Recognizing Fentanyl Overdose (OD) Signs and Symptoms
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By:
Valerie Puffenberger, PMHNP-BC
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Editor:
Phyllis Rodriguez, PMHNP-BC
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Clinical Reviewer:
Dr. Ash Bhatt, MD, MRO
Fentanyl is one of the strongest and deadliest drugs in the world.
Fentanyl, especially when mixed with other drugs, is the leading cause of the skyrocketing overdose fatality rates in the United States.
Every year, tens of thousands of Americans die as a result of fentanyl overdose. Luckily, most fentanyl overdoses are reversible if treated in time. This makes recognizing fentanyl overdose (OD) signs critical.
What Is Fentanyl and How Does it Compare to Other Opioids?
Fentanyl is a synthetic (manufactured) opioid drug. As with all opioids, the chemical structure of fentanyl is very similar to that of heroin or oxycodone. Fentanyl is legally available and can be prescribed to treat pain.
How fentanyl works is because its chemical structure is similar to that of opioids naturally produced in the body, which allows it to bind to its receptors and block the transmission of pain signals. By blocking signals from your brain to other parts of the body, fentanyl can cause vital organs to slow and entirely shut down.
Initially intended to treat the extreme pain that terminal cancer patients experience, fentanyl is incredibly strong, much stronger than most other opioids. Fentanyl is 100 times stronger than morphine and 50 times stronger than heroin.
Because of its strength, fentanyl can produce euphoric “highs” that are much stronger than most other opioids. Fentanyl’s strength also makes it highly addictive; it is widely believed to be not only one of the most addictive opioids but one of the most addictive substances in the world.
Most fentanyl overdose deaths happen because it causes the respiratory system to shut down. As the body’s breathing rate slows, less and less air is available for the lungs to pump through the body. This worsens as the heart starts to beat more slowly. Eventually, your body no longer has enough oxygen to function properly. This is why the lips and fingernails of opioid overdose victims turn blue or purple—they are starved for air. If a lifesaving intervention is not conducted at this point, the victim will die from respiratory failure.
In rarer cases, fentanyl overdose can kill by asphyxiation. Victims who have either passed out or are unable to move due to fentanyl use may vomit. If they are on their backs, they may choke to death on their vomit.
What Are the Signs of Fentanyl Overdose (OD)?
Although fentanyl overdose can cause death within minutes, there are treatments available that will reverse the overdose and prevent death if provided quickly enough.
It is therefore very important to recognize the signs and symptoms of fentanyl overdose. Some of the most common or serious signs of fentanyl overdose include:
- Blue or purple lips or fingernails
- Clammy or cold skin
- Inability to be woken up
- Inability to speak
- Lack of awareness
- Limp body
- Pale face and skin
- Slowed or stopped breathing
- Slowed or stopped heartbeat
- Small, constricted pupils (“pinpoint” pupils)
- Vomiting or gurgling noises
What to Do if You Suspect a Fentanyl or Other Opioid Overdose
Although fentanyl kills quickly, reversing a fentanyl overdose can be just as quick. If you suspect or see the signs of a fentanyl overdose (OD), you should take the following steps immediately.
- Call emergency medical services. In the United States, you can do this by dialing 911 (most countries will have their unique number).
- If the person is unconscious, try to wake them up.
- If naloxone, often known by the brand name Narcan, is available, provide it to the victim immediately. Naloxone comes in three primary forms:
- A nasal spray that can be administered through the nose.
- An auto-injector that can be administered through the thigh.
- A liquid form that can be injected into the bloodstream (typically through the thigh) via a syringe.
- Attempt to revive their breathing through rescue breathing or CPR.
- Turn the person on their side or stomach if they are lying on their back. If they are seated, make sure that their head is pointed down toward the feet rather than backward, facing the sky. This is to prevent death by choking on vomit.
- Remain with the person until emergency services arrive, or the victim arrives at a hospital or other emergency care facility.
- Provide support to the victim after they recover and help them find a treatment program that will prevent future overdoses.
You can purchase Narcan without a prescription at your local pharmacy. It is a fast-acting drug that reverses the effects of fentanyl—and could save a loved one’s life.
Psychiatric mental health nurse practitioner (PMHNP) Valerie Puffenberger says, “The availability of Narcan to be purchased over the counter could significantly reduce the number of deaths caused by opioid overdose.”
If you’re concerned a loved one may run the risk of overdosing on fentanyl, Puffenberger recommends:
- Completing a first-aid course to recognize the signs and symptoms of opioid overdose
- Learning CPR
- Learning how to give naloxone (Narcan)
- Purchasing fentanyl test strips, as it is nearly impossible to know if drugs have been laced with fentanyl
How Fentanyl and Other Opioid Overdoses Are Treated
Fentanyl overdoses must be immediately treated medically to prevent death. Once the patient is stabilized, they must receive long-term fentanyl addiction treatment to help ensure that another overdose does not happen in the future.
Fentanyl overdoses are treated primarily with the drug naloxone (Narcan). Naloxone blocks the effects of opioids and does so almost immediately. If administered properly, naloxone can help the body return to normal breathing rates within two to three minutes. Naloxone is available over the counter in most states in either the nasal spray (Narcan) or auto-injector form. Most police departments and emergency medical departments require their workers to carry naloxone in some form.
Other medical treatments are also available to fentanyl overdose victims, depending on their needs. Examples of some of the emergency services provided to those exhibiting signs of fentanyl overdose include CPR, shock treatment, and rehydration.
Once an individual has been stabilized, they should enter a rehab program of some kind. There are thousands of different fentanyl rehab programs throughout the country, each unique. Most programs are either inpatient or outpatient; however, undergoing fentanyl detox before beginning long-term opiate addiction treatment is the first and most crucial step towards beginning recovery.
Inpatient fentanyl rehab programs require patients to reside in the treatment facility. Outpatient fentanyl rehab programs require patients to reside elsewhere and come to the treatment facility for several days a week for treatment.
Inpatient rehab is typically more expensive and disruptive to the patient’s life, but it provides the greatest likelihood of achieving and maintaining sobriety. Outpatient rehab is typically cheaper and allows patients to continue meeting professional, personal, and familial obligations. But it provides a lower likelihood of success.
Preventing a Fentanyl Overdose
Fentanyl is an incredibly dangerous drug. There is no safe way to use fentanyl without medical supervision. If an individual continues to use fentanyl (or virtually any other drug because fentanyl is so commonly mixed into other substances), they will constantly be gambling with their lives.
The ONLY way to prevent fentanyl overdose is to completely refrain from using fentanyl without medical supervision.
If you or someone you love is having trouble quitting fentanyl or even reducing the amount that they consume, it is very likely that a fentanyl use disorder, more commonly known as a fentanyl addiction, has developed. Addiction is a terrible disease with terrible consequences, especially when the substance is a drug as deadly as fentanyl.
Untreated addiction can make it very hard to prevent future fentanyl overdoses. That means that treatment is critical. Both inpatient and outpatient fentanyl rehab programs are some of the most important tools in treating fentanyl addiction, and therefore preventing fentanyl overdose.
Get Help for Fentanyl Addiction
You don’t have to wait for the first signs of fentanyl overdose to appear. Getting help now is the best way to save a life.
If you or a loved one is struggling with a fentanyl use disorder, the best thing you can do is find a treatment program immediately. Legacy Healing Centers offers treatment programs designed to help people get their lives back on track.
We believe that a holistic approach to rehab is the best way for our clients to achieve lasting sobriety. To heal minds, bodies, and spirits, Legacy provides patients with clinical therapy, proper medication management, and aftercare.
Don’t wait until it’s too late. Call 888-534-2295 today to talk to the staff at Legacy Healing to learn about your fentanyl addiction treatment options.
Related Reading:
Sources
- United States Drug Enforcement Administration. (no date). Fentanyl.
- Centers for Disease Control and Prevention. (2023, June 27). Fentanyl Facts.
- UC Davis Health. (2023, January 11). Fentanyl Facts, Overdose Signs to Look For, and How You Can Help Save a Life.
- Texas Health and Human Services. (no date). Fighting Fentanyl.
- Florida Department of Health in St. Johns County. (2022, July 8). Florida Public Health and Safety Alert: Fentanyl Overdoses.
Frequently Asked
Questions about Fentanyl Overdose
How quickly can a fentanyl overdose happen?
Fentanyl overdoses can occur within minutes, especially when high doses or illicitly manufactured fentanyl are involved. Because it is extremely potent, it can rapidly slow or stop breathing, making immediate recognition and response critical to prevent death.
Can naloxone (Narcan) reverse a fentanyl overdose?
Yes, naloxone (Narcan) can reverse the effects of a fentanyl overdose by blocking opioids in the brain. However, because fentanyl is very strong, multiple doses of naloxone may be required. Emergency medical help should always be called, even after administering Narcan.
What does a fentanyl overdose feel like?
A person experiencing a fentanyl overdose may feel extremely drowsy, confused, or unable to stay awake. As the overdose progresses, they may lose consciousness, experience slowed breathing, and become unresponsive. In many cases, the individual is not aware that an overdose is happening.
Can you overdose on fentanyl without knowing it?
Yes, many fentanyl overdoses happen unintentionally. Fentanyl is often mixed into other drugs like cocaine, heroin, or counterfeit pills without the user’s knowledge. Even a very small amount can be fatal, which is why accidental overdoses are so common.
What should you do after someone survives a fentanyl overdose?
After an overdose is reversed, it’s important to seek medical evaluation and ongoing care. Individuals are at high risk of overdosing again, especially without treatment. Entering a professional detox or rehab program can help address the underlying addiction and reduce the risk of future overdoses.
