Introduction to Opioid Overdoses

Opioid overdoses represent a critical medical emergency with profound implications for public health and safety. Defined by the excessive consumption of opioids, these overdoses can result in life-threatening complications if not promptly recognized and addressed. From prescription painkillers to illicit substances like heroin and fentanyl, opioids encompass a broad range of drugs that exert powerful effects on the central nervous system.

Despite efforts to curb opioid misuse and abuse, the prevalence of overdoses remains alarmingly high, affecting individuals of all ages, backgrounds, and socioeconomic statuses. The opioid crisis has become a pressing concern worldwide, prompting concerted efforts from healthcare providers, policymakers, and communities to mitigate its impact.

By gaining a better understanding of opioid overdoses and equipping ourselves with the necessary knowledge and skills to respond effectively, we can play a vital role in saving lives and combating the opioid crisis.

Opioids and Their Effects on the Body

Opioids are a class of drugs that act on the body’s opioid receptors, primarily located in the brain and spinal cord. These receptors play a crucial role in regulating pain perception, pleasure, and mood. When opioids bind to these receptors, they can produce a range of effects, including pain relief, euphoria, and sedation. When opioids bind to opioid receptors central nervous system (CNS) depression occurs.

This CNS depression causes a decrease in a person’s alertness, causing drowsiness and potential unresponsiveness. Additionally, the patient’s respiratory rate, or how many times in one minute you breathe, also goes down. Your body requires oxygen to maintain normal function and we receive oxygen everytime we breathe in. So what you get in an opioid overdose is someone who loses awareness and experiences a decrease in oxygen intake. Their body continues to function until it is ultimately starved of oxygen and bodily systems start to fail.

A person overdosing will have a period where the overdose can be reversed and they can be saved. At the onset of the overdose they will lose alertness and their breathing will slow/stop. Without intervention their body will starve of oxygen and their heart will stop. It is in this period you can save them.

Recognizing an Opioid Overdose

A person experiencing an overdose may still have a pulse and exhibit any combination of the below signs.

  • Pinpoint Pupils

  • Slow/No Breathing

  • Not Responding

  • Blue/Grey Skin

  • No Signs of Life

The most powerful sign of an opioid overdose is pinpoint pupils.

Responding to an Opioid Overdose

Be mindful that there may be drug paraphernalia that could injure you.

When responding to an opioid overdose remember the following:

  • Call 911!

  • Check for a pulse as you may need to start CPR

  • Look for the four signs of an opioid overdose

    • Pinpoint Pupils

    • Apnea (Not Breathing/Very Slow Breathing)

    • Altered Mental Status/Unconscious

    • Cyanosis (Blue Skin Especially Around the Lips/Fingertips)

  • If comfortable provide rescue breathing with one breath every six seconds

  • If available provide Naloxone/Narcan

Rescue Breathing

Rescue breathing will allow you to replace depleted oxygen in the victim’s blood. Three options of rescue breathing exist: mouth-to-mouth, mouth-to-mask, and bag-valve-mask. With either technique you will want to provide one rescue breath every six seconds.

Mouth-to-Mouth

  • Pinch the victims nose closed

  • Tilt their head back

  • Place your mouth over their mouth forming a seal

  • Exhale one breath into their mouth watching for chest rise and stopping when you see the chest rise

Mouth-to-Mask

Mouth-to-Mask ventilations reduce your risk of disease by utilizing a mask barrier between you and your victim. You place the mask over the victims mouth and nose and breath through a one-way valve to deliver breaths.

  • Start by tilting the patient’s head backwards to open their airway.

  • Place the mask over the victims mouth and nose forming a secure seal.

  • Then provide one breath over one second or until their chest rises.

  • Release your breath for one second to allow the air to escape from their lungs.

Bag Valve Mask (BVM)

  • Place the mask over the victim’s nose and mouth with your thumb and index finder with enough pressure to form a tight mask seal

  • Tilt the victims head back while keeping a tight mask seal

  • Deliver one breath over one second (stopping when you note chest rise)

  • Release the bag for one second allowing the victim to exhale

Administering Naloxone

Administering naloxone, a life-saving medication, is crucial in reversing the effects of an opioid overdose. Naloxone can be administered via pre-packaged nasal spray by non medical personnel. When you suspect an opioid overdose, call emergency services immediately. Administer the naloxone by placing the nozzle of the nasal spray into one nostril of the victim and pressing the plunger firmly. Observe the person closely; if there is no response within 2-3 minutes, administer a second dose. Naloxone temporarily reverses the overdose effects, providing critical time for medical professionals to arrive and offer further treatment. It is important to stay with the person until help arrives, as multiple doses may be required to keep the person stable.

Common Myths

Common myths about opioid overdoses persist despite efforts to educate the public. Let us address and dispel some of these misconceptions:

Myth 1: Opioid overdoses only happen to people who use opioids regularly or are addicted.

Reality: Opioid overdoses can occur in individuals who use opioids infrequently or even for the first time. Anyone who consumes opioids, whether prescribed or obtained illicitly, is at risk of overdose, regardless of their level of use or addiction.

Myth 2: Opioid overdoses are always fatal.

Reality: While opioid overdoses can be life-threatening, they are not always fatal, especially if prompt medical intervention is provided. The timely administration of naloxone, along with appropriate medical care, can reverse the effects of an overdose and save lives.

Myth 3: It is safe to consume opioids with alcohol or other drugs.

Reality: Combining opioids with alcohol or other central nervous system depressants significantly increases the risk of overdose and death. Mixing substances can potentiate the sedative effects of opioids, leading to respiratory depression, coma, and even death.

Myth 4: Naloxone (Narcan) can harm someone if administered unnecessarily.

Reality: Naloxone is a safe and effective medication used to reverse opioid overdoses. It only works to reverse the effects of opioids and has no adverse effects if administered to someone who is not experiencing an overdose. When in doubt, it is better to err on the side of caution and administer naloxone if an overdose is suspected.

Myth 5: Once someone has been revived with naloxone, they are out of danger.

Reality: While naloxone can temporarily reverse the effects of opioids and restore breathing, its effects may wear off before the opioids fully metabolize, putting the individual at risk of re-entering overdose. It is essential to seek emergency medical attention after administering naloxone to ensure the person receives comprehensive care and monitoring.

Dispelling these myths is crucial for raising awareness about the realities of opioid overdoses and empowering individuals to take appropriate actions to prevent and respond to these emergencies effectively. Education, coupled with access to naloxone and comprehensive treatment services, is essential in addressing the ongoing opioid crisis and saving lives.

Review

What is the most powerful sign of an opioid overdose?

If you do not have Naloxone/Narcan what else can you do?