Overdose deaths occur even in persons taking opioids for legitimate medical reasons because, over time, continuous use can produce addiction with the experience of serious withdrawal effects if the drug is stopped or even reduced in quantity.

The three primary signs of opioid overdose are pinpoint pupils, depressed breathing, and unconsciousness, a combination known as the  overdose triad . The cause of death is generally from respiratory depression.

How can we address the deaths associated with opioid abuse? As of July 2017, laws have been passed in all 50 states and the District of Columbia to increase public access to naloxone, a drug that can reverse the overdose effects of opioids. In Nebraska, naloxone can be dispensed without a prescription to “family, friends, and bystanders” by a pharmacist who can create a prescription under a standing order. This means that if a family member or friend of an opioid user (legal or illegal opioid) is concerned that the individual might be at risk for an overdose, the concerned person can request that a pharmacist provide the naloxone under the name of the at-risk individual. Costs and insurance requirements vary.