Preventing Opioid Overdose: Focus on Fentanyl

FACULTY/STAFF ORDER FORM

According to the U.S. Drug Enforcement Administration (DEA), 42% of all counterfeit pills tested contained a potentially lethal dose of fentanyl. A lethal dose of fentanyl can be as little as 2 mg, depending on a person’s body size, tolerance and past usage--that's a fraction of raindrop or a few grains of salt. 

Fentanyl can be found in non-prescription substances purchased anywhere other than a pharmacy. Drug traffickers often mix fentanyl into other drugs because it’s cheaper to produce a high with fentanyl. Fentanyl can take the form of a powder, a capsule, or can be pressed into counterfeit pills that are made to look like prescription opioids, such as oxycodone (Oxycontin®, Percocet®) and hydrocodone (Vicodin®); alprazolam (Xanax®); or stimulants like amphetamines (Adderall®).  Where else might you find fentanyl?

• Fentanyl is sometimes mixed in with heroin but is much more potent.
• Meth and cocaine are sometimes cut with fentanyl to reduce the cost of production.
• Many drug suppliers mix fentanyl with meth or oxy, and then add red, yellow or blue food coloring to form a pill sold as MDMA, or ecstasy.

As a result, people who use drugs can easily and unknowingly ingest a lethal dose of fentanyl.

• The following tips can help you or a loved one avoid opioid overdose:
  • Take medicine as prescribed by your practitioner.
  • Do not take more medication or take it more often than instructed.
  • Never mix pain medicines with alcohol, sleeping pills, or illicit. substances. Using different drugs together, including alcohol, increases your risk of overdose.
  • Never take anyone else’s medication.
  • Prevent children and pets from accidental ingestion by storing your medication out of reach.
  • Dispose of unused medication safely.
• Anyone who uses drugs that may contain fentanyl, even occasionally, is at risk of death by overdose. If you choose to use drugs, there are steps you can take to reduce but not eliminate your risk of overdose due to fentanyl:
  • Don’t use drugs alone. Identify someone who remains sober and can monitor your safety if you are under the influence.  
  • Get naloxone. Naloxone is an emergency medication that can reverse an overdose from heroin and other opioids, including fentanyl. When you use drugs, leave naloxone out where others can find it.
  • If you’ve used fentanyl or other substances in the past but have recently been sober, your tolerance for the drug has likely decreased. If you choose to use again, be mindful of potential changes in drug potency and start with a smaller dose than you might have used in the past.
  • Test your drugs using fentanyl test strips. 

Fentanyl test strips can detect the presence of fentanyl. However, it’s important to know that a negative result does not mean there is no fentanyl present. For example, fentanyl may exist in an untested area of a pill, or the pill may contain a different synthetic opioid product. To be effective, fentanyl test strips need to be used in accordance with directions such as these. 

• Fentanyl test strips can be purchased from:

  Amazon (order online)
  Dance Safe (order online)
  Northern Colorado Health Alliance (call 1-844-944-7529 for resources)
  Colorado Department of Public Health and Environment (list of access programs within CO)

• Fentanyl strips are also available at no charge from

  Northern Colorado Health Network (also known as NCAP, or Northern Colorado Access Point), located just off the UNC campus at:

  807 17th Street, Suite D
  Greeley, CO 80631
  970-353-1177

  Birdie Light (5 free strips, donation encouraged)

Opioid overdose is life-threatening and requires immediate emergency attention. It’s important to know that signs of a drug overdose vary depending on the substance the user ingested. It’s not always obvious when someone is overdosing, and a common misconception is that a person has to be obviously unconscious or in severe distress to have an overdose, but that’s not always the case.

• In addition to being unconscious, there are several other signals of an overdose. Call 911 immediately if a person exhibits ANY of the following symptoms:
  • Their face is extremely pale and/or feels clammy or cold to the touch.
  • Their body goes limp.
  • Their fingernails or lips have a purple or blue color.
  • They start vomiting or making gurgling noises.
  • They cannot be awakened or are unable to speak.
  • Their breathing or heartbeat slows, is abnormal, or stops.

Remember: It isn’t necessary for someone to be showing every symptom listed to be overdosing--exhibiting even one symptom could be a sign of an overdose.

• If you suspect someone is experiencing an opioid overdose, immediately consider the following actions to save their life:
  • If you are on-campus, call UNC Police Department at 970-351-2245 to engage first responders for medical support. If you are off-campus, call 911.
  • Give naloxone if you have it. Spray Narcan® Nasal Spray into one nostril or inject intramuscular naloxone into the upper arm or thigh.
  • If the person is not breathing, do rescue breathing (mouth-to-mouth) or CPR if you know how.
  • Wait two minutes for the person to respond. Continue rescue breathing (or CPR if you are trained). If the person does not respond after two minutes, give a second dose of naloxone.
  • Lay the person on their side in the rescue position, so they do not choke if they vomit.
  • Wait for help to arrive.

• Naloxone is the generic name for Narcan®.
• Naloxone (Narcan®) only works on opioids (such as heroin, fentanyl and prescription painkillers) but is safe to use, even if opioids aren’t present.
• Anyone who needs naloxone can get it at participating pharmacies, without a prescription. This includes people at risk of overdosing and people who may witness someone else overdosing.
• There are different ways to administer naloxone—either as a nasal spray or via intramuscular injection.

For cases of emergency, nasal-spray naloxone doses have been placed in each AED (automatic external defibrillator) unit located across the UNC campus.
In an on-campus emergency, call UNC Police Department at 970-351-2245 to be guided to an AED near you, and to begin the process of engaging first responders.