Why Fentanyl Is Different
Fentanyl is 50-100 times more potent than morphine. Doses that would have caused a slow overdose with heroin or pain pills cause near-instant respiratory arrest with fentanyl. Where you might have had 20-30 minutes to act before fentanyl was widespread, you may now have 2-3 minutes. Speed matters more than ever.
Recognizing an Overdose
The signs of an opioid overdose: unresponsive (won't wake up to shouting or sternal rub), slow or stopped breathing (fewer than 12 breaths per minute, or gasping), blue or gray lips and fingertips, pinpoint pupils, limp body, choking or gurgling sounds. With fentanyl specifically, onset can be much faster — sometimes the person collapses mid-conversation.
What to Do — Step by Step
1. Try to wake them with loud voice and firm sternal rub. 2. If unresponsive, call 911 immediately. California's Good Samaritan law protects you from drug-related arrest when calling for an overdose. 3. Administer naloxone (Narcan) if available — one dose in each nostril, or as injection. 4. Begin rescue breathing or CPR if trained. 5. Place in recovery position if breathing returns. 6. Stay until paramedics arrive — overdose can recur as naloxone wears off.
Using Naloxone (Narcan)
Naloxone is a opioid blocker that reverses overdose. It comes as a nasal spray (most common) or injection. To administer the nasal spray: peel open the package, tilt the person's head back, insert nozzle in one nostril, press the plunger fully. If no response in 2-3 minutes, give a second dose in the other nostril. Naloxone has no effect on someone who hasn't taken opioids — there's no risk in using it if you're not sure.
Where to Get Naloxone
In California, naloxone is available without a prescription at most pharmacies — Walgreens, CVS, Rite Aid, Vons. Many community organizations distribute it free, including the Los Angeles County Department of Public Health. If you or someone you love uses opioids, having naloxone on hand is essential. It's free, legal, and lifesaving.
What Not to Do
Don't put the person in a cold shower — it can cause shock or hypothermia. Don't try to induce vomiting — they could aspirate. Don't inject them with anything (saltwater, stimulants) — useless and dangerous. Don't leave them alone after naloxone — overdose can return. Don't delay calling 911 to avoid trouble — California protects you.
After an Overdose
Surviving an overdose is a serious medical event with high risk of recurrence. The person should be evaluated at a hospital. They also need treatment for their underlying opioid use disorder. Overdose is often the moment when people become open to treatment they previously refused. If that's the moment, our admissions line is open 24/7.
Carry naloxone if you or someone you love uses opioids. Call 911 first. Act fast. You can save a life.
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