Opioid Safety in Mississippi: What You Need to Know, and Why Overdose Deaths Are Finally Declining

Where Mississippi stands

According to tracking data from the Centers for Disease Control and Prevention, Mississippi has consistently maintained an age adjusted drug and opioid overdose death rate that sits below the United States national average. This is not because the state has been untouched. It is because the response, including state level prescribing rules, pharmacist administered naloxone, prescription drug monitoring programs, and expanded access to medication assisted treatment, has been more effective here than in many other states.

That lower rate, though, sits inside a decade of real loss. Mississippi's own overdose death rate surged by roughly 60 percent between 2014 and 2024, driven primarily by illicit fentanyl and other synthetic opioids. The encouraging part is the most recent direction. After peaking in the early 2020s, the state's overdose death rate has come down meaningfully in the last few years. The trend is finally moving the right way, but the decade behind it is the reason no one should treat this as solved.

There is also a paradox worth understanding, because it changes where the real danger sits. Even though Mississippi's overdose death rate is lower than the national average, the Mississippi State Department of Health reports that the state regularly ranks among the highest in the country for per capita opioid prescription dispensing. In other words, a great many opioid prescriptions are written here, and yet the fatal overdoses increasingly do not come from those prescriptions. They come from the illicit supply.

That said, the work is not finished. Fentanyl contamination of the illicit drug supply, including in counterfeit pills sold as benzodiazepines or stimulants, remains a serious risk. Many overdose deaths in recent years involve fentanyl in people who did not knowingly take an opioid.

What opioids are and how they work

Opioids bind to receptors in the brain and spinal cord that reduce pain perception and produce sedation. They include prescription medications (hydrocodone, oxycodone, morphine, fentanyl, tramadol, codeine), illicit substances (heroin, illicit fentanyl), and the medications used to treat opioid use disorder (methadone, buprenorphine, naltrexone).

Tolerance develops with regular use, meaning higher doses are needed for the same effect. Physical dependence develops too, meaning stopping after regular use produces withdrawal symptoms. Opioid use disorder is a specific condition that involves continued use despite negative consequences, often along with tolerance and dependence.

When opioids are appropriate

Opioids are appropriate for acute severe pain (after major surgery, severe trauma, cancer pain that has not responded to other approaches), some chronic pain situations where alternatives have failed, end of life care, and for medication assisted treatment of opioid use disorder.

They are usually not the first choice for most chronic pain conditions. Tolerance, dependency risk, and limited long term effectiveness mean that alternatives are tried first in most current pain management approaches.

Naloxone, the overdose reversal medication

Naloxone (Narcan, Kloxxado) reverses opioid overdoses by displacing opioids from their receptors. It is available without a prescription in Mississippi. Every household with an opioid prescription, every parent of a teenager or young adult, and many others should have it on hand.

The nasal spray form is easy to administer. No medical training is needed. Recognizing an overdose (unresponsive, slow or absent breathing, blue lips or fingertips), administering the spray, and calling 911 are the key steps. Mississippi has Good Samaritan provisions that protect people from many drug related charges when they call for help in an overdose situation.

Fairview stocks naloxone and can dispense it without a prescription. We will walk you through how to use it. The conversation is private and free.

Safe medication practices for patients on opioids

• Take only the dose prescribed. Doubling up is one of the most common ways overdoses happen.
• Do not combine with alcohol, benzodiazepines (alprazolam, diazepam, lorazepam, clonazepam), or sleep aids without specific medical guidance. These combinations are particularly dangerous.
• Keep medications in their original containers and out of reach of children, teenagers, and anyone in the home with a history of substance use.
• Do not share prescriptions. Even pills that look identical can have different contents.
• Dispose of unused medication safely. Fairview accepts opioid medications for disposal at no charge.
• Use one pharmacy for all opioid prescriptions to allow review for interactions and duplicate prescribing.

Pain management without opioids

For most chronic pain conditions, the most effective long term approach uses a combination of:

• Acetaminophen or topical NSAIDs.
• Oral NSAIDs in carefully selected patients.
• Antidepressants used at lower doses for chronic pain (duloxetine, amitriptyline).
• Anti seizure medications used for nerve pain (gabapentin, pregabalin).
• Physical therapy.
• Cognitive behavioral therapy.
• Interventional procedures for some conditions.
• Exercise and movement, often the strongest single intervention.

Treatment for opioid use disorder

Opioid use disorder is treatable. Three FDA approved medications, buprenorphine (Suboxone, Subutex), methadone, and naltrexone, are highly effective. Combined with counseling, they produce sustained recovery for many patients.

Mississippi has expanded access to medication assisted treatment significantly in recent years. If you or a family member is struggling with opioid use, treatment is more accessible than it was even five years ago. A pharmacist conversation can be a starting point for finding the right resources.

Where pharmacy fits

Free, confidential conversations for any Mississippi patient or family member dealing with opioid related questions. Naloxone dispensing without a prescription. Safe disposal of unused medications. Coordination with prescribers for tapering when patients want to come off opioids. Serving Hattiesburg, the Pine Belt, Central Mississippi, and South Mississippi.

When to call a pharmacist

• You have been prescribed an opioid and want a naloxone prescription for the household.
• You have unused opioids and want to dispose of them safely.
• You are taking a benzodiazepine, sleep aid, or alcohol regularly and have been prescribed an opioid.
• You want to begin tapering off opioids you have been taking long term.
• You or a family member needs help finding opioid use disorder treatment resources.

This article is for general information only and is not a substitute for personalized medical advice. Before starting or changing any medication, including over the counter products and supplements, talk with your pharmacist or physician about your specific situation.