How to Avoid Fentanyl Overdoses While Going Out

For many in the U.S., this summer has marked a return to our local queer nightlife venues, with the hopes that we can once again find the sanctuaries and community our physical gathering spaces often hold. And as we venture out into the post-quarantine world, we might have a few drinks, while some of us might partake in drugs like cocaine or ecstasy.

People use drugs for many purposes, but one common reason is that they make people feel good. It’s only natural to want to reach for something that can help us feel relaxed, even euphoric, after a year that was indescribably tough for many. Yet the illegal nature of some drugs means that some people will use them in ways that are less safe. This requires harm reduction, a set of strategies and ideas aimed at minimizing negative consequences associated with drug use and advancing the rights of and respect for people who use drugs. Shaming people for using drugs will only cause more harm by pushing them away from resources and support that can keep them alive.

The government’s criminalization of some drugs has also created a dangerous market for them, with no guarantees on quality or safety. Substances that come in powder form, like cocaine or meth, and pill form, like Xanax or Adderall, have increasingly been contaminated with a drug called fentanyl, a very strong opioid that only requires a small amount to cause an overdose. According to the CDC, fentanyl overdoses have been rising at an exponential rate over the last decade, and have likely increased during the pandemic.

While this might sound scary, it’s important to know that overdoses are preventable, and you can take certain steps and gather certain supplies to help keep yourself and your friends safe before a night out. Whether or not you’ve used drugs before, here are some tips on how to party more safely. 

Opioids are a class of drugs that interact with the opioid receptors in your brain to reduce feelings of pain; they can also make people feel euphoric. As the demand for heroin, oxycodone, and other opioids has grown over the last two decades, drug traffickers have looked for cheaper ways to meet these needs.

While some opioids like heroin can be made from compounds naturally occurring in the opium poppy, fentanyl is a synthetic opioid, meaning it can be made more cheaply, using chemicals in clandestine laboratories. Because fentanyl is a white powder that doesn’t have a distinct taste or odor, many drug traffickers have mixed small amounts of it into their supplies of other opioids so that they can sell more of it.

As fentanyl use has become more and more common, it has been accidentally or intentionally mixed in with other illegal drugs like cocaine, producing a contaminated drug supply. Fentanyl is about 50 to 100 times more powerful than morphine, so it takes very little to cause an overdose, especially if you’ve never used an opioid before or are not expecting to use an opioid.

It can be tough to tell if drugs have been mixed with fentanyl by just looking at them or tasting them. Fentanyl test strips are easy-to-use tools to see if the substance is mixed in with your drugs. Dissolve a little bit of your supply in water, dip the test strip, and you’ll get a result in a few minutes. If you see one red line, it means you have a positive test and fentanyl is in your supply. If you see two red lines, then it means you have a negative test and fentanyl might not be in your supply. False negative results can occur when a drug sample contains fentanyl but a test fails to identify it, so it is important to remain cautious.

Despite the fact that fentanyl test strips are easy to use, cheap to buy, and proven to help avoid overdoses, they’re not as widely available as they should be. Access varies from state to state, but you can find them at many syringe exchange program locations; check this database from the North American Syringe Exchange Network to see if there is availability in your area.

Naloxone is a medicine that rapidly reverses an opioid overdose. It is available as a spray that can go in someone’s nose or as a shot that can be injected into someone’s muscle. If you or those you’re with may be using drugs that could lead to an opioid overdose, carrying naloxone is a good idea — and could save a life.

In some states, like California, New York, and Texas, you can get naloxone without a doctor’s prescription at any major pharmacy like CVS, Walgreens, or Rite Aid. You may also be able to get it for free from your city or state’s health department, or a local harm reduction group. Check this database from the Harm Reduction Coalition to find naloxone nearest you. Regardless of where you get your naloxone, someone will be able to show you how to use it in case of an emergency.

Naloxone is sold with a shelf life of 1 to 2 years, but any naloxone is better than none. Even if it’s past its expiration date, recent studies have suggested that it may remain effective even decades after it’s been purchased if it has been stored in a cool, dry place out of direct sunlight.

Depending on what drugs you’re using, you might need other supplies like straws for snorting or needles for injecting. It’s important to use new supplies every time and not share them with other people to prevent the spread of viruses like HIV, Hepatitis C, and COVID-19. If you’re injecting drugs, make sure you get new needles, cookers, and cotton every time. To find out where to get safer drug use supplies near you, check out Next DISTRO.

Whether you’ve used a drug before or not (but especially if it’s been a while), it’s important to start low and go slow. This means starting by using a little bit and waiting a few minutes to see how strong it is. Read up on how you might feel when using a particular drug with these fact sheets from the Drug Policy Alliance. If something feels strong with a very small amount, you might consider using less or not using it at all that night. While you’re using, make sure you take breaks to cool off, drink water, have a snack, and rest.

Remember, we’re all out to have a good time. Whether you use drugs yourself or not, there’s no need to judge people for how they enjoy themselves. People who overdose cannot give themselves naloxone, so you might consider designating someone to be your “sober buddy” for the night. If you’re in a group where you’re all planning to use, take turns so that someone can call 911 and administer naloxone if someone overdoses. 

Unintentional overdoses are an unfortunate part of living in a world with a contaminated drug supply. The good news is that opioid overdoses can be reversed, meaning that many fatal overdoses are preventable. Because they can happen rapidly, you need to call 911 and act immediately if you think someone is overdosing.

Someone who is overdosing might be unresponsive, meaning that they don’t respond to your voice when you try to wake them up. They might have very slow, shallow breaths or stop breathing entirely, which you can assess by rubbing your knuckles on their chest. Another tell-tale sign is that they look very pale or have blue fingernails and lips.

If someone overdoses, call 911. After you’ve called 911, start giving rescue breaths by tilting their head back and breathing twice into their mouth with their nose pinched closed. Then continue to give a breath every five to six seconds.

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Next, give naloxone if you have it. To give nasal naloxone, take the cap off the naloxone before pushing the end of the container to firmly spray half the naloxone into the person’s nose. Repeat with the other half in the second nostril. Because fentanyl is very strong, you might need to give more than one dose. If the person doesn’t react in two to three minutes, give a second dose if you have it. Make sure you put the person in the recovery position on their side with their body supported by a bent knee. Stay with the person until first responders arrive and can give them more naloxone or other medical help.

When calling 911, you may want to say that someone is “not responsive” or “not breathing” rather than mentioning the use of drugs or the word “overdose.” If you’re worried about police, may only prompt EMS to arrive on the scene. You should always give as much detail as possible about where they can find you and the overdosing person, and you should tell 911 if naloxone was administered. Around 47 states have Good Samaritan Laws that protect people from prosecution if they report an overdose. Even if you’re able to reverse an overdose with naloxone, it’s important to have medical professionals evaluate someone who has experienced one, due to the risk of other complications that an overdose can bring, including heart problems and pneumonia.

Living through the COVID-19 pandemic has taught us all something about the value of human connection. In coming back to our favorite spaces, it’s important that we take care of ourselves and each other. These simple safer drug use tips can help us have a good time and make sure no night ends with a tragedy.

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