Do you know the signs of an opioid overdose? Here’s how to help, where to find resources
Four people incarcerated in the Whatcom County Jail in downtown Bellingham were recently taken to the hospital due to suspected opioid overdoses.
Opioid-related overdoses and overdose deaths are rising both locally and nationally. In a presentation given in October last year, Whatcom County Sheriff Bill Elfo said there were 58 suspected overdose deaths investigated within the first seven months of 2022.
One-third of those deaths involved fentanyl, The Bellingham Herald previously reported.
Drug overdoses have been one of two leading causes of accidental deaths in Whatcom County since 2000, according to the Whatcom County Medical Examiner’s annual reports. In 2021, the most recent annual report, nearly 57% of all accidental deaths were due to drugs, with fentanyl present in 58% of the drug overdose deaths.
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. Two milligrams of fentanyl, which is roughly the size of a few grains of sand, can be lethal.
Other common opioids include heroin, morphine, OxyContin and Percocet.
Anyone using opioids can be at risk for an opioid-related overdose, but people who use drugs after they stopped using drugs for a few days, people who mix opioids with other drugs or alcohol and people who are alone when using drugs are more likely to overdose, according to the Washington State Department of Health.
So what are the signs of an opioid-related drug overdose and how can you help?
Signs of an opioid overdose
Opioids depress the body’s ability to breathe, so an overdose can look like a lot of things, according to Cindy Hollinsworth, Communicable Disease and Epidemiology Manager with Whatcom County Health and Community Services, also known as the county’s health department.
A person found on the ground could be having an overdose, a heart attack or separate medical issue, so it’s important to take action right away in that type of situation, Hollinsworth said.
Other symptoms include:
▪ Loss of consciousness or ability to talk.
▪ Slow, shallow breathing.
▪ Unresponsive to shaking, yelling or pain.
▪ Blue lips on a person with a lighter skin color or ashy or white lips on a person with a darker skin color.
▪ Blue, purplish or black fingernails.
▪ Choking or gurgling sounds.
▪ Vomiting.
▪ Slow or erratic pulse, or lack of pulse.
▪ Limp body.
What to do
▪ Call 911.
▪ Try to wake the person up by shaking them or shouting their name to see if they respond.
▪ Rub your knuckles hard on the center of their chest and see if they respond.
▪ Put your ear close to their nose and listen and feel for signs of breathing.
▪ Administer naloxone, commonly known as Narcan, if available.
▪ Lay the person on their side to prevent choking.
▪ Stay with the person until emergency first responders arrive.
If you’re worried about being arrested or sued for using naloxone, calling 911 or providing aid while someone is overdosing, there are several laws in Washington that protect you.
Under the state’s Good Samaritan Law, if you seek medical help for someone having an overdose, neither one of you can be charged for having or using a small amount of drugs.
It also applies to people under age 21 who provide aid during an alcohol poisoning. Both the person who called 911 and the person suffering from alcohol poisoning cannot be charged with possession of alcohol as a minor, according to the law.
The law does not apply to outstanding warrants, controlled substance homicide, probation or parole violations or other crimes besides drug possession. A judge can take your actions to provide aid into account during sentencing, though.
How to administer naloxone
Naloxone, commonly known as Narcan, is a medication used to reverse the effects of opioids and is often used during suspected opioid overdoses.
Naloxone comes in either an injectable form or as a nasal spray. One kit usually has two doses.
If you’re using the injectable form:
▪ Remove the cap and uncover the needle.
▪ Insert the needle through the rubber plug, then turn the vial upside down. Pull back on the plunger and fill the syringe with 1 milliliter of naloxone.
▪ Inject the naloxone into an upper arm or thigh muscle. The syringe will go through clothes.
If you’re using the nasal spray form:
▪ Peel back the package to remove the device.
▪ Remove the cap.
▪ Place and hold the tip of the nozzle in either nostril.
▪ Press the plunger firmly to release the entire dose into a person’s nose.
If you’ve administered naloxone and a person is not breathing, start giving rescue breaths.
Wait around three minutes to see if the naloxone takes effect. If it does not and the person has not responded after three minutes, give them a second dose.
Stay with the person until medical aid has arrived or the person has been checked out by a medical professional. Naloxone lasts up to 90 minutes, but once the medication wears off, a person could start to experience overdose symptoms again.
Naloxone works on all opioids but not on other drugs, such as amphetamines.
There is no harm in giving a person naloxone if they’ve taken other drugs, according to the state health department.
Where to get naloxone
There are multiple ways to get naloxone in Whatcom County and across Washington state.
▪ There is a statewide standing order prescription for naloxone, which allows anyone to get or possess the medication.
You can go to any pharmacy and present them with the standing order, which can be found in both English and Spanish. Bringing a paper copy is recommended, but you can also pull up the PDF on a phone or tablet or ask if the pharmacist can pull the standing order up for you.
According to the standing order, the pharmacist will give you at least one kit, which usually contains two doses, per transaction. If you need more than one, ask the pharmacist if they have more available.
While you may be asked to provide identification, the pharmacist should not ask you why you are requesting a naloxone kit. You are not required to provide proof of needing the kit.
You may be required to pay for naloxone kit, or you can see if your insurance covers it.
▪ You can get naloxone in the mail statewide for free.
The mail-order program is intended for people who can’t easily go to a local community organization or a pharmacy to get a kit.
For every county except King County, you can get a naloxone kit in the mail through the People’s Harm Reduction Alliance. The form is also available in Spanish.
In King County, naloxone mail kits can be ordered free from the Kelley-Ross Pharmacy.
▪ Whatcom County Syringe Services
You can get injectable naloxone through the county’s syringe services program.
The program provides new, sterile needles and equipment to people who use injection drugs. It also provides connections to drug treatment, disease testing, vaccines and other social services.
The program also provides naloxone education and distribution.
Syringe services clinics are provided from 2 p.m. to 4 p.m. every Monday and Thursday, except on holidays.
The Bellingham clinic is located directly off York Street in the parking lot behind the Walton Place Apartments at 1511 N. State St.
There is also a mobile clinic in Maple Falls, according to the county health department.
The mobile clinic provides services from 10:30 a.m. to 12 p.m. every Monday, except holidays. The mobile clinic is located in the parking lot of the East Whatcom Regional Resource Center at 8251 Kendall Road in Maple Falls.
▪ Narcan Leave-Behind Program
Whatcom County Emergency Medical Services provides the Narcan Leave Behind Program, which provides naloxone kits to at-risk people, involved bystanders or family of people at risk of an opioid overdose, according to the county’s website.
The kits can be requested by emailing Steven Cohen at scohen@co.whatcom.wa.us
The emergency services department is available to train people and organizations on how to administer Narcan. The agency can also provide training resources.
Other resources
Hollinsworth, with the county health department, said addiction and drug use is complicated, but creating an open and safe environment for the person can help them move forward in getting help or treatment.
Providing compassion without stigma is critically important, she said.
“People have all kinds of misconceptions about opioid use or overuse. Addiction, it’s a disease, and I think the more that we understand about it and the more we can normalize this as a medical condition that you need to get help for, people are going to have better outcomes,” Hollinsworth said.
You can also find more resources on addiction, overdoses, finding naloxone, treatment and suicide prevention here:
▪ Whatcom Has Hope is a community education campaign focused on opioid addiction and prevention. The website provides numerous resources, including a list of where to get help and what services are provided locally.
▪ Stopoverdose.org provides educational and technical assistance for people statewide on how to prevent and respond to overdoses and how to improve the health of people who use drugs. It’s a program through the University of Washington Addictions, Drug & Alcohol Institute.
▪ 988 Suicide and Crisis Lifeline is a 24-hour, free and confidential support hotline for people in distress. It also provides resources for you and your loved ones.
▪ Washington Recovery Helpline provides 24-hour help for substance abuse, gambling and mental health
▪ Whatcom Homeless Service Center, provided by Opportunity Council, connects people to services to prevent and end homelessness.
▪ Teen Link provides services in Washington state for teenagers by trained teenagers for issues such as bullying, drug and alcohol concerns, relationships, mental health and other concerns.
▪ Never Use Alone is a toll-free nationwide service for people who use drugs alone. You can speak with someone by calling 800-484-3731 or online.
▪ Anne Deacon Center for Hope is a crisis stabilization center serving adults in Whatcom County and the North Sound region. The center offers short-term substance use disorder and behavioral health support services.
This story was originally published February 13, 2023 at 5:00 AM with the headline "Do you know the signs of an opioid overdose? Here’s how to help, where to find resources."
