Fentanyl Poisoning Is A Real Danger To People In Our Communities, Especially Unintentional Poisonings.
See our previous article on this topic here. The previous article discusses what the problem is, and what parents and the community can do to help.
The following questions were asked about opioid poisoning, including signs and symptoms accidental overdose and unintentional ingestion of fentanyl, as well as how to help in such a situation. See the bio for the physician below the questions and answers.
1- If someone is at a party and a person collapses, how can one know if it is from fentanyl poisoning or, for example, alcohol poisoning? Are there signs that distinguish fentanyl poisoning from other types of medical issues? An overdose from illicit fentanyl, or any opioid, will almost always have certain signs that people should look for. They are called the opioid overdose triad.
1) A decreased level of consciousness, even unconsciousness (no response)
2) Slow or absent breathing
3) Pinpoint pupils
Alcohol and other drug poisoning may have a decreased or absent level of consciousness, and possibly changes in breathing, but will not cause pinpoint pupils. Pinpoint pupils are a unique feature of an opioid overdose.
2- In the scenario above, if a bystander administers Narcan and it doesn’t work, how can they know that another dose is called for (if Kloxxado, which is double the dose of naloxone than in Narcan, is unavailable)? Are there signs to look for that show that more Narcan would help? The primary sign of response that we hope to achieve is restoring normal breathing (respiration). Either to get someone breathing if they aren’t breathing or to increase the rate of breathing to near normal (respiratory rate).
In a suspected opioid overdose, you should consider doing the following:
1) Have someone call 911 or call yourself
2) Administer the first dose of Intranasal naloxone
3) Stimulate the patient with a sternal rub or some other painful stimulation
4) If there is no improvement in terms of breathing, repeat naloxone administration in 2-3 minutes. You may repeat naloxone administration every 2-3 minutes until breathing improves.
5) Consider rolling the patient onto their side
6) Consider rescue breathing if you feel comfortable doing so
Continue 1 through 6 above until EMS arrives.
Bio:
David I. Deyhimy, MD, FASAM is an addiction medicine specialist and anesthesiologist with more than 20 years of experience who is dedicated to helping those suffering from substance use disorder and preventing overdose deaths from opioids. He is the founder and medical director of MYMATCLINIC, specializing in treating and prescribing medications for opioid use disorder (MOUD). He is also the Chief Medical Advisor for End Overdose and organizations dedicated to preventing opioid overdose deaths through education, training and distribution of overdose reversal resources. He serves as a medical advisor for healthcare companies with therapies to treat opioid use disorder and prevent overdose death, including Hikma Pharmaceuticals, Braeburn, Inc and Masimo USA. A firm believer in medical research and evidence-based substance use disorder treatments, he has helped thousands of patients improve their lives with medical treatments, education and behavioral change. He can also speak to the danger and lethality posed by recreational drugs laced with fentanyl and offer real-world advice to parents who are anxious about their kids’ safety.
Banner Image: Times Square Billboard. Image Credit – Facing Fentanyl
