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    Opioid Resources

    Opioid use disorder (OUD) is complex. We have curated a list of links and resources from experts in the field. From prevention and treatment to NARCAN, for community support groups or the science behind medically assisted treatment (MAT), see below.

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    Opioid Treatment

    Diagnosis and Treatment of Opioid Use Disorder

    If you suspect someone you care about has been misusing opioids, there are multiple resources available.

     

    For Minors

    Often the first step will be your pediatrician, who can order a urine drug screen or know local treatment centers with screening experts. A great resource is this Risk Assessment Survey. Originally created to assess minors, it is a great reference to learn more about the risk factors for your specific situation.

    SAMHSA's National Helpline

    If you are worried about yourself or another adult, the resources on the US government's Substance Abuse and Mental Health page are excellent. Hotline below:

    Website - https://www.samhsa.gov/
    Call - 1-800-662-4357
    Text - 435748

    Acute Overdose

    Download the OpiRescue App - The free overdose prevention and response tool that complements Naloxone distribution and use. Available for Android and iPhone.

    Naloxone (Narcan®) - Naloxone (Narcan) is a medication that stops opioids from working in seconds. It can be inhaled, sprayed up the nose, or given with an injection.

    Where to find and how to use Narcan - If you want to keep Narcan as a part of your at-home safety plan, this website will help you find where you can purchase it. 

    Naloxone Response Training - Train yourself on how to dispense Naloxone in the event of an overdose. Learn the signs for when the treatment is working and what to do next. 
     

    Medication-Assisted Treatment

    Medications used for opioid use disorder (MOUD): Because opioids target the brain's reward centers much more powerfully than other substances, medications blocking the reward centers are recommended. Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies leads to successful recovery for up to 95%, in contrast to fractional success with therapy alone. Learn more about medications that can help in recovery. 

    Buprenorphine - Suppresses and reduces cravings for opioids.

    Methadone - Reduces opioid cravings and withdrawal and blunts or blocks the effects of opioids.

    Naltrexone - Blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria.

    Opioid Prevention

    50% of opioid misuse starts with leftover unused pills. Keeping pain pills around the house "just in case" can lead to accidental overdose or OUD before you know they're gone. When teens or young adults try to take alcohol, adults notice. Remembering how many pills were in a bottle in a drawer from a surgery three years ago is less likely to be obvious.

    Reduce the risk.

    To reduce the quantity of at-home opioids left in medicine cabinets, the DEA hosts a Drug TakeBack Day event. Between these events, they also have a collection site locator available on their website.

    Home Disposal

    If take-back options are not feasible, the FDA recommends flushing opioids on FDA's flush list down the toilet to remove them from the home as soon as possible. You can also purchase RX Destroyer on Amazon. RX Destroyer absorbs and neutralizes the active ingredients and allows for safe and secure disposal of medications.

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    • Who's at risk? What we know so far.

    • Feeling euphoria with first opioid exposure
    • While most people feel sleepy with opioids, some feel extremely intense dopamine effects: motivation, popularity, happiness, well-being. Research on these feelings differentiates this "euphoria" from the pain relief. One 2022 study of people who misused opioids found that euphoria (and slurred speech!) with their first opioid dose was overwhelmingly correlated with later OUD. The question of whether there is a feeling of euphoria with opioids is rarely asked, so we can't know prospectively how much that feeling or being a rapid metabolizer (see below) matters. 
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    • Post-surgical Patients

    Different studies use different definitions, but a common one is continued opioid use 90 days after surgery. By this definition, on average 6.5% of people develop OUD after surgery. Risks vary by study, but often include: people taking opioids before surgery; duration of the prescription (risk starts going up after 3 days of home use); history of depression or use of benzodiazapines; fear of pain; history of trauma; history of substance abuse.  

    • Rapid metabolizers
      "About 15 percent of people metabolize opioids so quickly, they get a rush of euphoria beyond not caring about the pain. This reward stimulus then wears off quickly, so they notice pain again too soon to take another pill." The liver metabolism can't explain all of the opioid risk, but is part of the genetic picture. Dr. Baxter's advocacy op-ed.

     

    Reward Deficiency Genetics

    Reward deficiency syndrome (RDS) is a term Kenneth Blum used in 1995 to describe people with genetically low dopamine experiences, leading to susceptibility to depression and addiction to substances like opioids that activate dopamine receptors. David Borsook also notes that chronic pain can mis-wire the dopamine system, a state called "anti-reward" that can amplify reward deficiency. There are many different genes involved, but this is the reason family history matters so much.

    • Take a Risk Assessment from Partnership to End Addiction
    • The Partnership to End Addiction is a leading organization dedicated to addiction prevention, treatment, and recovery. Their risk assessment is designed to help parents assess if their child has or is at risk for opioid use disorder (OUD). 
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    • Continued Reading

    • Opioid FAQs

    • Am I at risk for opioid use disorder?
    • Risk factors for opioid use disorder vary on genetic and lifestyle factors. Home use of oral opioids begins increasing risk after three days. Many studies find no difference in pain relief after minor surgery when using home opioids or using over the counter medications and a pain plan, so if you have a family history, plan alternate pain relief options. A pain relief workbook is available free here.
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    • Someone in my family has an opioid use disorder, and I need surgery. Should I avoid any opioids in the hospital? 
    • Because IV opioids after trauma or surgery result in lower risk of PTSD or chronic pain, they should be considered separately from the risk of using opioids at home. Studies find relief from intense pain is different from the euphoria that can be a signal of risk for OUD. Discuss ways to minimize opioid use and eliminate opioid use once you're discharged with your surgeon.

    • What should I do to avoid opioid use disorder?
      To prevent opioid use disorder, you can look to opioid alternatives, and ask about long-acting lidocaine or blocks after surgery. View this page to see some resources for where to start.

    • My friend has been using pills from his parent's medicine cabinets. Can he die from withdrawal? Withdrawal is extremely unpleasant, but unless there are underlying medical conditions it is very rarely fatal. Consider finding an adult you trust to talk to his parents about your worry.
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    • Is my state receiving opioid funding from settlements?
    • View this link for a full list of State Participation with National Opioid Settlements from the National Opioid Settlement. 

    • How is opioid money being spent?
    • Several organizations are working to track this. View the ongoing list by the Appalachia Opioid Remediation Group.  

    Recovery & Support

    FindTreatment.gov lists various facilities across the country. If you're in the State of Georgia (our home state) you can try the Addiction Alliance of Georgia. They provide clinical services and resources for many facing various kinds of addiction. Start Your Recovery also has a list of treatment centers, support groups, and counseling programs in Georgia and the broader US.
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    • Find a Narcotics Anonymous Meeting Near You
    • Founded in 1953, Narcotics Anonymous is a global, community-based organization of those in recovery. On their site, you can locate a meeting near you or an organization to find resources in your area. 
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    • Join Young People In Recovery
    • YPR chapters support people in or seeking recovery by providing the following services: an alternative peer group, life-skills workshops, regular recovery meetings, and pro-social activities. 
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    Community support for those impacted

    After loss: Finding Meaning - The 6th Stage of Grief - David Kessler, grief expert who wrote with Elisabeth Kubler-Ross, lost his son to an overdose.

    Support for Families Affected by Addiction
    The Hazelden Betty Ford Foundation provides treatment for substance abuse disorder (as well as opioid use disorder) while supporting the whole family—including spouses, parents, caregivers, siblings, and children. 

    Find an Al-Anon or a Nar-Anon Meeting Near You
    Al-Anon is the group that supports the family members and community of people with alcoholism. (Alcoholics Anonymous is a different organization that helps people recover from alcohol misuse.) Because Al-Anon has been around such a long time, many opioid/narcotic websites suggest Al-Anon as a good support for people impacted by someone else's narcotic use, too. Although Nar-Anon also supports family members and the community of people with a wider range of addictions. The best option is the one with the meetings and a support group nearest you.

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      • Attend an Online Support Meeting for Parents or Caregivers of Children Using Substances
      • Hosted by The Partnership to End Addiction, these free online support groups are hosted by specially trained parent coaches, with clinical oversight. The organization focuses on empowering families, advancing effective care, shaping public policy, and changing culture. The support meetings can be themed or tailored for specific situations, such as grief groups. 

      • Post-Surgical Support

      • Pain Care Labs has an extensive home workbook as part of a What Works for Pain plan, with evidence-based ideas to learn more about.

      • Christopher Wolf Crusade (CwC) Pain Management Information
      • CwC has its own Care Coach to help patients through recovery. Care Coaches teach non-pharmacological pain management techniques and help craft pain plans as well as provide resources to the recovered and those who are helping through recovery.
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