In November 2021, the Centers for Disease Control and Prevention released truly startling statistics around fatal drug overdoses. During 12 months ending in April of that year, there were just over 100,000 fatal drug overdoses in the US.
Over 75,000 of those deaths were due to opioids, a class of natural and synthetic drugs. Synthetic opioid deaths were led by fentanyl, an extremely powerful painkiller ordinarily used to treat severe pain. Most fentanyl available on the streets is made in clandestine labs and smuggled into the US.
Worse, fentanyl often contaminates drug supplies, creating a dangerous situation where a person may wind up taking a drug they didn’t intend to, resulting in a fatal overdose.
Drug use is more dangerous than ever, and even active drug users are watching out for each other, making use of fentanyl test strips and other equipment to protect themselves from an overdose. There’s something else everyone concerned about the safety and welfare of others can do as well: familiarize themselves with what a fentanyl overdose looks like, and what to do if one happens around you.
What Does A Fentanyl Overdose Look Like?
Unlike depictions in movies such as Pulp Fiction, opioid overdoses are undramatic. Many people who are overdosing look like they’re quietly falling asleep. Deaths from opioids are generally caused by suffocation; high doses of opioids slow both heart rate and breathing. This means once a person loses consciousness, it’s hard to bring them back. Minutes matter during fentanyl overdoses.
However, there are recognizable signs of a fentanyl overdose:
· Losing consciousness or falling asleep: “Nodding off” is a familiar sign of opioid abuse. In an overdose, though, people don’t wake up. If you’re at a party, a concert, or any event where sleeping is extremely unlikely, someone slumped against a wall or asleep at a table might be in serious distress … especially if they’re not responsive to outside stimuli like shouting in their ear or poking them. Appearing awake but not able to talk is another potentially deadly sign.
· Tiny pupils: Opioid drugs cause the eye’s pupils to tightly constrict – they look almost like pinpoints. It’s because opioids like fentanyl stimulate the body’s autonomic nervous system, causing the pupils to shrink. Also, the pupils won’t respond to changes in light; they’ll stay constricted even if you shine a light directly into them.
· Shallow and/or slowed breathing: A major warning sign of an overdose. Studies have shown opioids strongly affect two areas of the brain responsible for breathing rhythms.
· The “death rattle”: The so-called “death rattle” sounds a little like a snore. It’s caused when people are no longer able to remove secretions from the back of their throat and is usually heard when someone’s close to death. Someone who’s overdosing may also make choking noises.
· Limp body and discolored skin: A person who’s experiencing a fentanyl overdose (or an overdose from any other opioid drug) will have a limp body. Their fingernails will appear blue or purple, and their skin will be discolored. In people with lighter skin, their skin will look blue or purple; darker-complected people will have a skin which appears greyish or ashen.
What To Do If A Person Overdoses: A 5-Step Strategy
The first thing to do is don’t panic – while yes, every minute matters during a fentanyl overdose, panicking will just make things worse. Instead, keep a cool head and remember these five steps. It’ll save a life:
Step 1: Call First Responders
Fentanyl overdoses are medical emergencies first and foremost. EMTs must be there to stabilize the person who’s overdosing and take them for further treatment at a hospital or other medical facility.
Many localities have also enacted “Good Samaritan laws,” which are laws designed to protect people who report overdoses from being prosecuted for lower-level drug offenses like possession or use.
Step 2: Use Naloxone
Naloxone, often referred to by the brand name Narcan, is a medication that reverses overdose from opioids like fentanyl. Naloxone is often available without a prescription as a nasal spray, which is much easier for an untrained person to administer.
A word of caution: while naloxone does reverse an overdose, it’s not a cure. The National Institute on Drug Abuse (NIDA) states Narcan only works for about 30 to 90 minutes. Opioids can stay in the body for hours, and it’s possible for an overdosing person to be revived – and then overdose again once the naloxone wears off. It’s critical to stay with the person until first responders show up – and let them know you used naloxone.
Step 3: Keep Them Awake
While you’re waiting for first responders or another medical professional to show up, it’s very important you do everything you can to keep the person awake and breathing. If they fall asleep, they could suffocate.
Step 4: Lay Them On Their Side
If you can’t get them up and moving, it’s best to keep them on their side – it’ll prevent choking if they vomit or if saliva starts building up in their throat. This also widens the airway, helping them breathe.
Step 5: Stay With Them
Fentanyl and other opioid overdoses are very touch-and-go. You must stay with the person until first responders arrive. As we said in the step about naloxone, the drug wears off – the person could simply overdose again if naloxone isn’t followed up with professional health.
Also, first responders need to know as much as possible so they’re able to treat the person more effectively.
Every Effort Matters
Fatal drug overdoses, driven by opioids such as fentanyl, have climbed steadily for a decade. It’s critically important to act quickly if you suspect someone is overdosing from fentanyl. Even an act as simple as calling 911 can potentially save a life.
If you have a relationship with the person who overdosed, encouraging them to seek treatment for their problem is key. A professional treatment program can treat fentanyl addiction (and addiction to other opioids), helping someone manage detox before they start on the path to recovery.
Sober Living Homes: Strong Protection Against Overdoses
Sober homes are key to recovery for several reasons. First, they make recovery much more effective. A person living in a sober home is surrounded by people on the same path to a life free from addictive substances. Sober homes are free from distractions, drug temptations, and harmful social influences which could cause relapses.
Secondly, they’re safe spaces where drug use isn’t allowed. They’re also staffed with house managers who are trained to recognize overdoses, know how to use medications like naloxone, and can provide lifesaving measures if an overdose still happens.
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