Opioids

Opioid Overview and Brief History

The opioid public health crisis began with the first wave of opioid-related overdoses in the 1990s, fueled by the widespread overprescribing of opioid medications such as OxyContin.^[1]This wave was followed by a second beginning in 2010, marked by a rise in heroin use, and a third wave in 2013, driven by a sharp increase in deaths involving synthetic opioids, particularly fentanyl.^[2]The American Medical Association reports that, although opioid prescribing rates decreased by 44% from 2011 to 2020, opioid-related deaths continued to rise. ^[3] This has largely been due to the increased availability and lethality of illicitly manufactured opioids such as fentanyl.

Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others. These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain. Opioid pain relievers are generally safe when taken as prescribed by a doctor and for a short period of time. However, because opioids can produce feelings of euphoria in addition to relieving pain, they have the potential for misuse—particularly when taken in ways other than prescribed, in larger amounts, or without a prescription. Regular use – even as prescribed by a doctor – can lead to dependence, and misuse of opioid pain relievers can lead to overdose incidents and deaths. ^[4]

Non-prescription opioids, such as heroin, are classified as Schedule I drugs, meaning they have a high potential for abuse and no accepted medical use in the United States. Prescription opioids—including codeine, morphine, and hydrocodone—are generally classified as Schedule II drugs, indicating a high potential for abuse but accepted medical uses under strict prescription guidelines.

Opioid Related Harms

A statement released by the U.S. Department of Health and Human Services in March 2025 reported that opioid-involved overdoses remained the leading cause of drug-related fatalities in the United States.^[5] In 2023, opioid-related deaths accounted for approximately 79,358 deaths—or 75% of all overdose fatalities in the United States.^[6]In the same year, 264 drug overdose deaths in Idaho were opioid-related, accounting for 68% of all overdose fatalities in the state.

The most recent preliminary data released by the CDC in November of 2024 indicates a significant decline in opioid-related deaths in the United States, with an estimated 56,542 deaths reported over the previous 12-month period.^[6]Although this predicted decline is encouraging, opioid-related overdoses continue to be the leading cause of overdose deaths across the country.^[5]

Fentanyl

Of the 79,358 opioid-related overdose deaths that occurred in 2023, approximately 72,776 (92%) were attributed to synthetic opioids such as fentanyl.^[7] In Idaho during that same year, fentanyl was responsible for 197 overdose deaths—accounting for 51% of all overdose fatalities in the state. This represents a sharp increase from 2019, when fentanyl was involved in just 23 deaths, or approximately 9% of Idaho’s total overdose deaths. Although 2024 data on fentanyl-related deaths is not yet available for Idaho, preliminary figures released by the CDC in November 2024 estimate that 50,283 overdose deaths involving synthetic opioids—primarily fentanyl—occurred across the U.S. over the preceding 12-month period.^[5] These preliminary data indicate that, of the estimated opioid-related deaths in the 12-month period prior to November 2024, 89% were related to synthetic opioids such as fentanyl.^[5]

Resources

Naloxone

Naloxone, commonly known by the brand name Narcan, is an opioid antagonist that blocks opioid receptors, effectively reversing the effects of an opioid overdose. It works against overdoses caused by all types of opioids, including heroin, fentanyl, and prescription pain relievers. Naloxone comes in various forms that anyone can use without medical training or authorization, including a prefilled nasal spray and an injectable. solution.^[8]

As of 2019, Idahoans may access naloxone at a pharmacy without a prescription. Call ahead to your local pharmacy to ensure availability of naloxone and to ask about your co-pay. If you have Medicaid, naloxone is free from the pharmacy. Community-based groups such as substance use disorder treatment and recovery and crisis centers near you may also offer naloxone free to individuals in need, regardless of your insurance status. ^[9]

Resources

Find Naloxone near you.
DHW Naloxone Request Form 2.0
Request Naloxone Trainings: naloxonedistribution@kootenaifire.com

Noteworthy Legislation

Prescription Drug Monitoring Program

2015: House Bill No. 4
Requires prescribers to register with the state prescription drug monitoring program. Enacted March 5, 2015.

2017: House Bill No. 5
Requires pharmacists to register with the state prescription drug monitoring program. Enacted February 16, 2017.

Naloxone Access

2015: House Bill No. 108
Allows prescribers and pharmacists to prescribe opioid antagonists to a person at risk of experiencing an opioid-related overdose; a person in a position to assist a person at risk of experiencing an opioid-related overdose; a person who, in the course of his official duties or business, may encounter a person experiencing an opioid-related overdose; or a person who in the opinion of the prescriber or pharmacist has valid reason to be in the possession of an opioid antagonist. Allows these persons, when acting in good faith and exercising reasonable care, to administer an opioid antagonist to another person who appears to be experiencing an opioid-related overdose. Requires the administering person to contact emergency medical services as soon as possible. Ensures said persons will not be held civilly or criminally liable. Enacted March 23, 2015.

2019: House Bill No. 12
Amends existing law to revise provisions regarding opioid antagonists. Addresses use of the phrase “prescriber or pharmacist” in previous legislation creating concern among hospitals and other health professionals about their ability to prescribe and dispense naloxone. Replaces “prescriber or pharmacist” with “health professional licensed or registered under this title.” Enacted February 14, 2019.

Good Samaritan Law

2018: House Bill No. 649
Adds a new Idaho Code Section 37-2739c to provide that certain persons acting in good faith seeking or needing medical assistance for drug related overdose shall not be charged or prosecuted for possession of controlled substances or drug paraphernalia. This Good Samaritan legislation shall not be grounds for suppression of evidence in other criminal charges. Enacted March 26, 2018.

Fentanyl Mandatory Minimums

2024: House Bill No. 406

Adds a new Idaho Code Section 37-2732D stating that anyone arrested with at least 4 grams but less than 14 grams of fentanyl—or any mixture containing a detectable amount of the drug—would be guilty of a felony, subject to a mandatory minimum sentence of three years in prison and a $10,000 fine. If the fentanyl is in pill form, possession of 100 to 250 pills would meet the threshold for this sentence. Individuals found in possession of between 14 and 28 grams of fentanyl, or at least 250 pills, would face a mandatory minimum sentence of five years in prison and a $15,000 fine. Possession of 28 grams or more, or over 500 pills, would result in a minimum sentence of 10 years and a $25,000 fine.

The bill also establishes a new offense called “drug-induced homicide,” which holds individuals criminally liable if they provide an illegal drug to someone who subsequently dies as a result of using it. This crime could carry a sentence of life in prison. Enacted February 26, 2024.