Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. Illicit fentanyl is a deadly synthetic opioid that is being mixed into heroin, cocaine, and other street drugs.
Drug overdoses are the leading cause of death for Americans ages 18-45, approximately 66% of overdose deaths were attributable to opioids. The increase in drug overdose deaths is being driven by illicit fentanyl. It is the most dangerous drug threat facing our nation.
Since 2013, deaths from synthetic opioids — including fentanyl — began to increase at unprecedented rates, accounting for 90 percent of the overall increase in drug-related mortality since 2012. While fentanyl is legally prescribed in the United States, evidence suggests that much of the fentanyl on the streets is illegally manufactured and comes from abroad. Opioid prescriptions have decreased over the years while overdose and death related to illicitly manufactured fentanyl, methamphetamine and cocaine increase. Xylazine and other toxic synthetic adulterants present new challenges.
Signs of Opioid Use
Physical Signs
- Loss of appetite
- Weight loss
- Intense flu-like symptoms (nausea, vomiting, sweating, shaky hands, enlarged pupils) are associated with opioid withdrawal
- Wearing long-sleeves or other clothing that covers the arms could indicate injection drug use
- Small (pinpoint) pupils are associated with opioid use or intoxication
- Decreased respiratory rate is associated with opioid use or intoxication
- Drowsiness or non-responsiveness is associated with opioid use or intoxication
Behavioral Signs
- Change in attitude
- Avoiding contact with family and/or friends
- Change in friends, hobbies, and/or activities
- Drop in grades or performance at work
- Isolation and changes in behavior
- Moodiness, irritability, nervousness/anxiety, giddiness
- Illicit behaviors
Environmental Warning Signs
- Missing medications
- Burnt or missing spoons and/or bottle caps
- Syringes
- Small bags with powder residue
- Missing shoelaces and/or belts
Overdose Prevention – Free Fentanyl Test Strips and Naloxone
Drugs containing fentanyl or similar highly potent opioids, even in very small amounts, substantially increase the risk of overdose and death. Just three milligrams of fentanyl can be fatal, compared to 30 milligrams of heroin.
Fentanyl is undetectable by sight, smell, or taste. Fentanyl Test strips are a harm reduction tool that detects the presence of fentanyl mixed into a substance, such as cocaine or heroin.
Fentanyl test strips, as well as naloxone, are available free of charge from New York State: https://forms.ny.gov/s3/Harm-Reduction-Order-Form
Naloxone (Narcan®) is a safe medication that can save someone’s life by reversing the effects of an opioid overdose. It only works on opioids, such as heroin, prescription painkillers and fentanyl, but it is safe to use even if opioids are not present. If you are worried you or someone you know may be at risk of an opioid overdose, naloxone is available to you.
Free Training
New York State is offering free overdose prevention trainings in multiple formats. NYSDOH Opioid Overdose Prevention Initiative’s registered overdose programs offer community overdose trainings for anyone in the community – regardless of level of understanding or knowledge about drugs and overdose. Trainings are offered in convenient formats (videos, in-person, virtual, one on one, small group, etc.).
The calendar is available: https://www.nyoverdose.org/Home/Calendar
More overdose training/resources: Find virtual naloxone and community opioid overdose trainings https://www.nyc.gov/site/doh/health/health-topics/naloxone.page
