Welcome to the LINCS Panel Discussion on the Impact of the Opioid Epidemic on Adult Education
Submitted by Michael Cruse on March 7, 2019 - 7:11am
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Welcome to the first day of our two-day discussion on the impact of the opioid epidemic on adult education. We’re fortunate to be joined by long-time adult educator, Paul Jurmo, Ed.D., family & preventive medicine physician, Richard Bruno, M.D., and corrections specialist, Jeffrey Abramowitz, J.D. in examining the issues impacting our learners, families, and programs.
To begin, I’d ask our panelists to share more on their background as it relates to the topic, and ask them to respond to the two questions below. For those interested in a little background information on opioids, we have provided a brief overview of the different types of opioids, both medically prescribed and non-prescribed, and their impact on the body. These are provided from resources available from the National Institute on Drug Abuse.
1. What is unique about opioid addiction, in its short and long-term impacts on individuals, that is different from other types of addiction, such as alcoholism? What is different in the approach to treating opioid addiction than other forms of addiction?
2. Opioid addiction is a disease that alters the structure and function of the brain. Understanding how this disease impacts the brain is important for educators working with persons with a history of opioid use. What should adult educators know, and what training do you recommend programs offer their staff to help them better understand these impacts?
Background information on Opioids:
Opioids are naturally found in the opium poppy plant. Some opioid medications are made from this plant while others are made by scientists in labs. Opioids have been used for hundreds of years to treat pain.
Heroin is also an opioid but is not classified as a prescription medication. Fentanyl is a powerful prescription pain reliever that is 50 times more powerful than heroin. It is sometimes added to heroin, leading many users to overdose. One of the ways opioids work to relax your body is by slowing down your breathing. When misused, opioids can slow your breathing too much. This can cause you to stop breathing entirely and lead to an overdose. For some people, just one dose is enough to make them stop breathing.
Naloxone is used to counteract an overdose. It works to quickly block the effects of opioids. It is available as an injectable solution, an auto-injector, and a nasal spray. Some states require a doctor to prescribe naloxone, but other states allow pharmacies to sell naloxone without a personal prescription.
Our brain has receptors that receive signals from other parts of our body. Opioids attach to receptors on nerve cells in the brain, spinal cord, and other organs. This allows them to block pain messages sent from the body to the brain.
When the opioids attach to the receptors, they also cause a large amount of dopamine to be released in the pleasure centers of the brain. Dopamine is the chemical responsible for making us feel reward and motivates our actions. The dopamine release caused by the opioids sends a rush of extreme pleasure and well-being throughout the body. Over time, prolonged use of opioids causes harmful effects, like extreme sleepiness or insomnia, confusion, nausea, vomiting, muscle pain, constipation, heart infections, pneumonia, and addiction.
Prescription pain relievers and heroin are chemically similar and can produce similar effects. Heroin is sometimes cheaper and easier to get than prescription opioids. As a result, people who are addicted to prescription opioids sometimes switch to using heroin. Four out of five new heroin users report misusing prescription opioids before trying heroin.8 You can overdose on both heroin and prescription opioids. Less than 4 percent of people who had misused prescription pain medicines started using heroin within 5 years.
Opioids can show up on a drug test within hours of being taken. Opioids, including heroin, can show up on a drug test for days, and in some cases weeks, after being taken. How long they stay in your system depends on how long a person has been taking the drug, the amount of drug they use, or the person’s metabolism.
The most commonly used prescription opioids are oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, and morphine. Opioids also go by different names: oxy, percs, and vikes are slang terms for opioid pills. Common names for heroin include Big H, Horse, Hell Dust, and Smack.
The brain gets so used to the opioids that when someone stops taking them, they can go into withdrawal. Withdrawal symptoms include sweating, shaking, vomiting, sleep problems, and diarrhea. The symptoms can be so severe that it can be hard for someone to stop using opioids, even if they want to. Quitting opioids can be hard, but it is possible.
There are three Food and Drug Administration approved medicines to treat opioid addiction. Medicines like buprenorphine and methadone bind to the same receptors in the brain as prescription opioids to reduce cravings. Naltrexone is another medication that treats opioid addiction by preventing opioids from having an effect on the brain. Additionally, an old medicine called clonidine, and a newer medicine called lofexidine, help lessen withdrawal symptoms for people who are trying to stop. A combination of behavioral therapy and medication has proven to be the most effective in treating opioid addiction.