Opioid use and overdoses across the country have increased throughout the pandemic. CONTRIB: aacom.org

More than 70 percent of drug-overdose deaths in America were attributed to opioids in 2019, according to the Center for Disease Control and Prevention.

Anita Jacobson, a clinical professor of pharmacy at the University of Rhode Island and the program director of the Community First Responder Program (CFRP), researches the opioid epidemic, focusing on responding to opioid-related breathing emergencies.

Jacobson spoke at the first Faculty Office Hours of this semester on Oct. 6, hosted by the URI Foundation and Alumni Engagement.

Before Jacobson began her presentation, Massiel Frias, the CFRP’s program coordinator, gave an overview of the program and its availability to Rhode Island residents. 

“I just want to let everyone know that this program does outreach in Rhode Island broadly, so if after this presentation you are interested in getting the naloxone kit that is something we can absolutely do,” Frias said.

Jacobson began by discussing the history of the opioid epidemic. When she was a student at URI in the 1990s, she said that drug representatives would visit URI and tell students about oxycontin and tout it as a non-addictive pain killer. Jacobson said that this information was untrue and led to an increase in pain killers being prescribed and more people overdosing.

In 2010, there was an increase in heroin overdoses across the country, Jacobson noted. There was an increase in the usage of fentanyl and other synthetic opioids following addictions resulting from painkiller prescriptions as addicts searched for other drugs, according to Jacobson.

“Someone who is using unregulated products like cocaine or heroin would not know the fentanyl is in the product that they had,” she said.

She also said that many counterfeit opioids have fentanyl in them as well.

She showed a chart representing the steady increase in opioid overdoses since 2009. This chart showed that 2020 had the most overdose deaths in recorded history, which she attributed to an increase in mental health issues during the pandemic.

“Everyone likely knows someone who has been touched by the opioid overdose epidemic,” she said. 

According to Jacobson, the CFRP has been more used in urban areas, such as Providence, that have had more opioid overdoses. They are working to educate rural communities on opioid addiction and help them learn how to help during opioid-based breathing problems often stemming from overdoses.

“We do face a lot of stigma from people,” she said. “We really try to spend a lot of time trying to help people understand what opioids are and how people can go on to develop an opioid use addiction.”

According to her, opioids affect everyone differently and some people do not understand opioid addiction because they do not have the same experience with opioids. She said that people with addictive traits can feel euphoria and great pleasure from opioids. Up to 25 percent of the population can be addicted to opioids, according to her.

Opioid addiction can be caused by many different factors but tends to start after being prescribed pain killers. From there, people who experience euphoria and an increased tolerance for pain may become addicted after withdrawals begin.

Jacobson also warned people not to take opioids without a prescription.

She mentioned naloxone, a medicine used to reduce opioid overdoses, as a new immediate measure to save people during an opioid overdose by rapidly removing opioids from the receptors in the person’s body.

“It’s an opioid blocker, an antagonist, so it literally pushes the opioids off their receptors,” Jacobson said.

While it removes the opioids from the receptors of pain in the body, it does not remove them completely from the body. 

Some harm reduction measures that the government can take, according to Jacobson, include legalizing some opioid drugs and offering safe and supervised opioid injection sites, which Rhode Island has recently passed a bill to offer in July. 

The CFRP has worked with police across the state as well as with the Rhode Island Department of Health to educate the public about opioid addiction and show how to use naloxone in an emergency. 

After her presentation, the audience was given a chance to ask Jacobson questions.

Frias asked Jacobson about the causes and implications of the current shortage of naloxone in America right now.

“This is sort of a two-pronged issue actually,” Jacobson said. “There is a shortage of naloxone, the generic version of naloxone, which is the intramuscular injection formulation.” 

She said this is due to a manufacturing shortage currently. The intramuscular injection of naloxone is a much lower cost option, according to Jacobson, but can be more challenging for someone not trained in its usage to administer. 

The program, according to Jacobson, only distributes the naloxone nasal spray, otherwise known as Narcan, which is not experiencing a manufacturing shortage but suffers from a lack of a sustainable source of funding.