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Talk about it

    Preventing heroin and opioid abuse or addiction requires communication. Physical dependency on opioids happens quickly, so talking about saying no to heroin and how to safely use prescription opioids should start early. These discussions should address the reasons people use drugs or prescription medicines, and the impact of use on the body, brain, family and community.

Talk to children

    Talk to your children about drugs, why people use them and why they are harmful. Employ age-appropriate advice and keep talking about it as kids get older. Keep in the mind the importance of modeling and discussing ways of handling stress, crises, and the ups and downs of daily life without relying on alcohol or drugs. At the same time, do positive, healthy things with your kids. When discussing drug use with your kids, remember to:

      • Focus on the facts, including how prescription medicines can be helpful to people if used appropriately.
      • Set clear rules and expectations around drug use.
      • Give kids an out – maybe a code word they can call or text if they’re in a situation they want to get out of quickly.
      • Keep the door open whenever they want to talk.

Talking to loved ones and friends

    The support of family and friends is critical to preventing opioid addiction. If prescribed opioids, let your family members and friends know. Share details about what to look for in terms of the signs of dependence or addiction, and when and how you plan to stop using.

    The National Institute on Drug Abuse has practical tips about how to talk about substance abuse with a friend or loved one, and good resources on dependency and addiction.

    If a family member or friend you know has been prescribed opioids, or if they have had a surgery, injury or chronic pain where pain medication may have been prescribed, ask if they’re using opioids and find out their plan for stopping use. Know how to get help when you or someone you know needs it.

    Familiarize yourself with the signs of overmedication: slurred speech; stumbling while walking; dizziness or confusion; excessive drowsiness or difficulty staying alert; and difficulty waking from sleep. Know what an overdose looks like – slow, shallow breathing; extreme sleepiness; inability to talk, or unconsciousness; blue or grayish skin color; dark lips and fingernails; snoring or gurgling sounds – and know how to respond.

    If a close friend or family member is struggling with addiction, ask about naloxone, a drug that blocks or reverses the effects of heroin or opioid prescriptions.


Talking to health care providers

    When given any prescription, ask about the associated risks and side effects. Explain your concerns and make sure they’re addressed by your health care provider or pharmacist. Knowing how a medicine works and affects you is particularly important with opioids. Ask why you are being prescribed an opioid, what the risks are, how much relief you can expect, what you should watch out for, and what your exit strategy is.

    Talk to your healthcare provider about the range of pain management options and request the lowest-strength medication for the shortest period of time that will work for you. Remember to tell your doctor about your health history, including:

      • Any other health conditions, including depression, anxiety and PTSI
      • Any other medications you’re taking, such as benzodiazepine
      • Previous use of opioids
      • Any substance abuse, addiction or mental health conditions in your family, as these things can increase the risk of addiction


What are opioids?

    Opioids (also called narcotics) are medications that relieve pain and are sometimes also used to suppress cough or severe diarrhea. They reduce the intensity of pain signals reaching the brain and affect those brain areas controlling the sense of well-being, diminishing the effects of a painful stimulus.
    Some examples include:

      • hydrocodone (e.g., Vicodin): most commonly prescribed for a variety of painful conditions, including dental and injury-related pain
      • oxycodone (e.g., OxyContin, Percocet): prescribed for relief of moderate to severe pain
      • morphine (e.g., Kadian, Avinza): often used before and after surgical procedures to alleviate severe pain
      • fentanyl: a power opioid that is used to treat severe pain
      • heroin: a powerful opioid that is currently illegal in the U.S.
      • codeine and related drugs (e.g. diphenoxylate (Lomotil)): often prescribed for mild pain, can be used to relieve coughs and severe diarrhea

How do they work?

    Opioids attach to specific proteins called opioid receptors, which are found in the brain, spinal cord, gastrointestinal tract, and other organs in the body. When these drugs attach to their receptors, they reduce the perception of pain. Opioids can also produce drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can depress respiration.

How are they abused?

    Some people experience a euphoric response to opioid medications, since these drugs also affect the brain regions involved in reward. Users may seek to intensify their experience by taking more than prescribed or taking it more often than prescribed, or by taking the drug in ways other than prescribed. As they abuse the drug, their tolerance to its effects increases so they need more and more to feel good. As dependency develops, the user will also use the drug to avoid the unpleasant effects of withdrawal. Find our more about the science of opioid addiction here.

How are prescription opioids and heroin related?

    Of people currently using heroin, 80% report that they started using opioids with prescription painkillers. A person who has become addicted to opioids may switch to heroin or supplement with heroin because it can be readily obtained, costs less, and is easier to prepare for injection.


Know how to use prescription opioids safely

    Talk to your health care provider in detail about how to use opioids safely. Generally, avoid any other drugs, alcohol or adjustments of dose when using prescription opioids.

      • Do not combine opioids with alcohol or street drugs.
      • Do not drink or take other medications or drugs with opioids unless your doctor has said it is OK.
      • Stop taking prescribed pain medications as soon as the doctor agrees they are
        no longer needed, but never stop or change a dosing regimen without first discussing it with a healthcare provider.
      • Always follow the prescribed directions; when taking liquid doses, use an accurate measuring device and measure out only the prescribed amount.
      • If you miss a dose, do not take a double dose to catch up.
      • Use the medication only in the form in which it’s prescribed.
      • Never take prescription medicines in the dark where you might take the wrong medication or dose.
      • Never use another person’s prescription or share your prescription with others. This is how some people addicted to opioids continue to use.
      • Do not drive a car or use heavy machinery until you have become used to the medicine’s effects.

Store and dispose of medicine safely

    Do you have leftover prescriptions, especially pain pills?

    Please get rid of unused medication promptly and safely. This protects children from accidental poisoning, and prevents theft by visitors, relatives (including teens) or strangers.

      • Most drugs should not be flushed or thrown in the trash. You can get safe disposal bags from your local public health center that deactivate certain drugs, such as opioids. All you need to do is add your medication and water according to the instructions on the bag. When you're done, the bag is safe to throw away. These bags are currently available free of charge at many State of Alaska Public Health Centers.
      • There are also spring and fall national drug take-back events in many Alaska communities. You can bring in old or unneeded prescriptions and drop them off with law enforcement, no questions asked. You can find more information here and in FDA guidelines.

    Also, don’t share your prescriptions with anyone. Half of the people who misuse prescribed opioids get, buy or steal them from a friend or relative, according to the Substance Abuse and Mental Health Services Administration.

    Keep your current prescriptions out of the reach of children and visitors and locked in a hidden place (not the medicine cabinet). Store prescriptions in their original packaging.

    Carefully note when and how much medicine you take in order to keep track of how much is left.

    If you think that someone has taken your medicine, ask the person why. If they might need help because they depend heavily on drugs, or might even be addicted, they can talk to their doctor.

    There is effective treatment for drug dependence.

    If necessary, contact the police. If someone has a problem, this might be exactly what they need to get help.

    Responsibly storing and disposing of prescriptions can save lives.