Overdose Prevention

Naloxone (also known as the brand name Narcan) is a medication that counters the effects of an opioid overdose.

When someone is overdosing on an opioid (for example: vicodin, morphine, or heroin) their respiratory system slows until they fall unconscious and eventually stop breathing. In an overdose situation, interventions like rescue breathing and administering naloxone may reverse the overdose and save the person's life.

If you are ever around someone who has been prescribed opioid medication, or are around people who use heroin, other opioids, meth*, cocaine*, or crack*, it's important to carry a naloxone kit and know how to respond in case of an overdose.

Naloxone will not have an effect on someone who doesn't have opioids in their system. It typically comes as an intramuscular injection or as a nasal spray. Naloxone cannot be abused. Learn more here.

*Meth, cocaine, and crack are not opioids, but users of such substances may be exposed to fentanyl (a powerful opioid) during use, which can cause an overdose that may be reversible with naloxone.

Contents of a nasal naloxone kit:

If you encounter an overdose and you do not have naloxone, call 911 and begin rescue breathing.

Know the Good Samaritan Law

In 2016, Michigan passed a Good Samaritan law that protects individuals from prosecution for drug possession when they seek medical assistance for an overdose or other drug related health emergency. This law only protects the individual or individuals experiencing the medical emergency and the person who seeks medical assistance on their behalf.  Individuals are only protected from possession when they have a "personal amount" of drugs on them and they may not be protected from other illegal activities or from arrest due to an outstanding warrant.

View Michigan's Good Samaritan Law

 

Overdose Prevention

Below are 4 main risk factors that increase someone's risk of overdosing or dying from an overdose.

1. Mixing: Overdoses are more likely to occur when mixing opioids with uppers or downers.

         Prevention Techniques

                 a) Use one drug at a time, or don't mix drugs that have the highest

risk (like uppers and downers, or opioids and benzodiazepines).



2. Tolerance: After not using for even just a few days, whether this be from jail, rehab, or choice, an individual's tolerance to opioids decreases significantly.
 

Prevention Techniques:


        a) If using opioids after a period of abstinence (especially after 2 or 3 days of abstinence), users should use less than they think they need.


        b) If injecting heroin, inject a partial dose and wait. This can mean doing a "slow shot" where the user injects only a portion of the substance using a syringe but keeps the needle in the injection site and withdraws the syringe or continues the shot based on the effects they feel. It can also mean a "tester shot" where the substance is divided into separate injections and taken at different times.*

 

3. Quality: The quality of illicit drugs can vary greatly from batch to batch and the strength of prescription dosages can vary greatly from drug to drug (for example, 50mg of __ is different from 50mg of __).


Prevention Techniques:

        a) 
Tester shots (see above)

        b) Know what you're getting, use a reliable dealer, and/or test your drugs.
Because illicit drugs are not regulated, users may obtain something impure, something laced with other substances, or something completely different from what they're expecting.
 

- Substances may be impure due to cross-contamination.
- Heroin, meth, cocaine, crack and other substances may be cut with fentanyl (a powerful opioid) or other substances that can greatly increase one's risk of overdose. 
- "Prescription" drugs purchased or distributed illicitly may be counterfeit. For example, a benzodiazepine like Xanax purchased on the street may be alprazolam powder cut with fentanyl or other substances and pressed to look 
like prescription grade Xanax.

People are safest when they purchase drugs from those they know and trust, or from people who test their drugs for substances like fentanyl. You may also purchase kits to test your own drugs. 

- Learn more about Fentanyl here.
Purchase Fentanyl test strips here.


c) If injecting heroin, first use a non-injecting route (snorting, smoking, or tasting a small amount) prior to injection to determine strength and quality.

d) If using drugs with a friend, stagger who uses and when in case the substance causes you to overdose. This decreases the likelihood that you will both fall unconscious at the same time and gives one of you time to respond.

e) Seek feedback from others using heroin of the same batch or observe those with higher tolerance injecting heroin from the same batch before judging how much to use.

 

4. Using Alone: When someone overdoses on an opioid, they cannot administer naloxone to themselves. They need someone to call for help, rescue breath, and administer naloxone to them. When someone uses alone, they risk overdosing when there is no one around to help.


Prevention Techniques:


a) Don't use alone. There are many reasons someone might use alone including by choice, because they have no one to use with, because they don't want to share, because of secrecy, shame, fear of judgment, or other reasons. Whenever possible, it is recommended to:
 

- Use with a friend (see 3d above)

Tell someone what you are using, when, and where you are.
 

- This can be a close friend or trusted family member who can check in on you, remain on the phone, or remain on speakerphone while you use. If you don't answer their calls or texts or if you don't respond to them on speakerphone, they can call first responders to your location.

This can also be a family member, friend, or roommate who you live with. If you feel you have open, safe, and non-judgmental communication with them, you can tell them when you are using so they know to check on you. If you aren't comfortable telling them when you are using, you can instead create a pact where they are allowed to check on you if you quietly disappear into a bedroom, bathroom, basement, garage, etc. for a period of time. Their check-in can be as simple as a knock on the door. If you respond, they know you're safe and can leave you alone. If you don't respond, they have permission to check on you and call for help if needed. 

 

If you do not feel that you have someone you can be this open and honest with, or if you feel shamed and judged into secrecy in your own home, please reach out to us. Our family and community meeting has helped many families learn to understand their loved one's drug use while offering both parties support for what they're dealing with. Even if you feel that open communication with your loved ones just isn't possible, our meeting can still offer you support, resources, and connections so that you are no longer alone.

- Use the Never Use Alone line. This is a safe and confidential hotline that does what is described above.
Their number is 1-(800)-484-3731.
Their backup line is 1-(931)-304-9452. 
Check their website for more information.

b) Carry Narcan and have a 'designated reviver'. If you have a Narcan kit on or around you while you using, let people know where it is and make sure they know how to use it in the event of an overdose. 

c) Don't lock doors, barricade yourself, or rest against a closed door while using. This can make it harder for first responders to get to you in the event of an overdose.

d) Use in public in a place where you are likely to be found quickly in the event of an overdose. A good example is a high-traffic public restroom (like a fast food restaurant or grocery store bathroom) where someone is likely to recognize an unconscious person and call for help. Avoid single bathrooms, places where people will assume you are sleeping, or places where you might be overlooked.

e) DO NOT DRIVE. It's best to avoid driving while on substances, especially if you don't know how a substance effects you, if you feel high, or if you could be at risk of an overdose. Overdosing while driving puts you and others at a greater risk of serious harm.

Overdose Response

Overdose leads to death if adequate care is not given in a timely manner. 

 

cause the victim's respiratory system to slow down to the point where they eventually stops breathing 

Report Use of a Kit
Special Thanks To:
Understanding Overdose

Overdose is not death, but overdose leads to death when adequate care is not given. 

Opioid overdose occurs when someone takes too high of a dose for their tolerance level. 
 
can occur minutes to hours after using. T
Someone who is overdosing cannot administer Naloxone to themselves. They need someone to stay with them, rescue breathe, and administer Naloxone. At the very least. 


 

The following are symptoms of an overdose:
 

  • Body is very limp

  • Face is very pale or clammy

  • Fingernails and lips turn blue or purplish black

  • For lighter skinned people, the skin tone turns bluish purple, for darker skinned people, it turns grayish or ashen.

  • Breathing is very slow and shallow, erratic, or has stopped

  • Pulse (heartbeat) is slow, erratic, or not there at all

  • Choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”).

  • Vomiting

  • Loss of consciousness

  • Unresponsive to outside stimulus

How to Respond

Our grant allows us to distribute Naloxone for free to anyone in our 8 county region of Southwest Michigan. If you are not in our area but would like a kit, please don't hesitate to reach out and we will find a distributor for you. You can also check www.naloxoneforall.org OR www.bitly.com/naloxonefinder

Know how to respond to an opioid overdose, and get trained in how to use Naloxone
 

Stimulation- are they overdosing, are they responsive?

Call for help- call 911.  They may need additional medical attention.

Airway- Check to make sure their airways are clear.

Rescue breathing- Lift up on neck, and tilt head back and chin forward.  2 short breaths, then one breath every 5 seconds for 3-5 minutes.

Evaluation- are they getting any better?  If not, do they need a dose of Naloxone?

Mucosal Atomization  (Nasal Spray) in a single application dispense one dose in one nostril, continue rescue breathing   OR

    Muscular injection- Inject 1-2 ccs in the thigh, shoulder or butt, and continue to breathe for them      

Evaluation- Are they getting better?  After 5 minutes, with continued rescue breathing, if they have not come out of it, give them another shot or another dose of nasal naloxone in the other nostril continue rescue breathing.

​Know what to do after an overdose: Naloxone takes 3-5 minutes to work, and wears off after 60-90 minutes.  They may need another dose.  Do not allow them to use more opioids, they will be wasting them and could OD again.  Need to watch them for at least an hour in case the overdose returns.

Report Use of a Kit

Our grant allows us to distribute Naloxone for free to anyone in our 8 county region of Southwest Michigan. If you are not in our area but would like a kit, please don't hesitate to reach out and we will find a distributor for you. You can also check www.naloxoneforall.org OR www.bitly.com/naloxonefinder

What you should know: (good samaritan law) (identifying an overdose) (how to respond) (aftercare) (clean use supplies)

Save a Life
Know the signs of an opiod/heroin overdose


 

The following are symptoms of an overdose:
 

  • Body is very limp

  • Face is very pale or clammy

  • Fingernails and lips turn blue or purplish black

  • For lighter skinned people, the skin tone turns bluish purple, for darker skinned people, it turns grayish or ashen.

  • Breathing is very slow and shallow, erratic, or has stopped

  • Pulse (heartbeat) is slow, erratic, or not there at all

  • Choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”).

  • Vomiting

  • Loss of consciousness

  • Unresponsive to outside stimulus

If someone is making unfamiliar sounds while “sleeping” it is worth trying to wake him or her up. Many loved ones of users think a person was snoring, when in fact the person was overdosing. These situations are a missed opportunity to intervene and save a life.