Fatal and non-fatal overdoses are preventable. Harm reduction strategies to prevent overdoses vary a bit by the specific type of drug, but generally include using less, testing your drugs, using a less risky method of administration, and not using alone. For opioids, naloxone can be used to reverse the effects of an overdose.
The video below describes how to identify and respond to an opioid overdose using naloxone. Additional information regarding opioids and overdose prevention can be found further down on this page.
View an accessible version of the above graphic(PDF, 161KB)
Opioids are pain relievers, which include opioid analgesics (prescription painkillers), heroin, and fentanyl. Examples include: methadone, oxycodone, hydrocodone (Vicodin), and morphine.
Opioids work by binding with opioid receptors in the brain to:
- Relieve pain
- Relieve withdrawal
- Produce feelings of mental and/or physical comfort
- Cause side effects such as constipation, drowsiness, and respiratory depression
Opioids are NOT:
- Stimulants such as cocaine, crack, or methamphetamines
- Benzodiazepines such as valium, Xanax, klonopin
- Alcohol
- Muscle relaxers
- Sedatives, such as xylazine or ketamine
Note that some non-opioids, such as cocaine, have been found to contain fentanyl (an opioid) in Denver. Therefore, DDPHE encourages anyone who uses illicit substances such as pressed pills and stimulants and/or may be in the position to respond to an overdose to carry naloxone, regardless if they intend to use an opioid.
What is Fentanyl?
Fentanyl is a powerful synthetic opioid that is up to 50 times more potent than heroin and 100 times more potent than morphine. Therefore, overdoses happen faster and are harder to stop. It comes in pills, pure powders, and powder mixed with other drugs. It cannot be seen, tasted or smelled when mixed into other drugs.
Be careful!
It is important for people who use drugs to know there are ways to reduce their likelihood of overdose:
- Don’t use drugs alone. But if you do, let someone know you’re using, so they can check in.
- Fentanyl kills quickly, Naloxone can save a life. Always carry naloxone or make sure those around you do. Naloxone can reverse an opioid overdose.
- Avoid mixing drugs: mixing opioids with alcohol and/or benzodiazepines (such as Xanax, Valium, and Klonopin) increases overdose risk.
- Test the potency of your drugs. This harm-reduction technique encourages you to use less than your normal dose to test potency and strength. This could mean injecting or snorting a smaller amount, or breaking off a piece of a pill.
- If you think it’s an overdose, call 911. Every minute counts.
The presence of fentanyl has led to epidemic levels of overdoses in other parts of the country, including New York City. According to NYC Health, fentanyl was the most common drug involved in overdose deaths at 57% in 2017, with no sign of decreasing.
Denver experienced 209 drug-related deaths in 2018, and as of September 2019, we have endured 77 drug-related deaths. The majority of drug-overdose deaths in Denver involve multiple substances: 64% of drug- related deaths involved three or more drugs in the deceased’s system and 28% involved five or more drugs.
Opioids include strong prescription pain relievers, such as:
- Oxycodone
- Hydrocodone
- Tramadol
- Morphine
- Codeine
Addiction is a disease. Recovery is possible and available.
Denver is focused on preventing substance use, improving treatment access and retention, and reducing harm. By concentrating on prevention, removing barriers to essential support services, and making treatment more readily available, we can reduce unnecessary deaths and the impacts of opioid addiction on our community.
Learn the facts about fentanyl(PDF, 382KB)
Xylazine is a veterinary tranquilizer, that is not for human consumption. It has been linked to a growing number of overdose deaths across the country. The Denver Police Department has found xylazine mixed with fentanyl in Denver’s drug supply.
Because xylazine is not an opioid, naloxone will not reverse its effects. Still, experts always recommend administering naloxone if someone might be suffering from drug overdose since xylazine is typically cut into illicit opioids. The naloxone will work to remove the burden of the opioids on the body, and while the xylazine will still be present, this can decrease the risk of fatal overdose.
Xylazine causes breathing to slow down or stop (respiratory failure) so giving rescue breaths (one breath very 5 seconds) in between naloxone doses is necessary.
People who inject drug mixtures containing xylazine also can develop severe wounds, including necrosis—the rotting of human tissue—that may lead to amputation. Wounds can develop in various places on the body from consuming xylazine in any manner (including smoking), not just the injection site. It is important for people to access wound care, and tend to wounds as much as possible to decrease the spread of the infection and avoid amputation.
View an accessible version of the above graphic(PDF, 87KB)
Opioid overdoses happen when a person takes too many opioids or a combination of opioids and other drugs that lead to respiratory depression, or slowed breathing.
If a person is not breathing enough, oxygen levels in the blood decrease. The lack of oxygen eventually inhibits the function of other vital organs including the heart and the brain. This can lead to unconsciousness, coma, and ultimately death.
This process is rarely instantaneous; respiratory depression can last over the course of minutes to several hours after the drug was used until a person stops breathing completely. This means there is usually time to intervene between when an overdose starts and the person’s death.
The window to respond to an overdose may be shorter with other synthetic opioids. It is also important to note that certain medical conditions can impact someone’s respiratory function.