Opioid Overdose Prevention Toolkit Updated for 2014

Opioid Overdose Prevention Toolkit (2014): Are you up to date? SAMHSA is!

Opioid Overdose Prevention Toolkit, Update for 2014

Opioids are valuable tools for addressing pain; however, overdose is always a concern.

The Opioid Overdose Prevention Toolkit equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. The Opioid Overdose Prevention Toolkit Addresses issues for first responders, treatment providers, and those recovering from opioid overdose.

Scope of Opioid Overdose

Opioid overdose continues to be a major public health probem in the United States. It has contributed significantly to accidental deaths among those who use, misuse or abuse illicit and prescription opioids. In fact, U.S. overdose deaths involving prescription opioid analgesics increased to about 17,000 deaths a year in 2010 [1, 2], almost double the number in 2001 [1]. This increase coincided with a nearly fourfold increase in the use of prescribed opioids for the treatment of pain [3].

What are Opioids?

Opioids include illegal drugs such as heroin, as well as prescription medications used to treat pain such as morphine, codeine, methadone, oxycodone (OxyContin®, Percodan®, Percocet®), hydrocodone (Vicodin®, Lortab®, Norco®), fentanyl (Duragesic®, Fentora®), hydromorphone (Dilaudid®, Exalgo®), and buprenorphine (Subutex®, Suboxone®). Opioids work by binding to specific receptors in the brain, spinal cord and gastrointestinal tract. In doing so, they minimize the body’s perception of pain. However, stimulating the opioid receptors or “reward centers” in the brain also can trigger other systems of the body, such as those responsible for regulating mood, breathing and blood pressure.

How does overdose occur?

A variety of effects can occur after a person takes opioids, ranging from pleasure to nausea, vomiting, severe allergic reactions (anaphylaxis) and overdose, in which breathing and heartbeat slow or even stop. Opioid overdose can occur when a patient deliberately misuses a prescription opioid or an illicit drug such as heroin. It also can occur when a patient takes an opioid as directed, but the prescriber miscalculated the opioid dose or an error was made by the dispensing pharmacist or the patient misunderstood the directions for use. Also at risk is the person who takes opioid medications prescribed for someone else, as is the individual who combines opioids — prescribed or illicit — with alcohol, certain other medications, and even some over-the-counter products that depress breathing, heart rate, and other functions of the central nervous system [4].

Who is at risk?

Anyone who uses opioids for long-term management of chronic cancer or non-cancer pain is at risk for opioid overdose, as are persons who use heroin [5]. Others at risk include persons who are:

  • Receiving rotating opioid medicationregimens (and thus are at risk forincomplete cross-tolerance)
  • Discharged from emergency medicalcare following opioid intoxication orpoisoning.
  • At high risk for overdose because of alegitimate medical need for analgesia,coupled with a suspected or confirmedhistory of substance abuse, dependence, or non-medical use of prescription orillicit opioids.
  • Completing mandatory opioid detoxifi- cation or abstinent for a period of time(and presumably with reduced opioidtolerance and high risk of relapse toopioid use).
  • Recently released from incarcerationand a past user or abuser of opioids(and presumably with reduced opioidtolerance and high risk of relapse toopioid use).

A Word about Words

Tolerance develops when someone uses an opioid drug regularly, so that their body becomes accustomed to the drug and needs a larger or more frequent dose to continue to experience the same effect.

Loss of tolerance occurs when someone stops taking an opioid after long-term use. When someone loses tolerance and then takes the opioid drug again, they can experience serious adverse effects, including overdose, even if they take an amount that caused them no problem in the past.

For much more information about these and other issues, including key strategies to prevent opioid overdose, check out the full SAMHSA Opioid Overdose Prevention Toolkit Updated, released in August of 2014.

The toolkit includes a full digital version, Facts for Community Members, Essentials for First Responders, Safety Advice for Patients, and Information for Prescribers. The toolkit also includes resources for Overdose Survivors and Family Members.

Pub id: SMA14-4742
Publication Date: 8/2014
Popularity: 423
Format: Kit
Audience: People in Recovery as Audience, Prevention Professionals, Community Coalitions, Law Enforcement, Professional Care Providers, Family & Advocates

The toolkit was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the Association of State and Territorial Health Officials, in cooperation with Public Health Research Solutions, under contract number 10-233-00100 with SAMHSA, U.S. Department of Health and Human Services (HHS). LCDR Brandon Johnson, M.B.A., served as the Government Project Officer.

Drugs and Mental Health in US: SAHMSA Releases 2013 NSDUH

SAMHSA releases Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use and Health-Overview of Findings

The NSDUH Report provides 2013 estimates on the prevalence of substance abuse and mental illness in the U.S. Also reports on the need for and barriers to substance use treatment, mental health care, and co-occurring substance use disorders and mental illness.

Infographic Drug and Substance Abuse in US 2013

Infographic for 2013 SAMHSA NSDUH Report


Pub id: NSDUH14-0904
Publication Date: 9/2014
Audience: Prevention Professionals, Researchers, Program Planners, Administrators, & Project Managers, Policymakers, Public Health Professionals
Series: National Survey on Drug Use and Health (NSDUH)
Population Group: Adolescents as Population Group, New Substance Users, Young Adults as Population GroupSource: Substance Abuse and Mental Health Service Administration (SAMHSA)

“Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse” Booklet — Revised

The “Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse” Booklet (ICN 907798) was revised and is now available in a downloadable format. This booklet is designed to provide education on screening and behavioral counseling interventions in primary care to reduce alcohol abuse. It includes information about risky/hazardous and harmful drinking.

“Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse” Booklet — Revised

Upcoming Webinar: Incorporating SBIRT in the National Guard, October 3

Incorporating SBIRT in the National Guard
October 3, 2013
2:00 p.m. – 3:30 p.m. (E.T.)

Purpose: This webinar will focus on the emerging role of SBIRT in Army National Guard settings, with an emphasis on the special needs of addressing substance abuse in military settings. .


  • To better understand the nature of the military culture, the stresses of deployment and readjustment from combat to community life
  • To understand the steps taken to implement SBIRT in the Iowa Army National Guard


  • Michelle Tilotta, RN, BSN, MPA, Iowa Department of Public Health
  • Sergeant First Class Janet Richards, Army National Guard Substance Abuse Program

Teleconference and Webinar Instructions:

  1. Go to: https://jbsinternational.webex.com/jbsinternational/onstage/g.php?t=a&d=574847592
  2. If requested, enter your name and email address.
  3. If a password is required, enter the meeting password: sbirt123
  4. Click “Join”.
  5. To join the audio conference only

To receive a call back, provide your phone number when you join the event, or call the number below and enter the access code.
Call-in toll-free number (US/Canada): 1-877-668-4490
Call-in toll number (US/Canada): 1-408-792-6300
Toll-free dialing restrictions: http://www.webex.com/pdf/tollfree_restrictions.pdf
Access code: 574 847 592


Contact Marcus Hudson mhudson@jbsinternational.com or 240-645-4346

Essentials of 42CFR Part 2 for SBIRT Providers — Archived Webinar

This archived webinar covers
  • the essentials of Federal Regulation 42 CFR Part 2,
  • the interplay between 42 CFR Part 2 and HIPAA regulation in settings where primary care and substance abuse/mental health services are co-located or integrated
  • substance abuse documentation and information sharing using electronic health records.
Presenter: Karla Lopez, Staff Attorney, Legal Action Center
The Legal Action Center is the only nonprofit law and policy organization in the United States addressing the needs of persons with substance use disorders. The organization has national subject matter experts on Federal regulations governing confidentiality of alcohol and drug abuse patient records (42 CFR Part 2) and the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations.