Opioid analgesics (e.g. oxycodone, hydrocodone, fentanyl, meperidine, codeine, hydromorphone etc.) are commonly used for controlling pain such as postoperative pain, chronic cancer and non-cancer pain. However, their use often results in substantial risk for misuse, abuse and alternative use with associated adverse outcomes. Hence, opioids are a major global public health problem. Opioid overdose can lead to respiratory depression which, if untreated, can cause death. Opioid usage has also been found to be linked to adrenal insufficiency and causes a decrease in sex hormones (Aschenbrenner, 2016). Opioid usage also poses an amplified risk of fractures and acute heart attacks among elderly users (Ballantyne, 2012). Common routes of opioid usage are ingestion followed by inhalation (smoking, snorting and vaping) and injection (Gasior, Bond, & Malamut, 2016).
Deaths due to opioid analgesics have increased substantially in the United States. In 1999, about 4,000 deaths due to opioids were reported. These jumped to 16,235 in 2013 translating into an approximately four time increase in death rate from 1.4 to 5.1 deaths per 100,000 (Chen, Hedegaard, & Warner, 2015). Along with the abuse of prescription opioid analgesics, the illicit opioid drug, heroin, is also abused in the United States as well as globally. According to the National Survey on Drug Use and Health (NSDUH), in the US approximately 669,000 people in 2012 reported using heroin in the past year and the trend over the years showed an increase (National Institute on Drug Abuse [NIDA], 2014). The increase has especially been marked in young adults between the ages of 18 and 25 years.
The number of Americans who used heroin for the first time was reported to be a staggering 156,000 in 2012 (NIDA, 2014) which calls for prevention and treatment efforts on a war footing. Opioid drug abuse prevention has recently been on President Trump's political agenda and requires concerted educational and policy level health education and health promotion efforts.
One important facet of opioid prevention effort requires that patients and their family members be educated on safe usage, storage and disposal of opioids to prevent adverse drug effects in patients and prevent abuse by others (Costello, 2015). There is a definitive need to design, implement and evaluate patient and family member education programs for those suffering from opioid addiction or the use of opioid medication. Such educational efforts should be designed on robust behavioral theories so that much needed knowledge, transfer and behavioral change can occur. Some theories that can be reified in this context include social cognitive theory, theory of planned behavior, multi-theory model (MTM) of health behavior change and others (Sharma, 2017).
Another facet of preventative educational efforts pertains to averting opioid overdose in opioid users. In this regard, in order to prevent opioid overdose, several community programs in the US have provided lay persons who are at an increased exposure to opioid users, such as family members, friends and healthcare workers, with naloxone kits to reverse the commonly fatal respiratory depression caused by overdose of heroin and other opioids (Doyon, Aks, & Schaeffer, 2014). Naloxone antagonizes opioid effects by competing for the [mu], [kappa] and o opiate receptor sites in the central nervous system, thereby negating the adverse effects of opioid overdose and can save lives (Jackson, Grice, Hockings & Torpy, 1995). Naloxone can be administered by the intranasal route or by injection for which lay persons are trained. National advocacy organizations, Harm Reduction Coalition (HRC) and Opioid Safety and Naloxone Network (OSNN), provided naloxone kits to more than 150,000 lay persons between 1996 and 2004 and found that 26,463 opioid overdose reversals occurred as a result of these efforts (Wheeler, Jones, Gilbert, & Davidson, 2015). …
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