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Naloxone overdose intervention: When minutes count
News coverage and headlines document an epidemic in the U.S.: the surge of opioid addiction and deaths affecting every community in the country. Since 1999, more than 1 million Americans have died from drug overdoses. In 2023, more than 112,000 people lost their lives to overdoses, with 88% due primarily to synthetic opioids like fentanyl.
The drugs behind the epidemic
Opioids are one of the most commonly prescribed medications to treat acute pain. This class of drugs includes medications such as fentanyl, morphine and oxycodone. They work by blocking pain receptors in the central nervous system.
What makes opioids effective is also what makes them dangerous due to the risks associated with addiction and overdoses.
Fentanyl is the drug most responsible for the high rates of addiction and overdose. The market for illicitly manufactured fentanyl continues to change, and the drug can be found in combination with heroin, counterfeit pills and cocaine.
Signs of an overdose
Recognizing the signs of opioid overdose can save a life. Things to look for include:
- Choking or gurgling sounds
- Cold and clammy skin
- Discolored skin, especially lips and nails
- Falling asleep or losing consciousness
- Limp body
- Slow, weak or no breathing
- Slurred speech or confusion
- Small, constricted pinpoint pupils
Death from a fentanyl overdose can happen quickly. That's why it's crucial to intervene if you suspect someone is overdosing.
Reversing an overdose with naloxone
The Food and Drug Administration has approved a rescue medicine called naloxone, or Narcan. It quickly reverses an overdose by blocking the effects of opioids. Naloxone can restore normal breathing within two to three minutes in a person whose breath has slowed or recently stopped. While giving naloxone to someone who doesn't have opioids in their system won't hurt them, be aware that it can't reverse an overdose of every drug.
This lifesaving medication is now available over the counter as a 4-milligram nasal spray. It's being sold in pharmacies without a prescription, but also is becoming available at grocery stores, convenience stores, vending machines and other retail locations. The cost typically is less than $50 for a two-spray pack.
Due to naloxone's effectiveness in reviving people experiencing an overdose, many organizations and government entities offer it for free. People also are beginning to carry a naloxone pack in their vehicle or first aid kit.
If you suspect someone is overdosing:
- Call 911 immediately.
- Administer naloxone. Due to the strength of some opioids like fentanyl, more than one dose may be needed.
- Try to keep the person awake and breathing.
- Lay them on their side to prevent choking.
- Stay with them until emergency assistance arrives.
If you're concerned about being liable for administering naloxone, the majority of states have passed good Samaritan and naloxone access laws, which protects people without medical training who administer the medication.
Seeking help for addictions
Medications and other recovery strategies are available for people struggling with addiction. Contact your primary care provider or other healthcare professional to discuss available options.
Glenn Kauppila, D.O., is a Family Medicine physician in Eau Claire, Wisconsin, with special interest in addiction.