The opioid crisis in the US is taking a turn for the worse. According to the National Institute of Drug Abuse, the number of deaths by overdose in 2021 amounted to 80,411. This number shows an 11,781 increase from the previous year when the recorded number of deaths was 68,630.
These numbers reflect the extent and severity of the opioid crisis. Although it seems discouraging, the good news is that a timely emergency response can prevent some of these deaths. A medication known as naloxone can help reverse the effects of an overdose, but CPR also plays a significant role in treating opioid victims.
This article provides all the necessary information on giving help to someone suffering from an opioid overdose. You can read about recognizing the signs of an overdose, does CPR work on an opioid victim, and taking the necessary steps to save the person from a fatal outcome.
What Is an Opioid Overdose?
Opioids include heroin, fentanyl, codeine, morphine, oxycodone, hydrocodone, and other legal and illegal drugs. An opioid overdose occurs when a person takes a large dose of drugs — either deliberately or by mistake — or takes opioids with other substances such as alcohol and/or anxiety treatment medication.
The opioid binds to the mu receptors in the brain that are responsible for many different functions, breathing being the most important one of these functions. When these receptors are stimulated, certain chemicals are released into the body. The chemicals can tell the body to slow down or stop breathing altogether. This is known as respiratory depression and is the most common cause of death in overdoses.
How to Recognize an Opioid Overdose?
Before you administer help to someone who is seemingly suffering from an overdose, you need to be able to recognize the signs of an opioid overdose:
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- Unresponsiveness to stimuli
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- Loss of consciousness
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- Breathing has stopped or has become slow and erratic
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- No pulse or a slow and erratic one
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- Pale and/or clammy face
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- The skin turns blue/purple (light-skin people) or grey (darker-skin people)
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- Lips and fingernails can turn blue or purple
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- Choking sounds
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- Vomiting
If a person is exhibiting any of these signs, it’s reasonable to suspect opioid poisoning. In case the victim is responsive and able to talk, you can ask them whether they’ve taken drugs, what type of drug they’ve consumed, when was the last time they’ve taken it and how much they took.
If there’s someone else present on the scene, you can ask them for any of this information. It’s a good idea to tell the emergency response team the exact drug or drug combination that caused the overdose so they can react accordingly.
How to Help an Opioid Victim?
When you notice someone is displaying signs of an opioid overdose, it’s important to react quickly and provide the necessary help. If you’re unsure how to act in these situations, follow these resuscitation steps. By doing so, you can significantly increase someone’s chance of survival.
#1 Stimulate the Victim
If you have reasonable cause to believe that someone has overdosed, the first thing to do is try and elicit a response. You should start by talking loudly — if you know their name, call it out and see whether they react. If you don’t know their name, you can try yelling “Wake up” or “I’m calling 911.”
In case you don’t receive a response, you’ll need to move on to physical stimulation. The best way to approach this is by rubbing the sternum, i.e. the chest bone. Don’t be afraid to apply pressure. Rub the bone with the knuckles of your fingers and look for signs of life. If you manage to get a response from the victim, try to keep them conscious and alert until help arrives.
#2 Call 911
As in all other emergency situations, one of the first things you need to do is call 911. Report the condition of the victim — for example, “they’re not breathing” or “they’re unresponsive.” You should also tell the dispatcher that you suspect it might be an overdose.
After providing your exact location, the dispatcher may ask you to stay on the line and follow the instructions they provide while you wait for the emergency services. Even if you have no previous experience with administering emergency medication or CPR, the dispatcher can guide you through the process until the EMS arrives and transport the victim to a hospital.
#3 Administer Naloxone
The naloxone medication, often found under the name Narcan, is one of the fastest ways to reverse opioid overdoses. This is an opioid antagonist that binds to the brain receptors and reverses the effects of the other opioids.
There are two ways to administer naloxone if you are not a medical professional:
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- Nasal spray — the naloxone spray needs to be sprayed in the victim’s nose. Make sure you spray it directly into the nose and as deep as possible to ensure quicker absorption through the sinuses and into the bloodstream.
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- Injection — naloxone injections can be administered directly in the muscle or under the skin. These injections are widely available and resemble EpiPens, meaning they’re easy to use, even by people without medical experience.
It’s a good idea to carry naloxone if you believe you might witness an opioid overdose or if you know someone who is at risk of overdosing on opioids. The medication is available to buy over-the-counter in 50 US states, although the regulations differ from state to state. If you don’t have access to naloxone, start administering CPR right away.
#4 Start CPR
Naloxone needs 2 to 3 minutes to start working and in the meantime, you need to perform CPR and restore circulation. Make sure the victim is lying flat on their back before you start with chest compressions. Keep up with the compressions until the EMS arrives and are able to provide a professional medical intervention or until the victim has regained normal heart function.
In cases of cardiac arrest caused by an overdose, you can also use an AED to restore normal heart rhythm. Although these devices are designed to be used outside a hospital and by people with no medical expertise, they are not always readily available. However, even if you do have access to an AED, don’t use it unless you have previous experience or training.
#5 Implement Rescue Breathing
While the victim is lying on their back, tilt their head back and make sure the airway is unobstructed. Once you’re certain there’s nothing blocking the airway — either the mouth or the nose — you can start rescue breathing. If there is an obstruction, remove it before you proceed with rescue breaths.
Lift the victim’s chin upwards, hold their nostril shut, and start blowing into their mouth. Blow for approximately 1 second, in 5-6 second intervals, until you’ve given 10 to 12 breaths per minute. Consistently check whether the person has started breathing independently. If not, continue with the rescue breaths, but don’t forget that chest compressions take precedence when performing CPR on overdose victims.
#6 Hand It Over to the Professionals
Once the emergency services arrive on the scene, let them take over the resuscitation. Report whether you’ve administered medication (naloxone) and in what form and quantity, and provide information on the overall state and responsiveness of the victim.
The EMS will then take the victim to a hospital where they can provide the necessary help and addiction treatment on the road to a full recovery. By reacting quickly and providing CPR to overdose victims, not only can you increase the chance of survival, but you can also lower the chance of user hospitalization.
Conclusion
The opioid crisis has resulted in hundreds of thousands of deaths in the past several years. Although there are some predictions that this rate will go down, the main concern is treating victims of overdoses and preventing death.
Despite the fact that timely administered medication can often be the key factor in reversing opioid effects and saving a life, CPR administration is just as important. This is particularly true in situations where first responders don’t have access to naloxone or while they wait for the medication to work.
When administering CPR in overdose cases, remember that chest compressions are more important but need to be combined with rescue breathing. Utilizing this CPR combination and calling 911 as soon as possible can help save another life from the ongoing pandemic of opioid poisoning.