Lesson 1: Opioids 101

People commonly use opioids for pain management, to handle emotional or mental health challenges, and to manage withdrawal pains. Opioids are often associated with a numbing sensation that can feel supportive for people with severe health concerns as they manage daily life. Another common entry point for people to explore opioids is through prescription medications; there is a large portion of people who use street-based drug supplies like heroin or fentanyl to manage drug use initiated through prescription medications. The recent Tribal Opioid Settlement highlighted the disproportionate affect that opioid prescriptions has had on Native communities and addiction.

Opioids are used in a variety of ways that depend on the type and form. People may use opioids through smoking (via pipe or foil), injection (intravenously or intramuscularly), insufflation, or ingestion. Each come with their own risk factors and considerations for health concerns– some of the concerns listed are available to read about in Section 2.5: Injuries and Illnesses.

Opioid receptors “turn on” when a person uses opioids. This is how people feel the effects of being high. The opioid receptors affect the central nervous and respiratory systems, slowing down both and stimulating the body’s natural “reward” sensation, causing effects such as euphoria. 

Regular opioid use leads to the body adapting to their presence, and seeing opioids as the new threshold for normalcy: this means our body now relies on opioids to comfortably maintain normal function. This also means that people who have built up regular opioid use require gradually more opioids to feel the effects– this is when people may transition from something lighter like a prescription vicodin to something more strong such as heroin or fentanyl. Opioid dependence also means that stopping use causes severe pain, anxiety, strong flu-like symptoms, and overwhelm as the brain readjusts to not having a baseline of opioids. This is a reason why some people continue to use opioids even if they no longer want to: they don’t have access to a safe, comfortable place to experience the severity of withdrawal symptoms.

• Try not to use alone: People are at a much higher risk of fatal OD’s when using alone. Using with a buddy, calling a hotline*, or asking someone to stay on the phone with you while you ingest are all great options.

• Refrain from sharing equipment: Diseases like HIV and Hepatitis C are spread through blood-to-blood contact. Pick up enough supplies to share with others so everyone has their own!

• Do what you can: It’s important to know what best practices are so that we can aim for them, but they’re not always possible. Harm reduction is about reducing harm and acknowledging it is not realistic to completely eliminate the chance of harm!

• *Hotlines:

  • Never Use Alone 877-696-1996

  • Overdose Detection Brave App

• Gather info: Knowledge goes a long way! When we understand how drugs affect our brain and bodies, how infections occur, how diseases are spread, we are laying the foundation to understanding what we can do to look out for ourselves and those around us.

• Utilize services: While there is different access to resources depending on where you are; rural, urban, etc; there are resources that are available online, ones that will send via mail things like naloxone, etc. Get familiar with what you have access to and use what’s available. 

• Lean on community: This can be hard, especially if we have been culturally treated with isolation, banishment, or simply exclusion from participating with community due to substance use. However, there are people out there who will support you so you don’t have to go through things alone. When our emotional, spiritual, and social needs are met, it can decrease the harmful effect that substances can have on us. Find people you trust who help you feel accepted as you are.