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Addressing Overdose Risks with Informed and Empathetic Approaches in Substance Use Treatment
February 8, 2024
Understanding the dangers associated with these substances is crucial for informed decision-making and seeking appropriate help. Illicitly manufactured fentanyl and other synthetic opioids are commonly found in counterfeit pills made to resemble prescription drugs. This deceptive practice increases the risk of unintentional exposure to these potent substances. Fentanyl is often added to other street drugs like methamphetamine or cocaine, amplifying the danger of overdose. Veterans and other individuals using such unregulated drugs may unknowingly consume synthetic opioids, heightening the risk of a life-threatening overdose.
Regarding opioid use, it's important to acknowledge the potential for both therapeutic and harmful effects. Some side effects from opioids can lead to reduced saliva production, resulting in dry mouth, and may cause constipation. A critical aspect of opioid use is the development of tolerance—where the body becomes accustomed to a certain dose, necessitating higher doses to achieve the same effect. This phenomenon is part of physical dependence, which includes both tolerance and withdrawal symptoms. Withdrawal from opioids can be intensely uncomfortable, presenting symptoms like vomiting, diarrhea, and severe anxiety. While not typically fatal, withdrawal can lead to severe dehydration, posing significant health risks.
It's essential to differentiate physical dependence from addiction. Physical dependence is a physiological response and does not necessarily indicate an opioid use disorder. For instance, individuals taking opioids for chronic pain management or those using methadone or buprenorphine in opioid use disorder treatment may experience withdrawal if they abruptly stop or significantly reduce their medication. This reaction is a manifestation of physical dependence, not necessarily indicative of an opioid use disorder. The rise of stimulant use, especially methamphetamine, in the United States since 2009, marks a new phase in the ongoing overdose crisis. This surge follows previous increases in overdoses linked to prescription opioids, heroin, and illicit fentanyl. A concerning trend is the concurrent use of stimulants and opioids, often unbeknownst to the user due to the unregulated nature of these drugs. This dual use significantly increases the risk of overdose.
Methamphetamine and cocaine overdoses, or “overamping,” can occur without opioid involvement and can affect multiple organs simultaneously.
Symptoms may include cardiac issues like chest pain or palpitations, psychiatric symptoms such as agitation or delirium, and physical signs like seizures or strokes. Factors like lack of sleep, poor nutrition, and dehydration can exacerbate these risks. For veterans grappling with substance use disorders, comprehensive and veteran-centric treatment centers like Valor Lakes are here to help. Our facilities offer personalized IOP (Intensive Outpatient Program) treatment, focusing on trauma-focused therapy, relapse prevention, and life skills development. The goal is to guide veterans through a courageous transformation towards lasting recovery, acknowledging their unique challenges and providing a supportive, structured, and accountable environment for rehabilitation.
Understanding the risks associated with unregulated drug use and the complexities of addiction is a critical step toward recovery and long-term health and well-being. Understanding how an overdose occurs is crucial in addressing the escalating crisis of drug-related fatalities, especially among veterans who may be at a heightened risk due to various factors. An overdose happens when the quantity of a drug consumed exceeds what the body can metabolize or handle. This overconsumption can disrupt the normal functioning of vital organs, including the brain. For example, an opioid overdose typically leads to respiratory depression, a dangerous slowing or stopping of breathing caused by the drug’s impact on the brainstem’s respiratory center. This can deprive vital organs like the brain and heart of oxygen, leading to potentially fatal outcomes without timely intervention.
When considering the risk of overdose, it’s important to recognize that this risk is not uniform but varies based on individual and community factors. These factors are essential in understanding the problem's scope and designing effective prevention and intervention strategies. Here are some key individual risk considerations. Individuals who consume a dose of a drug that exceeds their tolerance level are at higher risk of overdose. This risk is particularly acute for those who have recently abstained from drug use, as their tolerance may have diminished during this period. Individuals returning to drug use after being in jail, prison, or a healthcare setting where they did not receive or take medication for opioid use disorder are at increased risk. Their tolerance levels might have decreased, making them more vulnerable to overdose.
For those being treated for opioid use disorder with naltrexone, an FDA-approved medication, the risk of overdose increases if they use opioids before receiving their next naltrexone injection. The opioid-blocking effects of naltrexone wear off over time, reducing previous tolerance levels. Using a drug that is much stronger than what the individual is accustomed to can significantly raise the risk of overdose. Individuals with underlying health issues, particularly those affecting the lungs or heart, such as asthma or sleep apnea, may be less able to tolerate the reduced oxygen levels that accompany an overdose.
Consuming drugs when alone is particularly dangerous because there is no one to assist or administer overdose reversal medication in the event of an overdose. For veterans and others at risk of overdose, it's imperative to understand these factors and to seek support from specialized treatment centers like Valor Lakes. Valor Lakes offers personalized IOP treatment, where veterans can receive comprehensive care tailored to their unique experiences and needs. The center’s focus on trauma-focused therapy, relapse prevention, and life skills development is critical in addressing the multifaceted nature of addiction and reducing the risk of overdose. Educating veterans and their communities about these risk factors and providing access to resources like overdose reversal medication can be life-saving.
Through informed, compassionate care, veterans can embark on a path toward lasting recovery, minimizing the risk of overdose and its devastating consequences. In the context of community factors influencing overdose risk, several elements are particularly relevant, especially for veterans who may encounter unique barriers in accessing care and support. Limited access to healthcare, including clinic closures or insufficient provider availability for pain treatment or Opioid Use Disorder (OUD) treatment, can lead individuals to turn to unregulated, street-purchased opioids. These drugs often have unknown contents and potency, elevating the risk of overdose. Additionally, the absence of drug-checking tools to test illicit drugs before use further increases this risk, as individuals are unable to verify the safety of these substances.
Similarly, using drugs in unfamiliar or stressful environments can reduce awareness and access to overdose prevention tools, adding to the risk. Understanding these community-level factors is essential in addressing the overdose crisis. It involves recognizing individual risks and considering the broader social and environmental context in which drug use occurs. This comprehensive approach is crucial in effectively preventing overdoses and supporting individuals, especially veterans, in their journey toward recovery and health.
Effective treatment of Substance Use Disorders (SUDs) plays a crucial role in reducing the risk of overdose and assisting individuals who have experienced an overdose in making positive life changes toward healthier living. Opioid Use Disorder (OUD) is a chronic condition comparable to diabetes, high blood pressure, or heart disease and requires a similarly structured approach to treatment. The U.S. Food and Drug Administration (FDA) has approved three medications for Opioid Use Disorder (MOUDs) treatment: buprenorphine, methadone, and naltrexone. Both methadone and buprenorphine, in particular, have been linked to significant reductions in the risk of overdose death. Research supports that these MOUDs are safe for long-term use, whether for months, years or even a lifetime, in supporting recovery from OUD. Integrating counseling and psychosocial support with MOUD treatment can offer additional benefits for some patients. These medications work by normalizing brain chemistry, blocking the euphoric effects of opioids, and relieving cravings (in the case of methadone and buprenorphine), thereby normalizing body functions without the negative and euphoric effects of the abused substance.
All providers authorized to prescribe controlled medications can prescribe buprenorphine for OUD or refer patients for methadone treatment, which is available only through specialized Opioid Treatment Programs. Naltrexone, not a controlled medication, can be prescribed by any provider within their scope of practice. While there are currently no FDA-approved medications specifically for stimulant use disorder, contingency management has been proven effective as a behavioral intervention. This approach supports recovery in individuals with stimulant use disorder and can complement MOUD for those with OUD. Harm reduction is a key component of this treatment landscape. It's an evidence-based, practical, and transformative approach that incorporates public health strategies—including prevention, risk reduction, and health promotion—to empower people who use drugs (PWUD) and their families to live healthier, self-directed, and purpose-filled lives. Harm reduction centers on the lived and living experiences of PWUD, especially those in underserved communities, and integrates these experiences into its strategies and practices.
For veterans, who may face unique challenges related to their service and experiences, accessing these treatments and harm reduction strategies is why we serve our communities. Centers like Valor Lakes, which specialize in veteran care, can offer the necessary support, combining FDA-approved medications with counseling, psychosocial support, and other personalized interventions tailored to the needs of veterans. This comprehensive approach is key to reducing the risk of overdose and supporting veterans on their journey to recovery.
