MSU Extension Michigan Substance Use, Prevention, Education and Recovery (MiSUPER)

This is part of a series covering myths about fentanyl. Read part one here, part three here, and part four here.

There are many different myths about fentanyl that get spread through media outlets, social media posts, and word of mouth. Fentanyl is a synthetic opioid that is 50 to 100 times as strong as morphine and used to treat severe pain in medical settings. While it is true that fentanyl can be very dangerous when used outside of a controlled medical setting and is responsible for most drug overdose deaths, there are many ways to protect yourself and others from fentanyl exposure properly. It is important that we address these myths, so our communities feel better prepared to address the opioid crisis together.

In part 2 of this article series, we will discuss myths about naloxone (also known by the brand name Narcan). In part 1 of this series, we discussed myths about overdose risk and testing for fentanyl. Part 3 will focus on the media narratives around first responders’ exposure to fentanyl and how this misinformation can be harmful. Finally, part 4 will provide an overview of where these myths come from and how they spread.

Myth #1: Narcan/naloxone does not work on fentanyl.

Fact: Narcan/naloxone will reverse the effects of all opioids present in the body, including fentanyl.

In the event of an opioid overdose, our bodies’ natural opioid receptors become overactivated, which can cause us to stop breathing. Naloxone can reverse opioid overdoses because it is an opioid antagonist, and it will bind to opioid receptors and block them from working. According to the Centers for Disease Control and Prevention, signs of an opioid overdose include:

• Small, constricted “pinpoint pupils.”
• Falling asleep or losing consciousness.
• Slow, shallow breathing.
• Choking or gurgling sounds.
• Limp body.
• Pale, blue or cold skin.

How to respond to an opioid overdose

Naloxone plays an important role in responding to an opioid overdose. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)’s five essential steps for responding to an opioid overdose include:

1. Evaluate for signs of opioid overdose (listed above).
2. Call 911 for help.
3. Administer naloxone.
4. Support the person’s breathing.
5. Monitor the person’s breathing.

When administered properly, naloxone should work to relieve overdose symptoms within two to three minutes. If the person is still not responding after three minutes, another dose of naloxone may need to be administered. After proper care has been provided to the person overdosing, it is important that you also take care of yourself.

Myth #2: The availability of Narcan/naloxone leads to more drug use.

Fact: Research has found that increased access to naloxone saves lives without increasing drug use rates.

One of the common myths about increasing naloxone access is the belief that it will lead to more risky drug use, however this is not true. Researchers interviewed people who use heroin and people receiving medication for opioid use disorder and found that having naloxone available did not lead to increases in drug use. Building on these findings, other researchers were able to model the impact of different strategies for addressing the opioid epidemic and found that expanding naloxone availability is the strategy that would save the most lives. The model predicted that expanding naloxone access by 30% would save 25% more lives.

Five things you should know about naloxone

Researchers interviewed people who use opioids to identify why people who use drugs may be hesitant to carry or administer naloxone. They identified five pieces of information that everyone should know:

1. Anyone can overdose.
2. It is critical to identify an opioid-involved overdose accurately.
3. Naloxone cannot do harm.
4. Naloxone is short-acting, and withdrawal sickness does not have to be long-lasting.
5. The prompt administration of the medication can help ensure that someone lives another day.

In summary, naloxone is an important medication that can save the life of someone overdosing from opioids. Even if you are not 100% sure the person is overdosing from opioids, it is still a good idea to administer naloxone if they are showing any of the overdose symptoms because naloxone will not cause the person harm. Some ways you can help your community respond to the opioid epidemic include getting trained to administer naloxone, carrying naloxone with you, and advocating for wider access to naloxone in your area.

MSU Extension supports harm reduction