Opioids and Opiates and Overdose Education

By Vanessa Blandford, M.Ed., LPC, LCDC

All opiates are opioids, but not all opioids are opiates (Sherrick, 2025, “Opioids and Opiates in Simple Terms” section). Opiates are drugs that are naturally derived from the opium poppy plant (Papaver somniferum). Opioids include all opiates, plus synthetic and semi-synthetic drugs that offer the same effects on the body that opiates do. Synthetic opioids are made in a lab, and semi-synthetic opioids are chemically modified from natural opiates (Sherrick, 2025; World Health Organization [WHO], 2025).

An exception to the above is Kratom and 7OH. These drugs act exactly like Opiates and Opioids do, including the withdrawals, but come from the Kratom leaf instead of the poppy plant. In spite of this differentiation, Kratom and 7OH are typically classified as semi-synthetic opioids (Alsbrook, Pro, & Koturbash, 2025). Kratom, 7OH, all opiates, and all opioids will show up on the Urinalysis (urine drug screening) that Luna performs on each client regularly while they are in treatment.

Awareness of the dangers of fentanyl has increased in recent years due to many overdoses being attributed to fentanyl laced drugs. Legal fentanyl is made in a lab and prescribed by a doctor for pain management in cancer patients (American Society of Health-System Pharmacists, 2025). Illegal fentanyl is added to other illegal drugs to increase the potency, such as mixing fentanyl with heroin. Fentanyl is also used in counterfeit tablets or pills that are made to look like real prescription drugs. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) (2025a), DEA lab tests found that 6 out of every 10 pills with fentanyl contain a potentially lethal dose of fentanyl. Most users are unaware of the presence of fentanyl and are surprised when their urinalysis comes back positive for fentanyl or chemically similar analogues (WHO, 2025). At Luna, we test for fentanyl and its chemically similar analogues in every urinalysis performed.

Opioid Overdose Risk Factors

Many factors increase a person’s risk of overdosing. Unfortunately, a common risk factor is returning to opioid use after a period of abstinence, such as being in treatment, being in jail or the hospital, on vacation, etc. When your tolerance decreases, the amount you were using previously may be too much. According to WHO (2025), other risk factors include:

• Tolerance changes due to a period of abstinence or “cutting back”
• A history of overdoses
• Mixing opioids with stimulants (cocaine, methamphetamine, etc.)
• Mixing opioids with downers or respiratory depressants (alcohol or benzodiazepines)
• Having other chronic health conditions (HIV, Hep C, lung or heart disease, etc.)
• Changes in drug suppliers
• A history of intravenous opioid use
• Misuse of prescription opioids or taking prescription opioids without medical supervision
• Taking a high dosage of prescribed opioids (100 mg of morphine or equivalent daily)
• Taking opioids that are not prescribed to you. Children are at risk for overdose if they take medication that is not for them (SAMHSA, 2025b).

Signs and Symptoms of an Overdose

An overdose happens when a substance overwhelms the body, causing organs to malfunction. Opioids suppress the brain’s breathing control—when breathing slows or stops, the brain and heart are starved of oxygen, and without intervention, this can be fatal. According to WHO (2025) and SAMHSA (2025b), signs someone is overdosing include:

• Pinpoint pupils
• Loss of consciousness, cannot be awakened, or are unable to speak
• Difficulties with breathing (breathing may be slow or stop altogether)
• Face is extremely pale and/or feels clammy to the touch
• Body goes limp
• Fingernails or lips have a purple or blue color
• Vomiting or gurgling noises
• Heartbeat slows or stops

Opioid Overdose Reversal Medication (OORM)

If you or someone you know is at risk of overdose, we highly recommend keeping a Naloxone product accessible. Narcan® Nasal Spray was the first FDA-approved naloxone nasal spray. Today, many generic Naloxone nasal spray products are on the market. These products may be purchased over the counter or obtained through non-profits and charities. Naloxone will reverse the effects of an opioid overdose if administered in time. It does not affect people who haven’t taken opioids (WHO, 2025).

The makers of Narcan nasal spray recommend ‘lay, spray, stay’ to remember what to do if someone is overdosing (Emergent Devices Inc., 2026).

1. Lay: check for slowed breathing or unresponsiveness. Lay the person on their back and tilt their head up
2. Spray: insert the device into either nostril and press the plunger firmly
3. Stay: call 911 immediately and continue to administer doses as needed. Do not leave the person unattended.

Each package contains two doses of Naloxone. Insert the nasal spray into one nostril and press the plunger to administer the Naloxone. If the person does not wake up within 2-3 minutes of the first dose, administer the second dose in the other nostril. When the person wakes up, they may experience withdrawal symptoms. Call 911 anytime you administer Naloxone, and encourage the person to go to the hospital for monitoring.

Where to Find OORMs

At Luna, we maintain a stock of Narcan and are happy to provide it to our clients and their families. There are also many other ways to obtain Narcan in Texas. Locally in Houston, the Council on Recovery has a free naloxone (Narcan) vending machine on their campus. Naloxone Texas provides Narcan by request through their website and through their Regional Naloxone Distribution Hubs. Nationwide, NEXT Distro partners with programs nationwide to provide access to Narcan and syringes.

Resources

• Never Use Alone: https://neverusealone.com/
• NEXT Distro, an online and mail-based harm reduction service: https://nextdistro.org/
• Learn more about OORM: https://www.samhsa.gov/substance-use/treatment/overdose-prevention/opioid-overdose-reversal
• Overdose Prevention Response Kit from SAMHSA: https://library.samhsa.gov/product/overdose-prevention-response-toolkit/pep23-03-00-001
• Naloxone Texas: https://naloxonetexas.com/
• Learn more about Opium: https://museum.dea.gov/exhibits/online-exhibits/cannabis-coca-and-poppy-natures-addictive-plants/opium-poppy

Citations

Alsbrook S, Pro G, Koturbash I. From kratom to 7-hydroxymitragynine: evolution of a natural remedy into a public-health threat. Pharm Biol. 2025 Dec;63(1):896-911. doi: 10.1080/13880209.2025.2590311. Epub 2025 Nov 23. PMID: 41275505; PMCID: PMC12671409.

American Society of Health-System Pharmacists. (2025). Fentanyl. MedlinePlus. Retrieved September 16, 2026, from https://medlineplus.gov/druginfo/meds/a605043.html

Emergent Devices Inc. (2026). OTC NARCAN® (naloxone HCl) nasal spray for healthcare professionals. https://narcan.com/en/healthcare-professionals

Sherrick, R. (2025, December 3). Opioid vs. opiate: What’s the difference? Community Medical Services. https://communitymedicalservices.org/opioid-vs-opiate/

Substance Abuse and Mental Health Services Administration. (2025a, September 23). Misuse of prescription, opioids, and fake pills. U.S. Department of Health and Human Services. https://www.samhsa.gov/substance-use/learn/prescriptions-opioids

Substance Abuse and Mental Health Services Administration. (2025b, December 22). Opioid overdose prevention and reversal. U.S. Department of Health and Human Services. https://www.samhsa.gov/substance-use/treatment/overdose-prevention

The Council on Recovery. (n.d.). Free Narcan vending machine now at The Council. Retrieved September 16, 2026, from https://www.councilonrecovery.org/resource/free-narcan-machine/

World Health Organization. (2025, August 29). Opioid overdose. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose