The Good, The Bad, and Other Things to Know About Opioids

by George Beddow

December 2024

Opioids are a group of pain-relieving medications that come in all shapes, sizes, and complicated names, although some may be more familiar, including fentanyl, oxycodone, and tramadol. They all are safe and effective when prescribed by your doctor and used appropriately. However, opioids are deadly if misused or if too many are taken at once, referred to as an overdose.

A common assumption is that all overdoses are intentional – that is, someone took too much medication on purpose to either meet a dependency or to end their life. However, the data shows that most deaths due to overdoses are unintentional due to taking a drug too often, taking too much of a drug or taking the drug by mistake.

Information from the North Dakota state health department reveals that overdoses most commonly occur in someone's home or apartment. Other experts add that these events can also occur in many other locations where opioids may be present, including public places, in the workplace, and even in schools.

Additionally, as indicated by health department information, most overdose deaths in North Dakota are in young adult men. Once again, experts identify that another age group is particularly at risk: older adults. Why? Because the aging body processes opioids differently, resulting in a buildup of opioids to toxic levels. Memory problems that are more common with aging can also lead to accidental extra doses.

What does toxicity look like? Just as there are key signs for heart attacks and strokes, there are keys signs that may indicate too much opioid. If someone is slumped over in a chair or on the floor and appears to be in a deep sleep and can't be awakened, think too much opioid. Pulling up the eyelids to look at the pupils – the black dots in the colored part of the eye – and finding them to be pinpoint is a key sign. Breathing can be checked by visualizing the chest rising and falling. If this is irregular, slow, or absent, opioid overdose can be suspected. No matter the sign, it is important to immediately call 911 anytime someone is down and unresponsive.

When first responders arrive, they will do a quick assessment of the unresponsive person. If an opioid overdose is suspected, they'll administer a life-saving medication, naloxone. Given as an easy-to-use nose spray, naloxone temporarily reverses an opioid's impact on breathing and responsiveness. Because it only lasts for a short time, it may need to be also given as the person is transported to get more medical treatment.

While it is important to be aware of opioid use, misuse, and treatment for misuse, taking steps to prevent any intentional or accidental overdose is vital. It starts with making sure that only the person prescribed the opioid is taking the opioid. Taking another person's opioid medication could be fatal, as each prescription has instructions and a dose unique to the person needing it. In other words, someone else's medication may be excessive, causing unexpected side effects – including death. It almost goes without saying that opioids, because of their strength, should be kept from the reach of children who may take a pill out of curiosity. For additional local and state resources regarding opioid use and dependence, visit the North Dakota Department of Health website and search for information using the search term "opioids."

About the Author

George Beddow is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. He was selected as one of the Hettinger participants for the school's ROME program, or Rural Opportunities in Medical Education. Part of the ROME program teaches student doctors how rural newspapers can be partners for disseminating health information. The information presented here is not intended for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed provider.