Cass County Opioid Settlement Fund Committee is providing the second in a four-part series on opioids to increase the community’s awareness. This includes facts about fentanyl, opioid overdose and naloxone, opioid prevention and response, and opioid treatment and recovery. This is in recognition of International Overdose Awareness Day which is Saturday, with the theme “Together We Can.”
An overdose occurs when a person has more of a drug (or combination of drugs) in their body than the body can cope with. All drugs can cause an overdose, including medication prescribed by a doctor. It is important to know the right amount and the right time to take your medication. It is also vital to know what drugs should not be mixed (see more about polydrug use below), and to seek help if you feel you are not in control of your drug use.
Drug overdoses can be both fatal and non-fatal. Fatal overdoses — or overdose deaths — can be either intentional, unintentional (also known as accidental), or of undetermined intent. There are many similar words and terms that are used in reference to overdose and overdose deaths. Some examples are drug toxicity or drug poisoning (or drug toxicity deaths or drug poisoning deaths). These terms refer to the adverse effects in the body — including death — that can result from drug use, whether those drugs that are illicit or licit and taken at either therapeutic or non-therapeutic doses as described on overdoseday.com.
Opioid overdose
Opioids are a class of drugs intended to manage pain. Prescription opioids are commonly referred to as pain relievers because they are often prescribed for pain.
Examples of prescription opioids include hydrocodone, oxycodone, morphine, methadone, and fentanyl. Illicitly manufactured fentanyl and heroin are illegal opioids.
Opioid use can lead to death due to the effects of opioids on the part of the brain which regulates breathing. What are some signs of an opioid overdose? Unconsciousness, very small pupils, slow or shallow breathing, vomiting, an inability to speak, faint heartbeat, limp arms and legs, pale skin and purple/blue lips and fingernails.
The onset of poisoning caused by fentanyl can occur at a much quicker rate (sometimes within seconds) than heroin. In the majority of cases, fentanyl poisoning appears very similar to other opioid overdoses. However, atypical symptoms due to fentanyl have been reported, including immediate blue or grey lips, body stiffening/seizure-like activity, foaming at the mouth and confusion before becoming unresponsive per facingfentanylnow.org.
Naloxone
Also known as Narcan, Naloxone is a potentially lifesaving drug that can reverse an opioid overdose. Naloxone is a safe medicine, and it only reverses overdoses in people with opioids in their systems. It can be administered as an injection or nasal spray.
In the event of a suspected overdose, administer naloxone every time, no matter what, and call 911 immediately. Opioids, such as fentanyl, have increasingly been mixed with other non-opioid drugs including xylazine, cocaine and methamphetamine. Although non-opioids do not respond directly to naloxone, the opioids that these substances are combined with will respond to naloxone.
It is legal to carry and administer naloxone. Additionally, Minnesota has a Good Samaritan Law and Steve’s Law which protects someone who administers naloxone and calls 911 in good faith from prosecution, even if they are also using drugs when the overdose occurs. When a person administers naloxone during an opioid overdose, or naloxone disables an opioid’s harmful effects to the brain, temporarily reversing an opioid overdose. It is only effective for an opioid overdose and is otherwise harmless. The effects of naloxone wear off after 30-45 minutes, so call 911 immediately.
Fentanyl and fentanyl analogues (some stronger than fentanyl, some weaker) are not “naloxone resistant.” They are opioids and will respond to naloxone if someone is overdosing. When it appears that someone who is overdosing is not responding to naloxone it may be because the naloxone needs more time to take effect (wait two to three minutes before administering more naloxone), they need more than one dose of naloxone (wait two to three minutes between doses), the naloxone was administered after the person had been without oxygen for too long. It is important to remember that the goal of administering naloxone is to get the person breathing, not to wake them up.
Anyone who is or knows someone who is at risk of an opioid overdose whether that be your friend, a relative or yourself should get naloxone. Carrying naloxone can save the life of a friend, loved one or even a complete stranger. Just as you would carry an EpiPen for allergies, you can carry a naloxone kit that could save your life or someone else’s life in an emergency. It is important to note, however, that you cannot administer naloxone to yourself.
Naloxone is available over the counter to purchase, or it can be prescribed by a medical provider in which the cost may vary based on insurance coverage when purchasing at a local pharmacy. It is important to be trained in naloxone administration. Find naloxone near you in Minnesota by using the Naloxone Finder map at knowthedangers.com/naloxone-finder/
Naloxone overdose training and kits are available free of charge at Steve Rummler HOPE Network at 952-943-3937 or Rural AIDS Action Network (RAAN) at 320-257-3036.
During the 2023 legislative session, the Minnesota Legislature mandated naloxone availability to select groups in the state, expanding access to the medication as an intervention to prevent opioid overdose deaths in Minnesota. These groups include schools, corrections, law enforcement and the Department of Human Services Licensed programs, which include substance use disorder treatment programs, children’s residential substance use disorder treatment programs, detoxification programs, withdrawal management programs and intensive residential treatment services / residential crisis stabilization programs (IRTS/RCS) and Sober Homes.
Increasing access to naloxone efforts are underway to have more public naloxone available at Cass County Public Health. Four naloxone emergency boxes are being established by Essentia Health in Cass County this September. Community members who are interested in learning more about naloxone can visit steverummlerhopenetwork.org
Help is available
Free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals and families facing mental and/or substance use disorders is available by calling 1-800-662-HELP (4357).
This and more information can be found at the Minnesota Department of Health Opioid Overdose Prevention website at health.state.mn.us/communities/opioids.
Cass County is currently accepting Opioid Settlement Fund Applications to respond to the opioid crisis opioid abatement response strategies. These strategies include treatment and recovery, prevention and others that will have a high impact.
Applications will be accepted through Aug. 31and more information can be found at www.casscountymn.gov or by contacting jamie.richter@casscountymn.gov or by calling 218- 547-6833.
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