A pair of 'drugged-up' cashier clerks in the US appear to fall asleep on the job as they serve a customer.

In a video entitled "America's Opioid Epidemic", uploaded to YouTube on Saturday, a person is checking out items at what seems to be a gas station in Sonoma County, California.

Midway through checking out the items, the cashiers appear to have fallen asleep - one with her head down and the other with her head back and her mouth hanging open.

"Hello!" a woman in the store calls out to the cashiers, who briefly come out of their stupor.

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The cashier wearing glasses and a gray sweater then appears to have a great deal of trouble with the scanner.

The other cashier, wearing a black shirt, starts bagging the items and manages to bag just one bottle of soda before her head falls forward again.

Her colleague appears to notice that she's having problems and calls on her to bag the rest of the purchases.

"I'm trying," says the cashier in the black shirt.

"You're trying?" her co-worker asks.

"Yes ma'am," she replies.

It is unclear from the video if indeed the workers were on drugs or how long ago they had been taken it if so.

The US has been gripped by an opioid epidemic that has been steadily rising over the last several years.

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Every day, more than 90 Americans die after overdosing on opioids. Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015.
Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015, according to the American Society of Addiction Medicine

HOW DO OPIOIDS WORK?

Opioids are a type of narcotic pain medication that act on the nervous system to relieve pain.

Continued use and abuse can lead to physical dependence and withdrawal symptoms. They come in tablets, capsules or liquid.

Opioid drugs work by binding to opioid receptors in the brain, spinal cord and other areas of the body. They reduce the sending of pain messages to the brain and lessen feelings of pain.

Some types of opioids include:
Codeine
Oxycodone
Fentanyl

One of the reasons your doctor needs to manage pain medication so closely is that they can potentially cause side effects, such as constipation, drowsiness, nausea and vomiting.

Tolerance

After taking opioid pain medication for a while, you might find that you need more and more of the drug to achieve the same effect in reducing pain.

Dependence

When you use opioid medication over an extended period of time, your body can become so used to the drug that, if you abruptly stop taking it, you experience withdrawal symptoms such as:
Diarrhea, nausea and vomiting
Muscle pain
Anxiety
Irritability

Addiction

People who are addicted to opioids compulsively seek out the pain medications. They typically have behaviours that lead to negative consequences in their personal lives or workplace.

If you are having a problem with addiction, you might need to see an addiction specialist.

Overdose

Opioids affect the part of the brain that controls breathing, and large doses can slow breathing to the point where it is fatal.

Additionally, mixing the drugs with other medications can create a reaction that sends you into cardiac arrest.