Overdose Response – Santa Barbara Opioid Safety Coalition

How to Recognize and Respond to an Opioid Overdose

Being prepared can save a life.

Know the Risks of Overdose

Prescription opioids (like hydrocodone, oxycodone, and morphine) and illicit opioids (like heroin and illegally made fentanyl) are powerful drugs that have a risk of a potentially fatal overdose. Anyone who uses opioids can experience an overdose, but certain factors may increase risk including but not limited to:

Combining opioids with alcohol or certain other drugs
Taking high daily dosages of prescription opioids
Taking more opioids than prescribed
Taking illicit or illegal opioids, like heroin or illicitly-manufactured fentanyl, that could could possibly contain unknown or harmful substances
Certain medical conditions, such as sleep apnea, or reduced kidney or liver function
Age greater than 65 years old

Death from an opioid overdose happens when too much of the drug overwhelms the brain and interrupts the body’s natural drive to breathe.

Signs and Symptoms of an Opioid Overdose

During an overdose, breathing can be dangerously slowed or stopped, causing brain damage or death. It’s important to recognize the signs and act fast. Signs include:

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

It may be hard to tell if a person is high or experiencing an overdose. If you aren’t sure, it’s best to treat it like an overdose— you could save a life. An opioid overdose needs immediate medical attention.

Don’t be afraid to call 911. All you have to do is say, “Someone is unresponsive and not breathing.” The California Good Samaritan Law protects any person who renders emergency care and acts in good faith without expecting compensation, from liability for their acts or omissions.

What To Do If You Think Someone Is Overdosing

Call 911 immediately.
Administer naloxone, if available, and utilize a second dose if there is no response within 2-3 minutes of the first dose. Naloxone is a safe medication that can quickly stop an opioid overdose. It can be injected into the muscle or sprayed into the nose to rapidly block the effects of the opioid on the body. Most people respond by returning to spontaneous breathing.
Try to keep the person awake and breathing. If necessary perform rescue breathing/CPR.
Lay the person on their side to prevent choking.
Stay with him or her until emergency workers arrive and keep the person warm.

What NOT to do.

DON’T slap or forcefully try to stimulate the person; it will only cause further injury. If you cannot wake the person by shouting, rubbing your knuckles on the sternum (center of the chest or rib cage), or light pinching, the person may be unconscious.
DON’T put the person into a cold bath or shower. This increases the risk of falling, drowning, or going into shock.
DON’T inject the person with any substance (e.g., saltwater, milk, stimulants). The only safe and appropriate treatment is naloxone.
DON’T try to make the person vomit drugs that may have been swallowed. Choking or inhaling vomit into the lungs can cause a fatal injury.

Where Can I Get Naloxone?

Free naloxone is available in the following locations:

Santa Barbara County Department of Behavioral Wellness – Alcohol and Drug Programs

Community members may request Naloxone for personal use by calling (805) 681-5323 or by completing the Naloxone Now SB request form. Requests will be processed within two business days and mailed within 3-5 business days.

Pacific Pride Foundation

Regional Naloxone distribution. Please call (805) 963-3636 or email for current information regarding community Naloxone distribution times and locations.

Gauchos for Recovery/UCSB Student Health

Gauchos for Recovery provides Overdose Prevention Kits that include Naloxone (NARCAN) and Fentanyl test strips free of charge to UCSB students, staff, faculty, and Isla Vista residents. Kits are available to pick-up or delivery, no questions asked. No identifying information will be collected. Pick-up a kit for yourself, your friends/loved ones, or to have in case of an emergency. Training on how to use Naloxone is available for individuals or student groups. Visit their website for pick-up location and hours.

Cottage Hospital – Santa Barbara, Goleta, and Santa Ynez Valley

Cottage Health hospitals provide 24-hour emergency care and Naloxone (NARCAN) distribution. NARCAN is available free of charge in the Emergency Departments at Santa Barbara Cottage Hospital, Goleta Valley Cottage Hospital and Santa Ynez Valley Cottage Hospital. Anyone who comes to the Emergency Department and requests NARCAN can receive it unconditionally and anonymously. Whether you use substances or love someone who does, you can get NARCAN at Cottage with no questions asked.

Lompoc Valley Medical Center Emergency Department

24-hour emergency care and Naloxone distribution. People at risk of an opioid-related overdose, or a person who is a family member, friend or anyone in a position to assist a person at risk, may go to LVMC’s Emergency Department and request a free box of Naloxone. That person must be willing to learn the basic elements of overdose prevention and how to administer Naloxone nasally. (805) 737-3333 lompocvmc.com

Marian Regional Medical Center Emergency Department

24-hour emergency care and Naloxone distribution. Anyone can walk into the Emergency Department to request and receive Naloxone over the counter for free. Recipients will receive education on the basic elements of overdose and how to administer Naloxone nasally. (833) 390-1930 dignityhealth.org

Sheriff’s Office Free Narcan Distribution Program

The Santa Barbara County Sheriff’s Office is hosting a FREE Narcan Distribution Program at Sheriff’s substations throughout the county. Members of the public are not required to provide personal information to participate.

Download a flyer here.

Locations:
Goleta Valley Patrol Bureau
City of Goleta Police Department
4434 Calle Real
Santa Barbara, CA 93110

Isla Vista Foot Patrol
6504 Trigo Rd.
Isla Vista, CA 93117

Lompoc Valley Sheriff’s Station
3500 Harris Grade Rd.
Lompoc, CA 93436

Buellton Sheriff’s Station
City of Buellton Police Department
140 W. Highway 246
Buellton, CA 93427

Santa Maria Sheriff’s Station
812 W. Foster Rd.
Santa Maria, CA 93455

Santa Ynez Valley Station
City of Solvang Police Department
1745 Mission Dr.
Solvang, CA 93463

Learn More About Naloxone

Naloxone (Narcan) is approved by the FDA and has been used for decades by EMS personnel to reverse opioid overdose and resuscitate individuals who have overdosed on opioids. Research has shown that women, older people, and those without obvious signs of opioid use disorder are under-treated with naloxone and, as a result, have a higher death rate. Therefore, it is also important to consider naloxone administration in women and the elderly found unresponsive with opioid overdose.

Naloxone can be given by intranasal spray and by intramuscular (into the muscle), subcutaneous (under the skin), or intravenous injection. All naloxone products are effective in reversing opioid overdose, including fentanyl-involved opioid overdoses, although overdoses involving potent (e.g., fentanyl) or large quantities of opioids may require more doses of naloxone.

The goal of naloxone therapy should be to restore adequate spontaneous breathing, but not necessarily complete arousal. More than one dose of naloxone may be needed to revive someone who is overdosing. People who have taken longer acting or more potent opioids may require additional intravenous bolus doses or an infusion of naloxone. Comfort the person being treated, as withdrawal triggered by naloxone can feel unpleasant. Some people may become agitated or confused, which may improve by providing reassurance and explaining what is happening.

All people should be monitored for recurrence of signs and symptoms of opioid toxicity for at least four hours from the last dose of naloxone or discontinuation of the naloxone infusion. People who have overdosed on long-acting opioids should have more prolonged monitoring. Because naloxone has a relatively short duration of effect, overdose symptoms may return. Therefore, it is essential to get the person to an emergency department or other source of medical care as quickly as possible, even if the person revives after the initial dose of naloxone and seems to feel better.

Is Naloxone Safe?

The safety profile of naloxone is remarkably high. When given to individuals who are not opioid intoxicated or opioid dependent, naloxone produces no clinical effects, even at high doses. Moreover, although rapid opioid withdrawal in opioid-tolerant individuals may be unpleasant, it is not life threatening. Naloxone can be used in life-threatening opioid overdose circumstances in pregnant women.

Who Should Carry Naloxone?

If you or someone you know is at increased risk for opioid overdose, especially those struggling with opioid use disorder (OUD), you should carry naloxone and keep it at home.
People who are taking high-dose opioid medications (greater or equal to 50 morphine milligram equivalents per day) prescribed by a doctor
People who use opioids and benzodiazepines together
People who use illicit opioids like heroin should all carry naloxone

Carrying naloxone is no different than carrying an EpiPen® for someone with allergies. It simply provides an extra layer of protection for those at a higher risk for overdose. Most states have laws that may protect a person who is overdosing or a person who calls for help.