Americans misused controlled substances in prescription form. According to that study, the medicine cabinets of their friends and family members are the source of most of that prescription misuse.

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Drug Take Back Days benefit the environment, too. Using sinks and toilets to get rid of medications can contaminate our groundwater and waterways. Wastewater treatment plants can’t remove lots of the compounds found in medications. When meds get flushed or put in a landfill, the drugs that become part of the environment get consumed by fish and wildlife.

It’s crucial to public safety to dispose of prescriptions and expired over-the-counter drugs in a responsible way. The easiest way to do that is a local take-back event.

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Opiates are not addictive if taken as prescribed by a doctor.

Correct! Wrong!

Even regulated use of opiates can shift into misuse. Having a prescription for an opioid doesn’t mean it’s less addictive or that you aren’t at risk for developing a substance use disorder. 

Opioid misuse can escalate fast . That’s because opiates are appealing to the body, specifically the nervous system. They bind to opioid receptors on cells found in the brain, spinal cord, and other organs, specifically targeting those involved with feeling pain and pleasure. Then they activate those receptors. This can lead to a strong potential for a user to want to repeat the experience.

In cases of opioid use disorders, the punishment for not producing the desired substance is putting the body through withdrawal symptoms. Some of them are brutal. The intense, focused craving for more opioids is one of the worst aspects, weaving itself through and around everything.

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Disturbing statistics about opioid misuse have the U.S. medical community rethinking their treatment approach. Healthcare professionals across the United States are taking active steps to slash the growth of opiate misuse. Some methods used are:

  • Providing patient education on responsible use
  • Encouraging non-opioid treatment options
  • Implementing drug-monitoring programs to watch for signs of dependence

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More people die from drug overdoses than car accidents in Virginia each year.

Correct! Wrong!

An average of two Virginians die every day from a prescription opioid or heroin overdose. That’s a frightening and sobering statistic.

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In their report on unintentional, preventable injuries, The National Safety Council tells us that for the first time in U.S. history, someone’s more likely to die from accidental opioid overdose (1 out of 96) than a car wreck (1 in 103). 

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Addiction to opioids can occur as soon as:

Correct! Wrong!

Five days can lead to a lifetime of struggling with an opioid use disorder.

Surprised? You shouldn’t be. Opioids are a class of drug that includes powerful prescription painkillers like oxycodone and hydrocodone as well as illegal drugs such as heroin and fentanyl. Using them for only five days causes a sharp increase in the likelihood for long-term use. 

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What percentage of people misused prescription pain meds before moving on to heroin?

Correct! Wrong!

80% of heroin users misused prescription opioids first, according to data as early as 2011.

Prescription opioid pain medicines like OxyContin® and Vicodin® feel similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use. 

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How many people died from drug overdoses in the US in 2017?

Correct! Wrong!

In 2017, there were 70,237 drug overdose deaths in the United States.

From 1999 to 2017, overdose deaths more than tripled, with the most explosive period occurring from 2014 to 2017. Opioids cause 67.8% of all drug-related deaths, most of which are males. 

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The younger you are when you take an opiate the more likely you are to become addicted.

Correct! Wrong!

Young adults from 18 to 25 are the biggest misusers of prescription drugs (to include stimulants, opioid pain relievers, and anti-anxiety meds). It’s a dangerous practice: In 2014, over 1,700 young adults died from prescription drug overdoses. That was more than died from any other drug, including heroin and cocaine combined.

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Who has a role in preventing opioid misuse?

Correct! Wrong!

Everyone has a part to play in preventing opioid misuse and addiction.

EVERYONE HAS A ROLE:

  • Everyone has a role in education
  • Everyone has a role in prevention
  • Everyone has a role in recognition
  • Everyone has a role in consequences
  • Everyone has a role in compassion
  • Everyone has a role in treatment
  • Everyone has a role in support and sobriety

We can ALL help fill an important role preventing opioid overdose deaths through education, partnership, and collaboration.

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