Opioids - Mental Health

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  1. Highly addictive prescription and illegal drugs
    1. Opioids are a highly addictive class of prescription and illegal drugs that can reduce pain and provide a euphoric feeling.
  2. Prescription opioids
    1. People who become dependent on prescription opioids — especially those with mental health conditions — sometimes go on to use heroin or other illegal opioids that are associated with a high risk of overdose.
  3. Caution about fentanyl
    1. One of the largest contributors to overdose deaths right now is fentanyl, which is a prescription drug that can be misused. Covertly produced fentanyl is also imported into the US and mixed with other illicit drugs, sometimes unbeknownst to the user.
  4. Depict opioid dangers in storytelling
    1. Tell stories that safely depict the dangers of opioids, their connection to mental health challenges, and advances in treatment and interventions that could save lives.

Storytelling Tips

Diversify Representation

  • Expand the narrative and help communities of color see hopeful stories of treatment and recovery.
  • While opioid misuse is more prevalent in the white community, Black and other BIPOC individuals have higher rates of overdose and are less likely to receive treatment.
     

Depict Effective, Realistic Help-Seeking and Treatment

  • Show people getting treatment before reaching the point of crisis, and addressing the underlying mental health conditions that can be a factor in opioid misuse.
  • In addition, find ways to highlight the effectiveness of medications to treat opioid use disorder — like methadone, buprenorphine, and naltrexone — and the overdose reversal drug naloxone, which can play a role in saving lives. 

Represent the Complex Causes of Mental Health Challenges

  • Expand the discussion beyond the addictive nature of opioids to underlying conditions that, if treated, might prevent misuse.
  • There is a documented connection between mental health conditions and substance misuse, including opioid misuse. 

Consider the Impact of Language

  • Try to use “opioid use” and “opioid misuse,” and “opioid use disorder” when possible. 
  • Previously, terms like “addict” and “drug abuse” were used to describe misuse and substance use disorder. This terminology reinforces the false narrative that substance misuse is a moral failing on part of the person struggling. 
  • For more guidelines around language, check out the language section of this guide.

Avoid Sharing Potentially Harmful Details 

  • Avoid providing any details in your story that might help viewers obtain, use, or hide usage of opioids.
  • People who are currently misusing substances or in recovery from using those substances can have impulses and cravings triggered by depictions of drug use.
  • Additionally, when stories give specifics about how opioids are inappropriately obtained, they could provide a blueprint for people struggling with opioid misuse to obtain these drugs through similar channels, including illegal means that increase the risk of dangerous substances such as fentanyl being unknowingly included. 

Snapshot

Opioids are a class of drugs that includes legal pain relievers like oxycodone, hydrocodone, codeine, and morphine, as well as illegal drugs like heroin and illicitly produced fentanyl. All of these drugs share chemical similarities and interact with opioid receptors in the body and brain.

Prescription opioids are important medical tools when prescribed by a doctor and used according to medical instructions for a short period of time. However, in addition to relieving pain, repeated use of drugs cause adaptations in the body that result in uncomfortable withdrawal symptoms after stopping use. People can develop a physical dependence on opioids even in the absence of addiction. For those who do struggle with opioid addiction, opioids also create a euphoric effect and can be very addictive, especially for individuals who experience mental health challenges and are looking for a way to escape from those difficult feelings. People with existing mental health conditions may be more likely to be prescribed opioids, and could be more likely to become dependent on them.

When a person continues to take opioids after usage has caused health issues or negatively impacted school, work, or relationships, they may have a substance use disorder (SUD). People who become addicted and can no longer get a prescription or increase their prescription may end up buying prescription opioids illegally or switching to illicit drugs like heroin. Opioids have a higher mortality rate than most substances, which is a primary reason that government agencies have deemed the opioid problem a national crisis. An estimated 128 people die from opioid overdoses every day, and fentanyl is involved in the majority of overdose deaths in America. Illegal fentanyl, a super-powerful synthetic opioid that is frequently associated with overdoses, can be mixed with other drugs, such as cocaine, heroin, methamphetamine, and MDMA (also called Ecstasy or Molly). This is especially dangerous because people are often unaware that fentanyl has been added.

One way we can address this crisis is to recognize the warning signs of opioid use disorder so we can start treating this condition — and any underlying mental health conditions — earlier. Other ways to combat this epidemic include:

  • Opening up conversations and pushing back against biases can help people experiencing an opioid-related substance use disorder speak up, understand that recovery is possible, and get help earlier.
  • Alleviating stigma by using language that reflects an accurate, science-based understanding of SUD. For people who are struggling, this stigma can reduce willingness to seek treatment, cause additional emotional distress, and even influence interactions with healthcare providers.
  • Educating medical professionals on evidence-based opioid prescribing practices and promoting alternative approaches to pain management.
  • Raising awareness of proven treatment options like methadone and buprenorphine — safer opioids that are given in controlled settings to help people detox and manage withdrawal and cravings, ideally while receiving mental health treatment.
  • Increasing access to and usage of overdose reducing drugs like naloxone that are proven effective in preventing overdose deaths and endorsed by the Surgeon General.
  • Safely disposing of unused prescription opioids. Find your community drug take-back program or your pharmacy mail-back program, or flush them down the toilet, following guidance from the Food and Drug Administration

If a person is concerned that they or someone they know might be misusing opioids, it’s important to seek the support of a mental health or medical professional to prevent complications from withdrawal and to identify and treat any mental health conditions that may play a role in the substance misuse.

Facts and Stats

Every day, 128 people in the United States die after overdosing on opioids.
Roughly 21% to 29% of patients prescribed opioids for chronic pain misuse them. Between 8% and 12% develop an opioid use disorder.
An estimated 4% to 6% who misuse prescription opioids transition to heroin.
About 80% of people who use heroin first misused prescription opioids.
The most commonly used prescription opioids are oxycodone (OxyContin), hydrocodone (Vicodin), codeine, and morphine.
The most commonly used illegal opioids are heroin and fentanyl.

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more in part 6