Angel: Hi, my name is Angel. Welcome to this Powerful Family Powerful Communities webinar. The focus of this webinar is opioids, what they are, and how they impact us.
For this webinar, we have Haylee Borden. Haylee is a student at UNC Wilmington where she studies pharmaceutical clinical research. Haylee has also been a very active member of 4-H. Let’s hear from Haylee about her experience.
Haylee: Sure. So I have been a North Carolina 4-Her in Alamance County for the past nine years and through my participation in 4-H I have been able to attend events on the county, district, state, and national levels. My main focus in 4-H was on the leadership and citizenship side of things. So I was able to participate in 4-H as a county council officer as well as the 2017-2018 North Central District vice-president and it was through my participation at National 4-H conference in Washington DC that I was able to be exposed to opioids and the crisis facing America today.
So I think that my initial interest in the medical field stemmed from the science classes that I took in middle and high school and then as well as learning about how Latin words transfer into the medical field. As well from there I attended a community college during high school and was able to take higher-level courses such as microbiology and that introduced me into the science field as well and then from there contemplating majors for college, I decided that I wanted to major in pharmaceutical clinical research and drug discovery at the University of North Carolina Wilmington where I am currently enrolled. Also at North Carolina State 4-H Congress I gave a presentation on opioids and won silver there. So that was kind of some more exposure that I had as well.
A: Haylee is a promising young leader in the fight against opioid addiction. Listen to her experience at the national level.
H: So National 4-H conference, which is held in Washington DC, is an event for youth to come together and generate ideas on topics that are affecting youth in America today. So I was assigned to a roundtable discussion group on opioids and I decided that I wanted to choose this topic because I heard a lot about them in the news during that time period. I had the opportunity to discuss different ideas to educate youth with my fellow roundtable group members and then we were able to present our findings to NIDA, the National Institute on Drug Abuse and their employees were very receptive and embraced our ideas that we presented to them.
A: As you can see Haylee brings a lot of 4-H passion to the challenge. Haylee, what are opioids?
H: So as a general description, opioids are a broad range of analgesic, which means it’s pain-relieving drugs that work by interacting with the opioid receptors on your neurons. So I think it is critical to first identify that there are two broad categories of opioids there is opiates and there are opioids.
So first you have opiates and they are directly derived from an opium poppy. Some examples of these include heroin and morphine. And then second we have opioids which is a more broad category that includes synthetic drugs as well such as hydrocodone and fentanyl.
A: Haylee, we hear a lot about prescription opioids tell us more about them.
H: Yes, like I said morphine is an analgesic and narcotic drug obtained from the opium poppy and it is medically used to relieve pain. Heroin is an opioid directly made from morphine and it is combined with a chemical reagent to make it three times more potent than morphine. Heroin is considered an opiate, not an opioid because it is combined with a chemical reagent and it’s not just coming directly from the opium flower.
On the other hand, fentanyl is a schedule two prescription drug which is used to treat chronic pain and patients that have just gotten out of surgeries and that is fifty to a hundred times more potent than morphine. And then lastly, we have hydrocodone which is a combination medication, which means that it includes the opioid pain relief but it is also combined with things such as acetaminophen so it has the opioid pain relieving and then it is also able to reduce fever.
A: Okay, those are the different opioids how do they impact our bodies how do we become addicted?
H: Opioids work in our body by entering our bloodstream and then they travel to the brain there they attach to the surface of opioid receptors on certain neurons. When this connection is made, it inhibits the body’s ability to conduct the flow of pain. There is a particular accumulation of these neurons in the ventral tegmental area, VTA, of the brain that release dopamine. Dopamine release is associated with feelings of euphoria, things that innately make us feel good. As well as reinforcing acts such as eating certain foods and caring for babies. However, opioids release excess amounts of dopamine and signals our brain that something good has happened and it needs to be repeated this is where opioid addiction comes into play.
Through the continued release of dopamine the body becomes tolerant to and requires a higher level of opioids to sustain the euphoric feeling they experience the first time they used opioids. This is a prime example of Pavlovian classical conditioning. Ivan Pavlov first discovered that dogs salivate when they smell or see a piece of meat, but do not salivate when a whistle is blown. When the dogs are trained to hear the whistle at the same time food is presented, they will over time be conditioned to salivate when they only hear the whistle blow. Our brains work in much the same way. We become conditioned to be dependent on opioids to elicit a euphoric feeling.
Some of the signs and symptoms of opioid abuse include a dry mouth, drowsiness, nausea, and constipation. It has been found that your risk of dependence is higher if you or someone in your family has a history of substance abuse or other genetic and environmental factors.
A: Thanks Haylee. We also hear a lot about opioid overdoses. Can you talk about those?
H: I think it is very important to first identify that the brain stem is vulnerable to an overdose. The brain stem houses the cardiac and respiratory control centers of our body and in the case of opioid abuse and addiction it can cause shallow breathing, a drop in heart rate and can lead to death if not treated. There are a triad of symptoms of an opioid overdose which includes pinpoint pupils, unconsciousness, and respiratory depression, which is shallow breathing.
A: So opioids are very addictive and dangerous. How do people get opioids?
H: Yeah. So people can gain access to opioids through a variety of routes. They might ask for, buy, or outright take opioids from friends or family members without asking them. They can also approach strangers on the street which gets them involved in bad situations with drug dealers and different things like that. I’d also like to mention that Afghanistan, China, Mexico, and Colombia are among some of the top importers of smuggled drugs into the United States.
There are also two other ways that people can gain access to opioids. They can be prescribed opioids by their physician and then they can also go to things called pill mills which is where doctors can write prescriptions for opioids for non-medical reasons and other inappropriate reasons just so the patients can receive access to them.
A: Wow. Opioids are frightening. How can young people like me help battle this crisis?
H: A good next step would be for communities that have local theaters and one-act play programs to educate teens about opioid abuse. They can then perform realistic plays depicting the short and long term effects of teen opioid abuse both on the addicted teen and on the community side of things. And this could impact many youth in North Carolina and in America. Easily have an area to practice their play and share information that they found on opioids as well. And that would be a great way to spread awareness of opioids around teens and then share that with their fellow classmates and friends.
However, not everybody expresses their thoughts and feelings verbally. So another idea would you have people present their thoughts and feelings on opioid abuse through artistic expression. They could create art pieces or posters and flyers that they could post throughout their cities and in their schools to help raise awareness. And they can also post these online on social media sites to help other viewers view it through different avenues such as that.
One last way to help combat opioid abuse is to get Naloxone certified. So Naloxone is an opioid overdose antagonist which means that it reverses the effects of an opioid overdose and you can find many trainings that normally last 30 minutes at local schools, community, centers, and different types of gyms as well. And it’s very simple. You can be certified in how to administer nasal or IM injections of naloxone that could potentially save somebody’s life.
A: Those are great ideas Haylee. One last question. How is this crisis impacting North Carolina?
H: That is a great question. Castlight Health, which is a San Francisco based health care cost transparency company took anonymous health data from employer-based health insurance to map the use of opioids in America. And they were able to compile the 25 top cities for opioid abuse. And it is funny to mention, that since we are filming here in Wilmington, North Carolina, which is located in New Hanover county, Wilmington is ranked a number one spot for opioid abuse in America. And that is followed by three other cities in the top 20 which include Hickory, Fayetteville, and Jacksonville, in North Carolina. So I think that brings it home to everybody that is watching this video that it is here in our cities, close to home, and any effort that you can take can save somebody’s life.
A: That was great. Thanks, Haylee and thanks to everyone who watched this webinar. For more information please visit one of the websites listed at the end of the webinar. Finally, keep an eye out for our next webinar. See you next time.