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What do you know about opioid abuse and addiction? Take our quiz to see how your knowledge compares to other students’, and find answers to questions like these:
- Is it risky to take prescription pain meds?
- Who’s at risk for addiction?
- How rare is opioid abuse among college students?
- Does opioid overdose reversal always work?
The US is experiencing a brutal opioid epidemic. In 2015, 33,000 Americans died from overdoses involving prescription painkillers, heroin, and synthetic opioids, according to the National Institutes of Health. Many opioid overdoses can be reversed with timely medical treatment, however—someday, you may be in a position to save a life. This brief guide shows you how.
The illicit use of heroin and prescription painkillers is rare among college students. Yet this epidemic is affecting demographics that were previously considered relatively immune to drug crises. “My freshman year of college, my older sister went to rehab for heroin addiction. People from all ethnicities and social classes are struggling with opioid addiction,” says a third-year undergraduate at Saint Louis University, Missouri.
In this article, “opioid” covers heroin, prescription painkillers, and synthetic opioids sold on the street. For info on getting help with abuse and addiction, see Get help or find out more.
What to do if someone may have overdosed: Call 911 immediately
- Act quickly: Most deaths occur one to three hours after the overdose, so you have a window for intervention.
- Get medical help: When people survive an overdose, it is because professional help was available. You do not need to be sure the person has overdosed on opioids (or any other substance) before calling 911. Calling 911 usually ensures quicker medical help than taking the victim to the hospital yourself.
- Tell the 911 dispatcher: Let them know if the person’s breathing has slowed or stopped and if they are unresponsive. Give the dispatcher the exact location.
- Be aware of Good Samaritan laws: In most states, people who seek help with a suspected overdose are immune from drug-related criminal charges under Good Samaritan laws (also known as 911 Immunity Laws). Your college may have similar policies (sometimes called medical amnesty). For information about your state, see Get help or find out more.
What does an opioid overdose look like?
» The signs of opioid overdose include:
- Small pupils
- Droopy arms and legs, and the inability to stand or walk
- Slurred speech
- Shallow and uneven breathing
- Being unresponsive
- Loss of consciousness
» As the window for intervening narrows, signs include:
- Pale face
- Blue lips
- Gurgling chest sounds
Could I be at risk for opioid abuse?
Opioid addiction is difficult to treat. Avoiding illicit drug use is the safest strategy. Here’s how to look out for yourself:
- If you are using a prescription opioid medication that was not prescribed to you, seek help.
- If you are using an opioid medication prescribed to you, be self-aware about your reasons: Opioid medications are prescribed for long-term pain associated with various medical issues or for short-term pain control after surgery or an injury. If you are using opioids for other reasons—e.g., to get high or buzzed—seek help.
- If you are using opioids for pain relief, and your pain is becoming more difficult to control, discuss that with your physician immediately.
- If you have a family history of drug abuse/addiction and need medication for short-term pain, consider asking your physician for a pain medication other than opioids. Having a family history of drug abuse/addiction puts you at a higher risk for abuse/addiction.
- If you are abusing opioids or may be addicted, you will need support with your recovery. See Get help or find out more (below).
Where can I get help with opioid abuse or addiction?
- Ask your physician or other health care provider for a referral to an addiction specialist.
- If you have health insurance, check the insurance company website for addiction specialists covered by your plan.
- Ask at your student health center, counseling center, place of worship, or community center about addiction assistance.
- Call your local hospital for help finding medical professionals with addiction expertise.
- Look at community directories or online for a specialist in your area: Make sure the person is licensed or certified in mental or behavioral health, or is a licensed counselor in social work or professional counseling.
- Try Narcotics Anonymous for local, free, anonymous support groups.
- Many detox centers offer free initial consultations.
- For more key info and resources, see Get help or find out more (below).
What are the options for accessing reversal treatment?
Many opioid overdoses can be reversed with treatment. The opioid reversal medications naloxone and naltrexone can be delivered via a nasal spray, by injection, or intravenously. These reversal drugs (or antidotes) are also known by various brand names (e.g., Narcan®).
Naloxone treatment can be accessed in several ways:
- At hospital emergency rooms
- Via police departments and paramedics (ambulance responders), after calling 911
- Via some fire departments
- In most states, via some trained laypeople (not medical professionals) who may have a history of opioid abuse or family members who are abusing opioids
- Some states allow pharmacies to dispense naloxone to people meeting certain criteria without a physician’s direct involvement (this is often reported as over-the-counter availability, although that term is technically incorrect)
What exactly does “unresponsive” mean?
Here’s what being unresponsive looks like, according to the Harm Reduction Coalition:
- Not answering to their name
- Not responding to information they may not want to hear (e.g., “I’m going to call 911”)
- Not responding to physical stimulation (e.g., rubbing your knuckles into their sternum, the place in the middle of their chest where the ribs meet, or pinching their earlobes)
- If the person wakes up but their breathing seems shallow or their chest feels tight, call 911 anyway
See Where can I get help with opioid abuse or addiction? in the article.
Free, confidential, 24/7 helpline (English and Spanish): SAMHSA
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—Alyssa O., California State University, San Bernardino
Here’s what I generally recommend to students:
- Go to school with ibuprofen (instead of aspirin)
- Keep a supply of acetaminophen too (Paracetamol and Tylenol are common brands)
To see why, read on.
Aspirin and ibuprofen do have quite a lot in common—I think of them as close cousins.
Aspirin is salicylic acid, a naturally occurring substance that Native Americans used to extract from willow bark. It’s an analgesic (meaning it blocks pain) and anti-inflammatory. It also inhibits platelets in the blood from clumping together. This can be a benefit, as when it decreases the risk of a blood clot after a heart attack or surgery. Aspirin can also be a risk, as it can lead to gastrointestinal (GI) bleeding (more commonly in the elderly).
Ibuprofen is a synthetic molecule based on the chemical structure of aspirin. It was originally a prescription medication, but proved safe enough that it went over-the-counter in the early 1980s. Ibuprofen is widely available in both name-brand and generic forms, as well as in combination with antihistamines or decongestants designed to treat colds or the flu. Ibuprofen shares many of the same risks as aspirin: Overuse can lead to GI bleeding or kidney damage. Occasional use, though, is generally safe. The over-the-counter doses are 200 mg a pill, which allows some flexibility in dosing.
Aspirin and ibuprofen are both useful medications for treating common pains (headaches, sore throats) and inflammation (ankle sprains). They also work nicely for the woozy headache one can get after sun overexposure.
I generally recommend ibuprofen instead of aspirin because aspirin carries the potential risk of a rare but serious condition called Reye’s syndrome. This can occur when a person under 18 takes aspirin while infected with the influenza virus (flu). Because the risks and benefits of aspirin and ibuprofen are similar, I keep it simple and recommend ibuprofen.
Acetaminophen isn’t an anti-inflammatory like ibuprofen or aspirin, so it’s not as good for musculoskeletal injuries. On the upside, it doesn’t have the risk of GI bleeding or kidney injury. It can cause liver injury if overused. The mechanism of action is different enough from aspirin and ibuprofen that it’s useful to have acetaminophen on hand too. Some pain responds better to one than the other.