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Open Collection of Student Writing (OCSW)

Opioids Kill More Than Just Pain

A new epidemic has struck the state of Utah. However, it is not a virus, bacteria, or other pathogen. It is a mental disorder called addiction. Addiction to prescription opioids resulting in physical dependency, increasing tolerance with every use and eventually death due to overdose.

Death from overdose is something which is preventable one hundred percent of the time. Therefore, citizens, CEOs, and lawmakers alike must take every action possible to make sure death from overdose never happens. The solution begins with prevention. The number of opioid prescriptions needs to be substantially reduced, or eliminated altogether. This can be done in various ways. Additional restrictions to the criteria of obtaining a prescription must be put into effect. Also, the public must be provided with better education about alternate methods of pain relief, as well as more encouragement to use those methods. Finally, we need to educate everybody about Naloxone (a drug designed to reverse or stop an overdose). Some make the argument that addiction and overdoses are a result of irresponsibility on the part of the user, and if used only as directed, opioids are not dangerous. However, this argument is mistaken because physical dependency teamed up with the body’s ability to build up a tolerance suggests that even when used as directed, opioids are extremely dangerous; and can easily lead to death.

Infographic showing heroin's affect on dopamine

Figure 1 (“Visualization of Dopamine in the Brain”)

According to The National Institute on Drug Abuse, opioids are a type of narcotic that interacts with opioid receptors on nerve cells in the brain, and is used primarily to alleviate pain (NIDA). When the chemicals attach to the receptors, they inhibit negative feelings such as pain and produce dopamine, which creates pleasurable feelings associated with reward. Negative effects include, but are not limited to: Slowing down the function of the respiratory system as well as being extremely addictive. Examples of opioids would be Oxycontin®, Vicodin®, Fentanyl and even Heroin (“Opioid use is a Utah Epidemic”). Most people know Heroin is bad, while still falsely believing prescription opioids are not.

Molecular structures of heroin, oxycodone, and hydrocodone

Figure 2 (“Chemical Composition of Heroin vs. Legal Opioids”).

Yes, Heroin is a type of opioid; and if more people knew that opioids and heroin are essentially the same thing, the public attitude toward prescription opioids would be much different. The most prominent difference between Heroin and any other opioid is its legal status. Even someone who is not a chemist can see how similar the chemical composition of Heroin is to those of other common opioids, such as Oxycontin® and Vicodin®. Therefore, in a situation involving addiction, cravings for the opioid “high” can be satisfied with Heroin.

Infographic describing other drugs used with heroin

Figure 3: Heroin use is part of a larger substance abuse problem (“Vital Signs”).

Because cravings for an opioid “high” can be satisfied with the use of Heroin, it is not uncommon for those with a prescription to resort to Heroin. In fact, 80% of Heroin users began with prescription opioids (“Stop the Opidemic”). Consequently, those who are addicted to prescription opioids are put at a substantially higher risk of developing a heroin addiction as compared to those who do not use prescription opioids (“Vital Signs”). So, how do we prevent addiction?

Red hand in "stop" position with "Rx" printed on it

Figure 4 (“Use Only as Directed)”

Many people believe that addiction arises from irresponsibility of the user, and that if everybody is responsible and simply uses their prescription as directed, they are at no risk of addiction or overdose. However, this belief is mistaken because avoiding addiction is much more complicated than that because of the body’s development of physical dependency on the drug as well as a tolerance to the drug. “Opioids trigger a release of chemicals in the brain that reduce the perception of pain. The brain may become accustomed to the heightened stimulation, demanding the unnatural levels to dull pain and feel pleasure, even when people take the drug as prescribed” (“Stop the Opidemic”). So, it is now clear that using as directed still puts users at substantial risk for addiction, and subsequently overdose. Therefore, prescriptions need to be avoided as much as possible, if not eliminated completely; and our absolute last resort for pain relief.

Painting of hand reaching up out from a pile of pills

Figure 5 (“Opioid Addiction”) Trigo.

Although addiction and dependency are different, they are often intertwined. Dependency is characterized by the brain’s slowing, or ceasing of the natural production of dopamine due to the continuous synthetic production coming from opioids. Therefore, the brain becomes dependent on the opioids for those chemicals. Whereas addiction is defined as repetitive, compulsive behavior despite harmful consequences (“Stop the Opidemic”). Addiction is often fueled by cravings as well as avoiding withdrawal. Withdrawal occurs when the body has built up a physical dependency on the drug, and the user stops supplying the brain with these chemicals.

Spilled bottle of pills on floor with human hand laying in background

Figure 6 (“Overdose”)

When one repeatedly uses an opioid, whether that be due to a prescription or an addiction, that person’s body begins to build a tolerance to the drug. Tolerance is characterized by the body becoming accustomed to the continual heightened stimulation, and starts to require more substance to get the same feeling. In other words, two pills are now required to feel the same effect as one pill had when the user first started. Often times, this is the reason people end up taking lethal doses. Overdose occurs because opioids depress the part of the brain which controls the respiratory system; therefore, when too much is ingested at once, the person may stop breathing and die (“Stop the Opidemic”).

Chart of drug poisoning deaths in Utah counties from 2002 to 2014

Figure 7 (“Prescription Opioid Deaths”)

This graphic depicts the rise of drug-related overdose in Utah from 2002 to 2014. The maps show the individual counties within Utah. The darker read a county is, the higher the number of deaths by drug poisoning. During that period, deaths caused by drug overdose increased at an alarming rate. Today, Utah is ranked 7th in the United States for drug overdose deaths, and prescription opioids are responsible for more deaths than any other category of drug, even illegal drugs. 6 people in Utah die every week from opioid overdose (“Prescription Opioid Deaths”). So, how do we effectively combat this crisis?

Judge's gavel resting on desk with books

Figure 8 (‘Legal Action).

One step that should be taken against opioids would be to create new legislation that would add restrictions to opioids. For example, the passing of laws which strengthen the criteria for a prescription and/or the duration of an opioid prescription. Another possibility would be to penalize those who produce and sell opioids with extra taxes or fines, if they exceed production of a certain amount. Ultimately, our lawmakers have the power to significantly impact this crisis; it is their responsibility to act.

Hands massaging a person's back

Figure 9 (“Massage Therapy”)

Another way individuals can fight the epidemic is to seek out alternative methods of pain relief before resorting to the use of opioids. There are countless methods practiced by cultures all around the world, many of which are much safer than opioids. A few examples are massage therapy, acupuncture, yoga and exercise. It is even recommended that one try supplements like Tylenol® or various forms of Ibuprofen before asking for opioids.

Syringe drawing liquid from a vial

Figure 10 (“Naloxone”)

Finally, if one has tried every method they can think of to manage their pain, and opioids seem to be the only thing that works, they must be sure to always have a dose of Naloxone within reach. Naloxone is a drug which is designed to reverse the respiratory depression caused by an overdose; likely saving their life. The Utah State Legislature passed a law in 2014 which allows pharmacists to prescribe Naloxone to a third-party individual who is close to an individual who may be at risk of an opioid overdose. This law also allows third party individuals to administer Naloxone to someone who has overdosed with no legal liability (“Prescription Opioid Overdoses”). Anybody who uses opioids must educate themselves, their family, and anybody else they regularly associate with about Naloxone. There is no excuse to not have it around.

In conclusion, death from opioid overdose has become a crisis in the state of Utah. Since the beginning of the millennium, rates of drug poisoning death in Utah have skyrocketed. However, these deaths are entirely preventable, and it is the responsibility of us all to do our part in assuring they are. Our representatives must use their influence to make real change; while we, the people, can make an impact by doing everything we can to stay educated on the matter, and avoiding opioids altogether. It’s time to say “no” to opioids.

Works Cited

“Chemical Composition of Heroin vs. Legal Opioids.” Advocates for the Reform of Prescription Opioids, Advocates for the Reform of Prescription Opioids, 2017, (Figure 2).

“Legal Action.” Addiction Blog, Addiction Blog, 2 Apr. 2017, (Figure 8).

“Massage Therapy.” Expert Beacon, ExpertBeacon, 2017, (Figure 9).

“Naloxone.” Utah Naloxone, Utah Naloxone, (Figure 10).

NIDA. “Opioids.” National Institute on Drug Abuse, , Accessed 13 Oct. 2017.

“Overdose.” Sober Recovery, Sober Recovery, 2017, (Figure 6).

“Prescription Drug Overdoses.” Prescription Drug Overdoses, State of Utah, 2014,

“Prescription Opioid Deaths.”, Utah Department of Health, Apr. 2017, Accessed 20 Oct. 2017. (Figure 7).

“Stop the Opidemic.”, Utah Department of Health, 2016, Accessed 13 Oct. 2017.

Trigo, Javier Maria. “Opioid Addiction.” Medical Consultant’s Network, Medical Consultant’s Network, 2017, (Figure 5).

“Use Only as Directed.” Use Only as Directed, Use Only as Directed, 2017, (Figure 4).

“Visualization of dopamine in the brain.”, Sober Media Group, 2017, (Figure 1).

“Vital Signs.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 July 2015, (Figure 3).

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