Heroin Heroin can be injected via syringe, snorted via straws, and smoked via vaporizing. There are many reasons there has been a rise in heroin abuse. First, because of the medical community’s crackdown on writing scripts, prescription opioids are available, but they are more difficult to obtain than heroin. Doctors are not as likely to give someone a prescription as they used to be. Second, because heroin offers nearly the same chemical Opioids affect the kidneys Kidney dysfunction, acute or chronic, is common with the continual use of opioids. The kidneys are responsible for the elimination of nitrogenous waste (uric acid, ammonia, urea) from the body (Mallappallil et al., 2017). When the kidneys are not working properly, waste is retained in the body tissues (Renzoni, 2019). Morphine causes renal ischemia, which leads to acute kidney injury. Additionally, the drug can cause vasoconstriction,
properties and a similar high as prescription pills, and is much less expensive and easier to obtain, individuals often switch from pills to heroin (Pearl, 2018). In fact, reports indicate that nearly 80% of heroin users said that they first used prescription opioids (National Institute on Drug Abuse, 2019). It all boils down to drug availability—heroin is prevalent because the pills are not. bloodstream and can build up throughout the tissues (Renzoni, 2019). Fentanyl and morphine decrease blood flow in the glomeruli, a group of capillaries that filter waste products from the blood (Mallappallil et al., 2017). Opioids are also known to cause urinary retention, especially in the elderly, which leaves a significant amount of urine in the bladder, and they are unable to excrete waste properly. If the kidneys are no longer functioning properly, dialysis or a kidney transplant may be required (Renzoni, 2019).
which leads to renal deoxygenation. Heroin use leads to rhabdomyolysis, a condition in which muscles and tissues begin to disintegrate and the proteins are released into the
STIGMA
and that is the first step to recovery. Terms like user, abuser, addict , and junkie should be avoided. A better alternative is saying an individual is opiate dependent or has a substance abuse disorder. The opioids that are used and abused are the same opioids that patients with cancer use to treat pain. Because of this abuse, the patients with cancer who truly need the drugs are being underprescribed the medications that they need (Ray & Hoffman, 2018). This pain can come from cancer treatments, from procedures, or from the cancer itself. If it has metastasized, the cancer can reach into different locations of the body, causing even more pain. As one can see, there is a direct correlation between the opioid stigma and its consequences for cancer patients. sites. The death of their loved one is not only devastating, but the circumstances surrounding the death are an embarrassment. Unfortunately for the family, this adds to their complicated grief. However, just as these rumors are spread before the breaking news on television, these widespread stories could serve as a warning to others of the dangers of opioids. The friends of the deceased read what happened, and this can serve as a cautionary tale.
There is definitely stigma when it comes to drug addiction. There is often a cloud of shame, guilt, and disgraced feelings of being weak-willed or not strong enough to beat the addiction. Though not intentional, inappropriate comments from family members or friends such as “Why are you doing this to us?” or “Just stop using drugs!” can be hurtful and even perpetuate the drug use. This can lead to a withdrawal from family and friends and even extracurricular activities. Many individuals are reluctant to attend Narcotics Anonymous (NA) or treatment centers, as they feel others will compare their current addiction situation with others’ situations. They do not want to be judged, or they may even feel as though they do not have a problem. But by attending such centers, the person who is dependent on opioids is indicating that they have a problem, Social media People no longer have to wait for the 5 o’clock news to receive information on what is going on in their community. Individuals now use Facebook, Instagram, X (Twitter), and other sites to obtain instant knowledge. When someone dies of an overdose, the news can spread on social media like wildfire—and the rumors spread faster. Numerous speculations on why and how it happened can be posted online for all to see and can be read by the immediate family. Something that they wanted to be kept private has now been broadcast all over social media Naloxone is a nonaddictive medication that rapidly reverses overdose symptoms and restores breathing (Conley-Keck, 2019). This product has become so popular that prescriptions have nearly doubled since 2017 (American Medical Association, 2018). It comes either as an intranasal spray that is used in the nares or as an injection via syringe that is introduced in the larger muscles of the body such as the deltoid, biceps femoris, or gluteus maximus. Once naloxone is administered to the victim, it dislodges the opioid molecules from the brain’s receptors and in turn binds to the same receptors to block that opioid (National Institute on Drug Abuse, 2018). This is because naloxone has a stronger affinity for the opioid receptors than for the opioid itself. These receptors control breathing, and this action temporarily restores respiratory function (Illinois Department of Public Health, 2019). After 30 to 90 minutes, the naloxone molecules wear down, and the opioids then reattach to the receptors and breathing begins to decrease once again, potentially causing a secondary respiratory depression leading to anoxia. Because of this short duration of effectiveness, it is imperative to contact first responders as soon as naloxone is administered.
NALOXONE
According to the International Journal of Molecular Sciences (2018): “With any suspected opioid overdose where respiratory depression is found, treatment needs to be begun with antagonists like naloxone hydrochloride that can cross the blood brain barrier to reverse respiratory depression. Attention should be paid to differences in the half-life of the opioid and the antagonist used. Reversal of symptoms may be temporary as the short acting antagonist evacuates the receptor and frees it for the opioid to re-bind to it.” (Mallappallil, M., Sabu, J., Friedman, E., & Salifu, M. 2017) Naloxone is as dangerous as water and has no abuse potential. Therefore, it is impossible to cause more damage than what has already been done by the opiate-dependent user. Naloxone is heat sensitive, so it should not be left in the removal vehicle because heat will inhibit its effectiveness. Additionally, it is vulnerable to light and can deactivate if left in direct sunlight. The prime locations for naloxone kits are in the preparation room for the exposed embalmer with an additional kit in close proximity to the funeral chapel for the overdose of a mourner. All funeral home staff should be trained in naloxone administration and know where the kits are located.
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