Fentanyl and Opioid Overdose | Young Men’s Health

What are opioids?

Opioids and opiates are very strong drugs derived from the opium poppy plant (opiates) or are synthetic drugs that resemble molecules from the opium plant (opiates). In this section, we will use the term “opiates” to refer to opiates and opioids. These medications can be taken by mouth in pill form, inhaled/snorted, or injected.

When used as directed by a doctor, opioids can treat pain. But some people take opioids in higher amounts or more often than prescribed to treat pain, trauma, mental health symptoms, and physical dependence on opioids. Improperly used opioids can cause overdose and even death.

What is fentanyl?

Fentanyl is an incredibly strong (or strong) opioid. It is now found in most opioid pills sold in illegal drug markets. It can also be added to stimulants such as cocaine or methamphetamines.

Fentanyl is much more likely to cause a fatal overdose than less powerful opioids, such as oxycodone.

What exactly is an opioid overdose?

Overdose refers to when someone “passes out” (passes out) and is not breathing normally. This can happen when someone takes a high or strong dose of opioids. If not treated promptly, an opioid overdose can lead to death. Fortunately, there are things you can do to recognize and respond to an overdose. These important steps can help save someone’s life.

Why are overdose numbers increasing?

Deaths due to drugs overdoses have increased the last 20 years. In 2021, more than 106,000 people died of drug overdoses, including more than 1,100 teenagers. The increase in overdose deaths is due to several factors:

• It is a very powerful opioid and is more likely to cause a fatal overdose. Sometimes people are exposed to it in other substances and don’t even know it.
• Xylazine. It is another new drug that increases the risk of overdose. Xylazine is not affected by naloxone (see below).
• There can be challenges in accessing opioid addiction treatments, in particular opioid use disorder medications; such as buprenorphine and methadone. Without treatment, people may use more opioids over time with a higher risk of overdose.
• People who experience stigma and shame associated with their opioid use may use opioids only covertly. This increases the risk of not noticing and treating the overdose.

How do I know if someone has overdosed?

No one wants to think about responding to an overdose as it can be very scary. But knowing how to react to an overdose can save someone’s life.

Someone who has overdosed may be:

• Fall down if you are sitting or lying on the floor.
• Does not respond to voice, touch or pain. Pinch someone’s fingernail or apply pressure to the sternum (the bone area in the middle of the chest) if you’re not sure.
• Like breathing. Breaths may be very shallow, only occur every ~15-30 seconds, or sound like gurgles or rattles.
• It starts to turn blue, especially in the skin around the eyelids, lips and nails.

People who are in increased risk of overdose include people who:

• You have health problems, especially lung (ie, asthma) or heart (ie, congenital heart disease) conditions.
• Use more opioids than their doctor recommended.
• Get opioids from people who are not their doctor.
• Mix opioids with other drugs, alcohol or benzodiazepines.
• Change who they buy drugs from.
• Change the way they use drugs, especially if they are switching from taking a pill by mouth to injecting.
• Use only.
• Use again after a period of non-use, such as during rehab or in the hospital.

What should I do if I think someone has overdosed?

If someone seems to be having overdosed as described above: call 911, give naloxone, provide rescue breathing (if you feel comfortable with this) and stay with the person until help arrives (if you feel safe to do so).

In many US states, Good Samaritan Laws protect people who call 911 and/or administer naloxone from getting into legal trouble. Checkout this resource to see the laws in your state.

What tips can I give friends to help them prevent an overdose?

While naloxone can help treat an opioid overdose, it’s even more important to prevent an overdose in the first place.

Damage reduction is a “set of practical strategies and ideas aimed at reducing the negative consequences associated with drug use.” This includes ideas that youth and adults can use to prevent overdose. Harm reduction includes treatment, including opioid use disorder medications. These are the best tools we have to prevent overdoses.

When people aren’t using drugs to treat opioid use disorder, there are others ways to prevent overdose. These include:

• Choosing less powerful drugs: People who take pills may be at lower risk of overdose than people who inject or inhale drugs. It may also be helpful to avoid pills that contain fentanyl (see below).
• Start with small amounts and “go slow”: Starting with a very small “trial” amount allows people to test the potency of a new drug. Increasing the amount slowly helps avoid overuse, which could cause an overdose.
• Avoid mixing opioids with other sedatives: Concomitant use of opioids with other sedative drugs such as alcohol or benzodiazepines may increase the risk of overdose and should be avoided.
• Use fentanyl and xylazine test strips: These test strips are available from harm reduction organizations and online and, if used correctly, can detect fentanyl in pills and powders.
  • To use these tests, a pill must be crushed and mixed in a plastic bag before using the strip to test for residue. This ensures that the strip tests a mixture of the substances included in a pill.
  • On most strips available, 1 line = positive for fentanyl, 2 lines = negative.
  • Remember to always read the instructions! Similar test strips are available for xylazine.
  • The use of fentanyl test strips is decriminalized in some states (such as Massachusetts), but is still illegal in some states.
• Never use alone: If someone overdoses when they are alone, no one can give them naloxone or call 911. So very important to encourage friends to never use drugs alone. People who use alone can use telephone communication lines or applications such as Brave or Canary to make sure someone calls 911 if they become unresponsive.

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