Opioid Overdose Prevention

Tragically, people die every day from opioid overdose. Learn how these deaths can be PREVENTED.

August 31st: International Overdose Awareness Day

International Overdose Awareness Day (IOAD) is observed annually on August 31st.

IOAD honors lives altered by overdose. On this day, we remember the lives lost, acknowledge the grief that remains, and renew commitment to ending overdose and related harms.

Overdose touches people and communities in many ways. This includes the lives of family and friends who grieve the loss of a loved one; workers in healthcare and support services extending strength and compassion; or spontaneous first responders who selflessly assume the role of lifesaver.

Everyone can play a role in ending overdose. Talk to your doctor if you or someone close to you needs help for substance use.

To participate in an IOAD event in your area, visit overdoseday.com >>

Source: overdoseday.com

Overdose: Signs & Symptoms

What causes an overdose?

When there is too much opioid in the body, a person can lose consciousness and stop breathing – this is an overdose. An opioid overdose can happen suddenly or come on slowly over a few hours. Without oxygen, a person can die. Most opioid users (64-97%) report that they have witnessed at least one overdose. And often friends and family likely have concerns for opioid use. Recognizing and responding to the early signs of overdose can save the life of someone you love.

The risk of opioid overdose increases when a person is:

  • Taking prescription pain medication more often or in higher doses than prescribed or using someone else’s prescription pain medication. The dose could be too much.
  • Using heroin or pills bought on the street. Heroin and street pills often contain other substances such as fentanyl that can be dangerously toxic.
  • Using opioids with alcohol or other drugs including sleeping pills, benzodiazepines (“benzos” like Valium and Xanax), cocaine and methamphetamine.
  • Using opioids again after your tolerance has dropped. This is common after being in treatment, a hospital, or jail. After a break from opioids, the body can’t handle as much as it did before.
  • Any current or chronic illness that weakens the heart or makes it harder to breathe.
  • Using opioids by yourself. You are more likely to die from an overdose if no one is there to help.
  • Previous overdose. A person who has overdosed before is more likely to overdose again.

Source: American Psychological Association (apa.org) and stopoverdose.org

Recognizing an overdose can be difficult. If you aren’t sure, it is best to treat the situation like an overdose—you could save a life. Call 911 immediately. Administer naloxone, if it’s available. Do not leave the person alone.

Look and listen for:

  • A person who cannot be woken up
  • Slow or no breathing
  • Gurgling, gasping, or snoring
  • Clammy, cool skin
  • Blue or gray lips or nails
  • Vomiting
  • Pills, needles, or burnt foil

Try to wake them up:

  • Shake them and call their name
  • Rub your knuckles hard over their chest bone

IF THEY DON’T WAKE UP… ACT FAST!

Call 911.

Give naloxone if you have it.

Start rescue breathing:

  • Tilt head back, lift chin and pinch nose
  • Give 2 quick breaths
  • Give 1 slow breath every 5 seconds
  • Continue until breathing starts or help arrives. Roll the person into a recovery position on their side

Stay with them. Naloxone wears off in 30-90 minutes so they may stop breathing again.

Naloxone only works on opioids. Opioids are substances such as fentanyl, heroin, oxycontin/oxycodone and other opioid-based pain medications. Here are two ways you can get naloxone in Washington State:

To find Naloxone near you, use Naloxone Finder >>

Source: Prevent Overdose Washington

In Washington state, anyone trying to help in a medical emergency is generally protected from civil liabilities by RCW 4.24.300.

Washington state’s 911 Good Samaritan Overdose Law RCW 69.50.315 gives additional, specific protections against drug possession charges:

  • If you seek medical assistance in a drug-related overdose, you cannot be prosecuted for drug possession.
  • The overdose victim is also protected from drug possession charges.
  • Anyone in WA State who might have or witness an opioid overdose is allowed to carry and administer naloxone. (RCW 69.41.095)

For more information on Naloxone Laws, click on the ‘Naloxone’ tab.

What are Opioids?

Opioids bind to specific receptors in the brain that reduce the transmission of pain signals throughout the body. Opioids include:

  • Fentanyl
  • Heroin
  • Prescription pain medications like:
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Morphine (MS Contin)
  • Oxycodone (OxyContin, Percocet)
  • Codeine
  • Methadone

Source: stopoverdose.org

Naloxone

Naloxone is a prescription medicine that temporarily stops the effect of opioids. This helps a person start to breathe again and wake up from an opioid overdose. Naloxone (the generic name) is also sold under the brand name Narcan®. 

Naloxone:

  • Only works on opioids; it has no effect on someone who has not taken opioids.
  • Cannot be used to get high and is not addictive.
  • Has a long safety history; adverse side effects are rare.
  • Can be easily and safely administered by laypersons.

In WA State, anyone who might have or witness an opioid overdose can legally possess and administer naloxone. Watch & share this video >>

Courtesy: preventoverdosewa.org

Brave – An overdose detection mobile app designed by and for people who use drugs.
VISIT: brave.coop/overdose-detection-app

National Harm Reduction Coalition – Find harm reduction resources near you.
VISIT: harmreduction.org

Never Use Alone Hotline – A stigma-free, volunteer peer-run call center with operators (24/7/365).
VISIT: neverusealone.com
CALL: 800-484-3731

Prevent Overdose WA – Learn how to Get Naloxone and Reverse an Overdose.
VISIT: preventoverdosewa.org

Stop Overdose – Resources for WA residents to respond to and prevent opioid overdose, and to find Naloxone.
VISIT: stopoverdose.org

The People’s Harm Reduction Alliance (PHRA) – Get Naloxone Delivered for FREE.
VISIT: phra.org/mail-order-naloxone

Washington Recovery Help Line – Help for Substance Abuse, Problem Gambling, and Mental Health. A service of Crisis Connections.
VISIT: warecoveryhelpline.org
CALL: 866-789-1511 to speak with a specialist (24/7/365)
TTY: 206-461-3219
TEXT: 866-789-1511 (Mon-Fri: 9:00a – 9:00p)
EMAIL: recovery@crisisconnections.org

WA State Department of Health (WA DOH) – Information on overdose, naloxone, and where to find local syringe service programs.
VISIT: wa.gov/YouandYourFamily/DrugUserHealth

Washington State Naloxone Finder – Naloxone is now available over-the-counter at many pharmacies. It’s also available using the Statewide Standing Order for Naloxone and insurance; if you have Apple Health (WA Medicaid) there’s no copay. Please purchase naloxone or use your insurance if you’re able to do so. Otherwise, use this map to locate FREE naloxone nearest you.
VISIT: preventoverdosewa.org

Naloxone is now available over the counter, and major pharmacies like Walgreens, CVS, Walmart, and Rite Aid sell a 2-dose box for around $45. Not all pharmacies may have it in stock, so it’s best to contact them before you go to confirm availability.

Some health insurance plans may cover the cost or provide a discount since the $45 price may be a barrier for some people who want to buy the medication. People enrolled in Apple Health can get the kit for free, without a copay.

Source: King County Public Health Insider

Naloxone by mail is ideal for those who may find in-person access challenging. Deliveries might take up to three weeks based on supply availability.

1. The Kelley-Ross Pharmacy Group provides mail-order and walk-in access within King County. The mail-order program is meant for people who do not have insurance coverage or who can’t easily go to a community organization or a pharmacy to get a kit.

2. Visit the Washington Department of Health for regions outside King County.

To find naloxone near you, search the Washington State Naloxone Finder. Be sure to contact the chosen location to confirm availability.

Naloxone is a prescription medicine that temporarily stops the effect of opioids. This helps most people start to breathe again and wake up from an opioid overdose. Naloxone (the generic name) is also sold under the brand name Narcan®.

Naloxone:

  • only works on opioids; it has no effect on someone who has not taken opioids
  • cannot be used to get high and is not addictive
  • has a long safety history; adverse side effects are rare
  • can be easily and safely administered by laypersons

In WA State, anyone who might have or witness an opioid overdose can legally possess and administer naloxone.

Watch & share this video >>


Source: preventoverdosewa.org

All of the Naloxone products available are similarly effective against opioid overdose. A health care provider or pharmacist can help you select which product is best for you.

Possessing, using and distributing naloxone

Washington state law RCW 69.41.095 allows anyone “at risk for having or witnessing a drug overdose” to obtain an opioid overdose medication and administer it in an overdose. This includes people who use opioids, family members, friends and professionals.

Washington state’s 2015 “Naloxone law” RCW 69.41.095 also permits naloxone to be prescribed directly to an “entity” such as a police department, homeless shelter or social service agency for staff to administer if they witness an overdose when performing their professional duties.

RCW 69.41.095 permits non-medical persons to distribute naloxone under a prescriber’s standing order.

Immunity from liability

Several laws in WA State (commonly called “Good Samaritan” laws) give certain protections to laypersons trying to assist in a medical emergency. RCW 4.24.300 provides immunity from civil liabilities when responding in a medical emergency. RCW 69.50.315 further protects both the overdose victim and the person assisting in an overdose from prosecution for drug possession.

Statewide Standing Order

Under the Washington Statewide Standing Order anyone can go to a pharmacy that carries Naloxone and obtain it without a prescription from their healthcare provider. Organizations can use the standing order to purchase naloxone to have on-site or for distribution.

Buprenorphine

Buprenorphine, also called suboxone, is a medication used to treat opioid use disorder. It is one of the best available treatments to alleviate withdrawal, reduce cravings, and reduce overdose risk by about half when taken as directed. It works by binding to the same receptors that opioids like fentanyl bind to, but it only turns them on about halfway. That keeps people from feeling sick and helps with their cravings.

The UW Department of Emergency Medicine recently launched a Tele-buprenorphine Hotline in partnership with Public Health—Seattle & King County to provide low-barrier medication for opioid use disorder.

This NEW Telebup Program offers on-demand treatment year-round 24 hours a day, 7 days a week through a FREE telehealth visit with one of 13 UW Department of Emergency Medicine physicians. Each physician’s team has two Linkage to Care Coordinators who are available to assist patients with linking to care within 72 hours of their first telehealth visit.

This service is for:

• anyone who is 13 years of age or older

• anyone who has an opioid use disorde

• anyone in King County, WA

Messaging is visually divided into sections on navy, salmon pink, and white backgrounds. Header reads "24/7 ON DEMAND BUPE". Beneath reads "Call 206-289-0287 for a prescription" and "How it works" with a definition of "BUPE". Footer contains community partner logos in black with website for more info (warecoveryhelpline.org).

Download Flier – (PDF)

Learn more & spread the word >>

Source: A joint initiative from Public Health–Seattle & King County, King County Department of Community and Human Services (DCHS), and the UW Medicine Department of Emergency Medicine (UWDEM).

Fentanyl

Talk to your kids about fentanyl.

You play an important role in keeping the kids in your life safe. Talk to them today about avoiding opioids like fentanyl, which can hurt them and their future. Find more information on how to spark a conversation at WA Friends For Life.


In King County, WA

“It’s a very real concern in King County, Washington. Three people a day are dying from a fentanyl overdose (in 2023). It’s stunning, we’ve never seen anything like this before,” said HIPRC associate member Caleb Banta-Green, PhD, MPH, MSW.

King County is seeing an increase in illicit drugs that contain fentanyl. Between 2018-2020, King County saw a 164 percent increase in the number of fentanyl-involved deaths. As of October 2022, 710 overdose deaths (12 overdose deaths among people under the age of 18) had occurred in King County, surpassing the total number of overdose deaths that occurred in 2021. 

If your child is using fentanyl they could quickly develop addiction. There are excellent treatment medications, such as buprenorphine, that can be prescribed. These medicines support recovery and are extremely protective against overdose and death. Find doctors who prescribe buprenorphine through the Washington Recovery Help Line or call the 24/7 ON DEMAND BUPE Hotline at (206) 289-0287 anytime to request a prescription.


Source: Centers for Disease Control and Prevention (CDC), Laced & LethalWA Friends for Life, Washington Recovery Help Line, Learn About Treatment, King County Medical Examiner’s Office, Public Health—Seattle & King County, and the University of Washington Department of Emergency Medicine (UW DEM).

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine. It is a major contributor to fatal and nonfatal overdoses in the U.S.

There are two types of fentanyl: pharmaceutical fentanyl and illegally made fentanyl. Both are considered synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer.

However, most recent cases of fentanyl-related overdose are linked to illegally made fentanyl, which is distributed through illegal drug markets for its heroin-like effect. It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.

Learn more Facts about Fentanyl >>

Protect yourself from the Dangers of Fentanyl >>

Fentanyl Exposure FAQs >>

Source: Centers for Disease Control and Prevention (CDC

Start a dialogue with your kids. Take a step back and have a more general conversation about pain, stress, medications, and basic messaging around pain and stress and how they are normal things that happen in life.

Build a list with your child on different things they can do when they feel pain or stress.

Some examples include:

  • Asking for help: talk to someone you trust either a parent, a friend, or a teacher. Let them know you’re feeling bad, concerned about someone/yourself, or let them know you’re scared
  • Normalize the conversation: talk with a healthcare provider about this with your child
  • Let the know it’s okay: to have conversations about having pain or having stress (physical or emotional), these things happen to everybody. It’s important to not hide them and talk about them.
  • What’s most important: is letting them know it’s okay to reach out and get social support. Medicine(s) should be the last item they reach for when they are feeling pain or stress.

 

Why is fentanyl so dangerous?

Fentanyl is a very strong opioid. It’s tasteless, odorless, and an amount about the size of two grains of salt can cause overdose. It can be mixed into powders and counterfeit pills. You can’t tell if drugs contain fentanyl by look, taste, smell, or touch.

Talk to your children about the consequences fentanyl-laced pills can have.

Focus the conversation on safety and drug use. Talk about how you as a parent or caregiver want them to be safe, instead of focusing on punishment for drug use.

Let them know it’s strongly advised they stop using, but if they do use it or are around people that do:

  • Use/start with a small amount
  • Only use when there are others around
  • Have Naloxone available
  • Know about Washington’s “Good Samaritan Law”
  • Know it’s okay to call 9-1-1 during an emergency

Look and listen for:

  • A person cannot be woken
  • Slow or no breathing
  • Gurgling, gasping, or snoring
  • Clammy, cool skin
  • Blue or gray lips or nails
  • Pill bottles, needles, or alcohol

Call 911 immediately. Give Naloxone if you have it. Start rescue breathing.

National Injury Prevention Day (NIPD 2021)

Shining a Light on Opioid Overdose Prevention

Harborview Injury Prevention & Research Center (HIPRC), UW Medicine’s Addictions, Drug, & Alcohol Institute (ADAI), and Safe Kids Seattle South King, in partnership with the Injury Free Coalition for Kids, took part in the second annual National Injury Prevention Day (NIPD 2021). Hospitals and trauma centers across the country came together to “Shine a Light” on youth injury prevention topics.

In 2021, HIPRC and ADAI published a digital toolkit for teen opioid-use prevention. The toolkit includes information for both teens and parents. Most importantly, there’s a unique section dedicated to how parents can initiate a conversation with teens about opioid use.

Learn more about National Injury Prevention Day >>

Learn more about UW ADAI >>

Drug Enforcement Administration (DEA) – National Family Summit on Fentanyl 2023
VISIT: dea.gov/familysummit

Grief Recovery After a Substance Passing – For those who have lost a loved one
VISIT: grasphelp.org

Learn 2 Cope – For families with loved ones who have a substance use disorder
VISIT: learn2cope.org

International Overdose Awareness Day (IOAD) – List of worldwide events
VISIT: overdoseday.com

UW Medicine, Right as Rain 5 Important Reminders for People Who Are Grieving

Find Support –
VISIT: FindSupport.gov or EncuentraApoyo.gov (Spanish)

Behavioral Health Treatment Services Locator –
VISIT: findtreatment.samhsa.gov (search by address, city, or ZIP Code)

Buprenorphine Treatment Practitioner Locator –
VISIT: samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physicianlocatorsamhsa.gov  (search by address, city, or ZIP Code)

Single State Agencies for Substance Abuse Services –
DOWNLOAD (PDF)

State Opioid Treatment Authorities –
VISIT: dpt2.samhsa.gov/regulations/smalist.aspx

Understanding Drug Overdoses and Deaths –
VISIT: cdc.gov/drugoverdose/epidemic

Resources

Overdose Prevention and Response – Public Health—Seattle & King County is addressing the overdose epidemic by working with partners to prevent overdoses, increasing access to evidence-based treatment, and providing harm reduction services.
VISIT: kingcounty.gov

9 Facts About Fentanyl – We need a health approach to fentanyl.
VISIT: drugpolicy.org/drug-fact/fentanyl
DOWNLOAD (PDF)

DANCESAFE – Learn about Fentanyl Use and Overdose Prevention Tips 
VISIT: dancesafe.org/fentanyl

Friends for Life – Friends for Life is a campaign to inform and educate people about: what illicit fentanyl is and why it is unpredictable; how to help teens avoid opioids like fentanyl; how to spot and respond to an opioid overdose; how to access and use naloxone (Narcan) in an emergency. Funded by the Washington State Health Care Authority (HCA).
VISIT: wafriendsforlife.com

International Overdose Awareness Day (IOAD) International Day of Awareness to remember a loved one who has struggled with overdose, connect or post on social media, and learn more about overdose prevention.
VISIT: overdoseday.com

Laced & Lethal – Source for information on pills and powders laced with fentanyl. Our mission is to provide critical tools that can help create a safer community for all: fentanyl education, access to confidential all-age naloxone distribution sites, overdose prevention resources, and overcoming stigma.
VISIT: lacedandlethal.com

National Harm Reduction Coalition – Working for the harm reduction movement. Building evidence-based strategies with and for people who use drugs.
VISIT: harmreduction.org

One Pill Can Kill – Share One Pill Can Kill materials with your friends, family, community, and workplace.
VISIT: dea.gov/onepill

Operation Prevention – The U.S. Drug Enforcement Administration (DEA) has joined forces with Discovery Education to provide no-cost online tools that support every member of the community with the power of prevention. Help kickstart life-saving conversations today with standards-aligned English & Spanish-language resources for students in grades 3-12, plus additional resources designed for educators, families, and professionals.
VISIT: operationprevention.com

Opioid Overdose – Learn the warning signs of opioid overdose and how naloxone and medications for OUD treatment can help treat and prevent it.
VISIT: samhsa.gov

Parents Guide to Fentanyl There is a significant risk for today’s generation because of fentanyl. It is a deadly hidden threat. Fentanyl-laced drugs are extremely dangerous, and the average person is unaware their drugs are laced with fentanyl. Parents, guardians, educators, and anyone responsible for children must rely on drug prevention education to safeguard children and teens from this growing threat.
VISIT: addicted.org/news/parents-guide-to-fentanyl
DOWNLOAD (PDF)

Partnership to End Addiction & Pluto TV – Untreated & Unheard: The Addiction Crisis in America

Safety First: Real Drug Education for Teens – The nation’s first harm reduction-based drug education curriculum for high school students.
VISIT: drugpolicy.org/resource/safety-first

Song for Charlie – Illicit Fentanyl is dominating the drug landscape and causing record numbers of drug deaths in America, particularly among our Gen Z youth. Learn the facts about fentanyl and take empowered action to protect yourself and your loved ones.
VISIT: songforcharlie.org

Supporting Parents & Infants Affected by Substance Use
VISIT: perinatalharmreduction.org/learn-about-substance-use

Team Awareness Combating Overdose (TACO) – Drugs Edu (search by drug or topic)
VISIT: tacoinc.org/drugeducation

UW Addictions, Drug & Alcohol Institute (UW ADAI) – formerly the Alcohol & Drug Abuse Institute, UW ADAI is a multidisciplinary research institute in the University of Washington School of Medicine’s Department of Psychiatry & Behavioral Sciences dedicated to advancing research, policy, and practice in order to improve the lives of individuals and communities affected by alcohol and drug use and addiction.
VISIT: adai.uw.edu

UW Medicine, Right as Rain – What Día de Muertos Can Teach Us About Healthy Grieving

Buprenorphine (TELEBUP) Hotline – In partnership with Public Health—Seattle & King County, the UW Department of Emergency Medicine (UW DEM) launched a new TELEBUP program to provide on-demand access to Buprenorphine “BUP” prescriptions for treatment of opioid use disorder. Prescriptions are now available 24/7/365 for people ages 13+ located in King County.
CALL: 206-289-0287
VISIT: TELEBUP Program | Department of Emergency Medicine (em.uw.edu)

988 Suicide & Crisis Lifeline – We can all help prevent suicide. The 988 Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the U.S.
CALL: 988
VISIT: 988lifeline.org (English) or 988lifeline.org/es/servicios-en-espanol (Spanish)

Crisis Connections (formerly Crisis Clinic) 24-hour crisis line
CALL: 1-866-427-4747
VISIT: crisisconnections.org

National Overdose Response Line – Meeting people where they are, on the other end of the line, one human connection at a time. No judgment. No Shaming, No Preaching, Just Love!
CALL: 1-800-484-3731
VISIT: neverusealone.com

Partnership to End Addiction – Get One-on-One Help to Address Your Child’s Substance Use. So many other parents and families have gone through the same challenges you’re facing now. We’re here to help.
TEXT CONNECT to 55753
SCHEDULE A CALL
EMAIL A SPECIALIST
VISIT: drugfree.org

SAMHSA’s National Helpline
CALL: 1-800-662-HELP (4357)
TDD: 1-800-487-4889 (for hearing impaired)
VISIT: FindSupport.gov or EncuentraApoyo.gov (Spanish)

WA Recovery Helpline – 24-hour crisis help and referral line
CALL: 1-866-789-1511
VISIT: warecoveryhelpline.org

WA Teen Link – a help line for teens by teens
CALL: 1-866-833-6546
VISIT: teenlink.org

Buprenorphine Practitioner Locator – Find practitioners authorized to treat opioid dependency with buprenorphine by state.
VISIT: samhsa.gov/medication-assisted-treatment/find-treatment/treatment-practitioner-locator

FindTreatment.gov – the confidential and anonymous resource for persons seeking treatment for mental and substance use disorders in the U.S. and its territories.
VISIT: findtreatment.samhsa.gov

Indian Health Service – The Federal Health Program for American Indians and Alaska Natives providing Opioid Stewardship.
VISIT: ihs.gov/opioids

Learn About Treatment – Information about treatments for opioid use disorder and stimulant use disorder.
VISIT: learnabouttreatment.org

Downloadables

Visit our Digital Resource Center to learn more about Opioid Overdose Prevention — plus, more injury and violence prevention topics year-round!