Opioid overdoses — mostly from prescription pain relievers and heroin — have quadrupled since 2000, and 2,601 people in Texas died from overdoses in 2014, according to the Centers for Disease Control and Prevention.
In July, Congress passed the first major federal legislation in 40 years to address the current opioid epidemic spreading across Texas and the rest of the United States.
The Comprehensive Addiction and Recovery Act, signed by President Barack Obama with bipartisan support, focuses on rehabilitation for those with addiction issues, increasing prescription drug monitoring and expanding the availability of naloxone, a drug that treats opioid overdoses.
Neuroscience associate professor John Mihic said opioids are medications that relieve pain by numbing the effects of the brain areas controlling emotion. Opioids come in various types, including morphine (used in surgery), hydrocodone and heroin.
Though heroin has historically plagued socioeconomically disadvantaged areas, the affected demographic has expanded from inner-city minorities to include white men and women living in the suburbs, according to Jane Maxwell, research professor in the School of Social Work.
“Basically drug patterns shift and change depending on where the drug is coming from, how it’s getting imported and how it’s marketed,” Maxwell said.
Drug addiction and abuse can be seen historically in various cultures, from the early 19th century opioid epidemic in China to the ’60s hippie movement in the U.S., according to American studies associate professor Mark Smith.
“The worst times that we see addiction are in societies [where] we see control has broken down … When people overdose, it’s normally because they get a real good batch of heroin that they’re not used to,” Smith said. “It’s a drug of despair.”
However, Maxwell said CARA, which currently lacks funding from Congress, could be used to combat the social stigma of drug addiction. Mihic said some of the social perception surrounding addiction would be unacceptable when talking about other biological conditions.
“How often would you ever look at a person with Parkinson’s and say, ‘Look, stop with the shaking, control yourself?’ Nobody would say that. So that’s a change in neurochemistry,” Mihic said. “If you can accept that, then why can’t you accept that a change in neurochemistry that leads to drug addiction isn’t also something that a person can’t necessarily control?”
CARA also expands the availability of naloxone to law enforcement agencies and first responders to help reverse overdoses. Last September, Texas passed Senate Bill 1462, allowing doctors to prescribe anyone naloxone, as long as basic prerequisites are met.
Naloxone can be administered in three ways: through the nose, injected into muscle tissue or into the veins. While there is a small chance of overdose, as there is with any external substance, naloxone does not lend itself to abuse.
“With opioid overdoses, it’s not like you immediately die. It can take a little bit of time, definitely on a minute time-scale. So if someone recognizes that someone else is passed out and non-responsive and not breathing, they’ve got the naloxone,” Mihic said. “And when you inject it, it works really quickly.”
Lack of breathing and a slow pulse is what leads to brain damage or death during opioid overdoses. Naloxone competes with the binding site on the opioid receptors, which buys around four to six hours for the person to receive emergency care to remove the opioid molecules from the bloodstream.
“You know how in the movies, they said ‘Give them the antidote’ when someone’s been exposed to a toxin?” Mihic said. “Well, to an extent, that’s kind of [BS]. Except in this case.”