Preventing Opioid Overdose and Accidental Death

01/31/2014

Opioid deaths have nearly doubled between 2001 and 2010,(1) largely because the number of people using, misusing, and abusing illicit and prescription opioids has been on the rise. Health care providers have increasingly been prescribing opioids for the treatment of pain at an alarming rate – fourfold since 2001(2). With that comes an increased risk of overdose and accidental death – and a significant public health problem that SAMHSA recognizes.

Last fall SAMHSA released the Opioid Overdose Prevention Toolkit to address overdose by educating and engaging key audiences. Within 36 hours of the toolkit’s release, it became the second most downloaded resource on the SAMHSA website – a testament to both need and usefulness. A comprehensive resource, the toolkit targets specific constituents and professionals as important points of intervention to prevent overdose, recognize the symptoms of overdose, and respond if opioid overdose has taken place.

What are Opioids?

Opioids include commonly prescribed drugs such as morphine, codeine, methadone, oxycodone (OxyContin®, Percodan®, Percocet®), hydrocodone (Vicodin®, Lortab®, Norco®), fentanyl (Duragesic®, Fentora®), hydromorphone (Dilaudid®, Exalgo®), and buprenorphine (Subutex®, Suboxone®), as well as illegal drugs such as heroin.

Who Should Use the toolkit?

The Toolkit provides information and simple strategies based on current science for five distinct audiences:

Facts for Community Members (487KB, PDF) helps local governments, community organizations, and private citizens develop sound policies and practices to help prevent opioid-related overdoses and deaths.
In Five Essential Steps for First Responders (455 KB, PDF), paramedics, EMS, police, and other helpers find steps to respond to an overdose – including how to use the drug naloxone, which can reverse the effects of an overdose – and provide other life-saving assistance.
In Information for Prescribers (356 KB, PDF), physicians and other health care professionals receive information about the risks of opioid overdose, as well as clinically sound prescription strategies for opioids as well as ideas to educate and monitor their patients who receive opioids in order to minimize the risk of overdose.
The Advice for Patients (306 KB, PDF) section of the toolkit empowers patients by helping them understand how to use opioid medications safely and minimize the risk of overdose.
The Recovering from Opioid Overdose (317 KB, PDF) section provides resources for overdose survivors and family members to help them recover from the trauma of overdose and become advocates for prevention.

Thoughts from SAMHSA

At a press conference to release the toolkit, Kana Enomoto, SAMHSA Deputy Administrator, said, “Opioids can be a valuable part of medical treatment. However, in addition to reducing the perception of pain, they also affect other body systems that affect breathing, heart rate, and blood pressure. Opioids can be harmful or fatal if taken in a larger or more frequent dose than usual, or when taken along with alcohol or certain other drugs.” Those taking opioids may not be aware of the risks and complications, which is one important component of the toolkit. Robert Lubran, Director of the Division of Pharmacologic Therapies at SAMHSA said, “There has been a steady increase of reported deaths resulting from opioid overdose. The medical and behavioral health communities can benefit from tips and strategies to recognize and address the problem.” By targeting five key audiences involved with this issue, the intent is to raise awareness and greatly reduce the adverse effects.

Treatment as Prevention

Effective treatment can reduce the risk of overdose and help to address misuse or addiction concerns. An evidence-based practice for treating opioid addiction is the use of FDA-approved medications, along with counseling and other supportive services. Physicians with addiction treatment training may also be helpful on the road to recovery.

Tactical Plans to Address Opioid Overdose

The toolkit was developed by multiple organizations, led by the Association of State and Territorial Health Officials together with the National Association of State Alcohol and Drug Abuse Directors and the American Association for the Treatment of Opioid Dependence, in collaboration with SAMHSA. In addition, SAMHSA sponsors a regular national teleconference with representatives from federal, state, and local public health offices along with academicians, overdose prevention programs, law enforcement, and HIV health care providers to discuss emerging trends of drug use that affect risk factors for opioid overdose as well as ways to get the toolkit to the target populations. To learn more about how you can prevent and address opioid overdose in your family or community, download the Opioid Overdose Prevention Toolkit.

Topic Discussions

Resources

Centers for Disease Control and Prevention (CDC), National Center for Health Statistics. CDC WONDER Online Database, 2012.
Harvard Medical School. Painkillers fuel growth in drug addiction: Opioid overdoses now kill more people than cocaine or heroin. Harvard Mental Health Let. 2011; 27(7):4–5.