Butte Glenn Medical Society

Understanding & Recognizing Addiction

Understanding & Recognizing Addiction

What is Addiction?

The American Society of Addiction Medicine recognizes addiction as a "treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences" (Adopted by the ASAM Board of Directors September 15, 2019).

established a Descriptive and Diagnostic Terminology Action Group to conduct extensive research on terminology challenges specifically pertaining to addiction, recovery, treatment and unhealthy substance use. Using clear language and terminology is critaically important throughout communication between medical practitioners, their patients and clients, and the general public. Using appropriate terminology that is not only medically correct, but also sensitive to the challenges that come with addiction medicine, such as stigma, buiding trusting relationships with patients, access barriers to care and how to appropriately have tough conversations between the patient and care provider.

How do people misuse prescription opioids?

Prescription opioids used for pain relief are generally safe when taken for a short time and as prescribed by a doctor, but they can be misused.

People misuse prescription opioids by:

  1. Taking the medicine in a way or dose other than prescribed
  2. Taking someone else’s prescription medicine
  3. Taking the medicine for the effect it causes-to get high
  4. When misusing a prescription opioid, a person can swallow the medicine in its normal form. Sometimes people crush pills or open capsules, dissolve the powder in water, and inject the liquid into a vein. Some also snort the powder.

Long-term use of opioids, even as prescribed by a doctor, can cause some people to develop a tolerance, which means that they need higher and/or more frequent doses of the drug to get the desired effects.

Drug addiction is a chronic disease characterized by compulsive, or uncontrollable, drug seeking and use despite harmful consequences and long-lasting changes in the brain. The changes can result in harmful behaviors by those who misuse drugs, whether prescription or illicit drugs.

For more information click: What is an addiction?

Opioids include prescription and illicit drugs.

Common opioids include:

  • Hydrocodone (Vicodin®)
  • Oxycodone (OxyContin®, Percocet®)
  • Morphine (Kadian®, Avinza®)
  • Codeine
  • Fentanyl
  • Heroin
  • For more information click: Commonly Abused Drugs

Heroin: Heroin is an opioid drug made from morphine. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Other common names for heroin include big H, horse, hell dust, and smack.

For more information, click: Heroin Drug Facts

Prescription Opioids: Prescription opioids are used mostly to treat moderate to severe pain, though some opioids can be used to treat coughing and diarrhea. Opioids can also make people feel very relaxed and “high” – which is why they are sometimes used for non-medical reasons. This can be dangerous because opioids can be highly addictive, and overdoses and death are common. Heroin is one of the world’s most dangerous opioids, and is never used as a medicine in the United States.

For more information, click: Prescription Opioids Drug Facts

Fentanyl: Fentanyl is a synthetic opioid that is 80-100 times stronger than morphine. Pharmaceutical fentanyl was developed for pain management treatment of cancer patients, applied in a patch on the skin. Because of its powerful opioid properties, Fentanyl is also diverted for abuse. Fentanyl is added to heroin to increase its potency, or be disguised as highly potent heroin. Many users believe that they are purchasing heroin and actually don’t know that they are purchasing fentanyl – which often results in overdose deaths.

Reports from law enforcement indicate that much of the synthetic opioid overdose increase
may be due to illegally or illicitly made fentanyl. According to data from the National Forensic Laboratory Information System, confiscations, or seizures, of fentanyl increased by nearly 7 fold from 2012 to 2014. There were 4,585 fentanyl confiscations in 2014. This suggests that the sharp rise in fentanyl-related deaths may be due to increased availability of illegally made, non-pharmaceutical fentanyl, and not prescribed fentanyl.

For more information, click: Fentanyl Factsheet

The two types of opioids are prescription pain medications and street/illicit drugs such as heroin. Prescription pain medications include: Oxycodone, Codeine, Morphine, and Fentanyl. Although opioids are usually prescribed by a doctor, using them in any way other than prescribed, even occasionally, is dangerous. The CDC has identified addiction to prescription pain medication as the strongest risk factor for heroin addiction.
2018 California Opioid Summit Video at Chico State
Check out this video about last year’s opioid summit. To view slideshows, please click here

2018 California Opioid Summit from Eventide Visuals on Vimeo.
Understanding the National Epidemic
From 1999-2017, almost 400,000 people died from an overdose involving any opioid, including prescription and illicit opioids. This rise in opioid overdose deaths can be outlined in three distinct waves.

  • The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
  • The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
  • The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids – particularly those involving illicitly- manufactured fentanyl (IMF). The IMF market continues to change, and IMF can be found in combination with heroin, counterfeit pills, and cocaine.
The Rx Awareness Campaign
The Rx Awareness campaign tells the real stories of people whose lives were torn apart by prescription opioids. The goal of the campaign is to increase awareness that prescription opioids can be addictive and dangerous. Almost 36 percent of all U.S. opioid overdose deaths involve a prescription opioid. Overdose deaths involving prescription opioids have increase by about 5 times since 1999. From 1999 to 2017, more than 200,000 people died from overdoses related to prescription opioids, with more than 17,000 overdose deaths involving prescription opioids occurring in 2017.

Understanding the Opioid Epidemic in Butte County
An assessment looking at the local opioid epidemic revealed that the county has higher rates than California and the nation as a whole for nearly all opioid related morbidity and mortality indicators and healthcare delivery system indicators assessed. These include: opioid overdose death rates; prescription opioid specific overdose death rates; number of opioid prescriptions per resident; number of morphine milligram equivalents per resident; number of residents on high dose opioids; rates of opioid hospitalizations and emergency department visits; number of residents with concurrent prescriptions for opioids and benzodiazepines; and neonatal absence syndrome incidence rates. These elevated rates put Butte County residents at a higher risk for opioid misuse and opioid use disorder (OUD) than Californians in the vast majority of other counties.
/var/folders/95/ggnsg_g12yzd5l4jg1ybftcw0000gn/T/com.microsoft.Word/WebArchiveCopyPasteTempFiles/Homepage-Opioid-OD-Death-300x240.jpg OPIOID OVERDOSE DEATH
Butte County’s opioid overdose death rate was 7.57 per 100,000 residents in 2017. Out of the 52 California counties, we rank 18th highest. California’s opioid overdose death rate was 5.35 per 100,000 residents.
Butte County’s prescription rate is the highest among all counties in California,
almost twice as much as the CA average. In 2017, the rate was 1036.83 opioid
prescriptions per 1000 residents. California’s rate was 508.65
This is another way to measure the amount of opioid dosing. High MMEs=High
dose. In 2017, Butte County had the highest MME dosing in all of CA. The county
had 1133.12 MME while the state had 421.78
As the opioid epidemic continues to grow, pregnant women and newborn babies are also being affected. The NAS incidence rate for Butte County from 2005 2016 was 15.8 per 1000 births, the 5th highest rate in the state.
In 2017, Butte County had the highest rate of hospitalizations for opioids in the state, including heroin. The hospitalization rate for opioids other than heroin was more than five times the statewide rate, and almost twice the national rate.
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