Fentanyl Overdose: Signs, Symptoms & Treatment

A fentanyl overdose occurs when an individual consumes more fentanyl than their body can handle, leading to potentially fatal respiratory depression and other severe symptoms. Recognizing these signs and symptoms early can be lifesaving.

Common signs and symptoms of a fentanyl overdose include10:

• Severe respiratory depression: Slow, shallow, or difficult breathing.
• Loss of consciousness: The individual may be unresponsive or difficult to wake up.
• Limp body: The person may appear extremely weak or floppy.
• Cold and clammy skin: The skin may feel unusually cold and moist.
• Purple or bluish lips or nails: Indicating a lack of oxygen.
• Vomiting, gurgling, or choking sounds: Sometimes referred to as a “death rattle,” this is a sign that the person is struggling to breathe.
• Slow or erratic pulse: The heart rate may become dangerously slow or irregular.

These symptoms can escalate quickly, so immediate action is crucial when a fentanyl overdose is suspected.

If you encounter someone who may be experiencing a fentanyl overdose, acting swiftly can make the difference between life and death. Here’s what you should do:

Steps to take in the event of a fentanyl overdose5,10:

• Call 911 immediately: Report the situation and provide as much information as possible about the person’s condition and the suspected overdose.
• Administer Naloxone (Narcan) if available: Naloxone is a life-saving medication that can reverse the effects of an opioid overdose, including fentanyl.
• Provide rescue breathing or CPR if necessary: If the person is not breathing or their heart has stopped, begin rescue breathing or CPR until emergency responders arrive.
• Stay with the person: Try to keep them awake and alert. If they are unconscious, place them in the recovery position on their side to prevent choking if they vomit.

Naloxone for Fentanyl Overdoses

Naloxone, commonly known by the brand name Narcan, is a medication designed to reverse opioid overdoses rapidly. It works by binding to opioid receptors in the brain, displacing the fentanyl and temporarily blocking its effects.

How to administer Narcan nasal spray8:

Step 1. Check for signs of an overdose

• Look for signs like the person not waking up, being very sleepy, or not breathing well.
• Gently shake the person and shout their name.
• If there is no response, proceed with administering Narcan.

Step 2. Give the first dose

• Hold the Narcan nasal spray device with your thumb on the bottom of the plunger.
• Insert the nozzle into one of the person’s nostrils.
• Press the plunger firmly to administer the first dose. Each nasal spray device contains one dose.

Step 3. Call 911

• Call 911 immediately after giving the first dose.

Step 4. Watch and give additional doses if needed

• Wait 2-3 minutes to allow the medicine to work.
• If the person wakes up, go to Step 5.
• If the person does not wake up, continue administering additional doses every 2-3 minutes until they do. It is safe to give multiple doses.

Step 5. Stay with the person

• Stay with the person until emergency services arrive, even if the person appears to recover, they still need medical attention because the effects of Narcan may wear off before the fentanyl does.
• Give another dose if they become very sleepy again. You may need to use all the doses in the pack.

Naloxone is a crucial tool in preventing fatal overdoses, and carrying it can save lives.

Understanding the causes and risk factors of a fentanyl overdose can help in taking preventive measures. Several factors increase the risk of overdosing on fentanyl:

Common causes and risk factors include6,11:

• High doses: Consuming more fentanyl than the body can handle is a primary cause of overdose.
• Mixing substances: Combining fentanyl with other drugs, such as alcohol, benzodiazepines, or other opioid drugs can significantly increase the risk of overdose due to the combined depressant effects.
• Using alone: Individuals who use fentanyl alone are at higher risk since there’s no one to assist in case of an overdose.
• Relapse after a period of abstinence: After a break from use, the body’s tolerance to fentanyl decreases, making the same dose more dangerous.
• Contaminated drug supply: Illicit drugs such as heroin, meth, and cocaine, are often laced with fentanyl, and users may unknowingly consume dangerous amounts.
• Age and health conditions: Older individuals and those with certain health conditions such as heart, liver, or kidney issues are at greater risk for overdose.

By understanding these risk factors, individuals can take steps to reduce their chances of experiencing an overdose.

Risk of Fentanyl-Laced Drugs

One of the most significant dangers in the current opioid crisis is the prevalence of fentanyl-laced drugs in the illicit market. Fentanyl is often mixed with other substances like heroin, cocaine, and counterfeit prescription pills to increase potency. This practice is particularly dangerous because it often goes unnoticed by the user, leading to a higher risk of overdose.

According to the CDC, synthetic opioids like fentanyl are responsible for the majority of opioid overdose deaths in the United States. In 2022, more than 73,000 overdose deaths were attributed to synthetic opioids, highlighting the deadly nature of fentanyl-laced drugs. This trend is exacerbated by the fact that fentanyl is 50 to 100 times more potent than morphine, meaning even a tiny amount can be lethal.

Heroin, one of the most commonly adulterated substances, is frequently laced with fentanyl, leading to a spike in overdose deaths. The unpredictability of street drugs makes every use potentially life-threatening, stressing the critical need for harm reduction strategies and awareness.

Preventing a fentanyl overdose requires a combination of awareness, preparation, and harm reduction strategies. Harm reduction is an approach that emphasizes minimizing the risks associated with drug use, rather than simply advocating for abstinence.

Tips to prevent a fentanyl overdose include6,9:

• Always carry Naloxone (Narcan): Naloxone can reverse the effects of a fentanyl overdose if administered in time. Many states have made it available without a prescription.
• Never use alone: Having someone nearby who can call for help or administer Naloxone in an emergency can be lifesaving.
• Test your drugs: Fentanyl testing strips can detect the presence of fentanyl in substances, giving users a chance to avoid or take precautions.
• Avoid mixing substances: Combining fentanyl with other depressants like alcohol or benzodiazepines increases the risk of overdose.
• Start with a small dose: For those who choose to use, starting with a small amount can help gauge potency and reduce the risk of overdose.
• Seek professional help: Long-term prevention of overdose involves addressing substance use disorders through treatment and support.

These steps, while not foolproof, can significantly reduce the risk of a fentanyl overdose and are part of a comprehensive approach to harm reduction.

For those struggling with fentanyl addiction, seeking professional treatment is a crucial step toward recovery. At Empowered Recovery in Atlanta, GA, we offer compassionate, evidence-based treatment programs tailored to each individual’s needs. Getting started with treatment is simple:

• Admission process: Our rehab admissions team will guide you through the process, from the initial assessment to creating a personalized treatment plan.
• Payment options: We offer various payment options, including insurance coverage. Our team of specialists can help verify your benefits and discuss financial arrangements.
• Treatment programs: At Empowered Recovery, we offer a range of rehab programs as well as addiction therapies, group counseling, medication-assisted treatment, and more.

If you or a loved one is struggling with fentanyl addiction, reaching out for help is the first step toward a healthier, more fulfilling life. Contact us today to learn more about our Atlanta rehab center and start your journey to recovery.

References

1. Altekruse, S. F., Cosgrove, C. M., Altekruse, W. C., Jenkins, R. A., & Blanco, C. (2020). Socioeconomic risk factors for fatal opioid overdoses in the United States: Findings from the Mortality Disparities in American Communities Study (MDAC). PLOS ONE, 15(1), e0227966. https://doi.org/10.1371/journal.pone.0227966
2. Centers for Disease Control and Prevention. (2022). Understanding the opioid overdose epidemic. https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html
3. Centers for Disease Control and Prevention. (2023). FastStats: Drug overdose deaths. https://www.cdc.gov/nchs/fastats/drug-overdoses.htm
4. Centers for Disease Control and Prevention. (2023). Trends in fatal overdoses involving benzodiazepines — 23 states and the District of Columbia, 2019–2020. Morbidity and Mortality Weekly Report, 73(6), 181–186. https://www.cdc.gov/mmwr/volumes/73/wr/mm7306a2.htm
5. Cleveland Clinic. (2022). What to do if someone overdoses. https://health.clevelandclinic.org/what-to-do-if-someone-overdoses
6. Massachusetts Department of Public Health. (2023). Opioid overdose risk factors. https://www.mass.gov/info-details/opioid-overdose-risk-factors
7. National Institute on Drug Abuse. (2022). Fentanyl. https://nida.nih.gov/research-topics/fentanyl
8. Narcan. (2023). Frequently asked questions. https://narcan.com/frequently-asked-questions
9. New York State Office of Addiction Services and Supports. (2023). Prevent overdose. https://oasas.ny.gov/prevent-overdose
10. Substance Abuse and Mental Health Services Administration. (2023). Opioid overdose prevention. https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/opioid-overdose
11. U.S. Department of Labor. (2023). Risk factors for opioid use disorder and overdose. https://www.dol.gov/agencies/owcp/opioids/riskfactors
12. Volkow, N. D., & Collins, F. S. (2017). The role of science in addressing the opioid crisis. The New England Journal of Medicine, 377(4), 391–394. https://doi.org/10.1056/NEJMsr1706626 
13. Zuckerman, M., Bollinger, I. M., & Harrison, P. V. (2019). Treatment and management of opioid use disorder: The case for combining medication and behavioral therapy. Journal of Substance Abuse Treatment, 102, 64–68. https://doi.org/10.1016/j.jsat.2019.04.006