Everything You Ever Wanted to Know About Fentanyl Harm Reduction

International Overdose Awareness Day was observed — as it has been every year since 2001 — on August 31. But DAP Health’s Harm Reduction team spreads the word about preventing overdoses 365 days a year.

By Daniel Hirsch, via DAPHealth.org

Given it’s a hundred times more potent than morphine and 50 times more potent than heroin, the prescription opioid fentanyl and its growing use have led to a spike in overdose deaths — 5,942 Californians in just three years, according to the California Department of Public Health.

Through its Harm Reduction program, DAP Health is working to stop overdose deaths. I spoke with Harm Reduction Program Supervisor Neil Gussardo to get the no-nonsense, no-stigma lowdown on preventing fentanyl overdoses and what harm reduction means at the organization.

What exactly does the term “harm reduction” mean?

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It’s a movement for social justice built on a respect for the rights of people who use drugs.

Let’s talk about harm reduction for fentanyl. What are the risks of taking fentanyl?

The big thing — really, why it’s so dangerous — is how it impacts the lungs by causing respiratory depression. When somebody starts to overdose, their body slows down to the point where they could stop breathing altogether.

How can you identify a fentanyl overdose?

See if a person is breathing. Look at their lips. If their lips are a lighter color than the rest of their skin, that’s a good indication that their breathing is super shallow. Or, if they’re drowsy and you’re unable to rouse them, that’s also a clear sign of overdose.

What can you do to help someone experiencing an overdose?

The first thing you do is call 911. After, I recommend people yelling at the person to keep them awake. The next piece that you would do is cause them a little bit of physical pain. Take your knuckles and give the person a hard sternum rub. If you can’t keep them awake, if their breathing is shallow, use Narcan if you have it.

What’s Narcan?

Narcan is the brand name of the drug naloxone, in nasal spray form. Opioids like fentanyl attach to receptors in the brain. The naloxone gets between the drug and the receptor, temporarily stopping the effects of the drug in the system.

How do you use Narcan — and can anyone administer it?

Absolutely. It’s super simple to use. You just spray it into a person’s nose. If after about two minutes, there isn’t a response and the person isn’t coming out of the overdose, you should give a second dose. A person can go into withdrawal after using naloxone because the opiate is temporarily not impacting their brain. So be warned, it can be an unpleasant experience for an individual, too.

What would you tell someone who is an occasional drug user but says they’d never use fentanyl, so they don’t need to worry about this stuff?

One can never know exactly what’s in the drugs they use. We suggest testing drugs prior to using them. So, we give out fentanyl testing strip kits. Our kits have everything in them that you would need to test your drugs. I’d also suggest you have Narcan so you can help other people.

This is a bit of a spicy question, but don’t some of the strategies DAP Health provides — and the philosophy of harm reduction in general — enable people to use drugs?

People who use are going to use. We’re enabling people to use drugs more safely, and to stay healthier longer. If a person’s not alive, they don’t have an opportunity for change. People who access harm reduction services are five times more likely to go into substance use disorder treatment than people who are not accessing those services.

DAP Health has a range of harm reduction resources, including a free vending machine that dispenses Narcan, fentanyl testing strips, and more at Hunters Nightclub on Arenas Road in Palm Springs. For more information, please visit daphealth.org/harmreductionfaq.