Every 11 minutes someone in America dies from an opioid overdose. But there is a solution, public health officials say: Carry naloxone, even if you don’t think you know anyone who uses opioids.
Naloxone — commonly referred to by brand name Narcan — is a cheap, readily available, easy-to-administer, lifesaving drug that reverses opioid overdoses.
As The Columbian’s homelessness reporter, I carry Narcan with me everywhere, even when I’m off the clock. Drugs and overdoses reach into all corners of the community, not just homeless camps.
Overdoses can happen to anyone, regardless of their background or socioeconomic status, said Nicole Hamberger, community engagement specialist for Southwest Washington Accountable Community of Health, also known as SWACH. I recently took a class on administering naloxone at the organization’s downtown Vancouver headquarters.
Clark County Public Health recommends everyone carry at least three doses of naloxone with them at all times because it may take more than two to reverse the effects of an opioid overdose.
“Naloxone saves lives,” said Marissa Armstrong, communications manager for Clark County Public Health. “Anyone could find themselves in a position to save the life of someone overdosing on an opioid. People who are trained and carry naloxone can intervene quickly if a loved one, friend or community member is experiencing an overdose and begin lifesaving treatment before first responders can arrive.”
Emergency medical services responded to 890 overdose calls in 2023, according to Clark County Public Health.
“I see our statistics of overdose deaths, and I think that the only way that we can combat this is together. If everyone walked around with Narcan and is ready to use it, what a difference we would see,” Hamberger said.
Fear not
Naloxone is widely available. Insurance covers it and several vending machines around Clark County supply it free of charge.
I first encountered naloxone when I was 18. I was at a night market with a friend when he asked me to hold a small vial of liquid in my bag. But I was hesitant.
“No way. What if they search my bag?” I remember saying, not understanding naloxone’s purpose and mistaking it for some type of illegal drug.
“It could save someone’s life,” my friend said. He explained what naloxone does. I stashed it in the bottom of my purse, covering it with my wallet and phone. Little did I know a mutual friend of ours had overdosed two weeks prior and naloxone saved his life.
Now, a decade after that moment at the night festival, I no longer feel sheepish about carrying naloxone. My bag is adorned with a pin that declares, “I carry Narcan to help save lives. Join me!”
“Learning how to administer naloxone and carrying the medication is similar to learning CPR: you hope to never need it but are trained in the event someone needs lifesaving intervention,” Armstrong said.
Look for signs
I watched someone administer Narcan once, a few years back when I was volunteering to deliver food to those living on the streets of Portland. I remember my hands shaking while I called 911.
I took SWACH’s class to relearn how to give someone Narcan, which is a nasal spray. I also learned how to administer injectable naloxone, which I had never done.
The first step is to know the signs of an opioid overdose:
- Slow or no breathing. You might hear gurgling, snoring, soft gasping or no sounds at all.
- Inability to speak or respond.
- Pinpoint pupils if you lift the person’s eyelids.
- On light skin, look for blue lips and fingertips; on dark skin, look for ashy lips and fingertips.
If you observe these signs, shake the person and shout at them. I understand it might be uncomfortable. You might think, “What if they’re just sleeping? I don’t want to bother them.”
The polite Midwestern-Canadian in me gets it, but I’ve banged on car windows and once shouted in someone’s ear at a city park.
The worst I’ve gotten is a dirty look and a name or two I can’t write in The Columbian. But it assured me that the person ws OK. In the event that the person didn’t wake up, however, Hamberger guided me through what to do.
Hamberger recommends giving the person a hard sternum rub and shouting, “Hey, I am going to Narcan you if you don’t wake up.”
That will get the person’s attention, Hamberger said. “Because any person who uses opioids knows that they will get sick from Narcan, and they don’t want that. So if they can muster up any energy to say ‘no,’ then you can respect their wishes and not give them the Narcan.”
If a person is unresponsive, administer Narcan and call 911.
You administer Narcan by placing the nozzle into one of the person’s nostrils and pressing the plunger firmly. Plug the person’s other nostril, Hamberger said, so no liquid drips out. The nozzle will deliver one dose of naloxone.
For injectable naloxone, draw all the fluid into the needle by pulling back on the plunger. Be sure the syringe fills with liquid, not air. Then, inject the needle straight into muscle. Aim for the thick part of the upper arm or the side of the thigh. (Although the idea of using a syringe scared me, once I was trained, I found it to be straightforward.)
Once you’ve administered the naloxone, set a timer for two to three minutes and begin rescue breathing.
“In the heat of the moment, and with all of the adrenaline, I would have no idea what two to three minutes is,” Hamberger said, which is why she recommends setting a timer on your phone.
If the person does not respond within two to three minutes, administer a second dose of naloxone if you have it.
Wait with the person until emergency services arrive. The Good Samaritan law protects residents — even minors — who provide assistance during emergencies, Hamberger said.
But for whatever reason, if you do need to leave the scene before emergency services arrive, place the person in recovery position on one side and lay out the package of naloxone so paramedics know what was provided.
If the person who overdosed wakes up and tries to flee because dispatch is coming, warn that naloxone wears off after 30 to 90 minutes, and to stay around people. Oftentimes people isolate themselves and ended up overdosing alone, Hamberger said.
“Opioids are still hanging out in the bloodstream, just hanging out there. Fentanyl lasts longer than naloxone,” Hamberger said. “They could overdose all over again.”
Narcan is safe for everyone — babies, older adults and even pets.
“The great thing about Narcan is that we don’t have to be medical professionals to know if this person who is unresponsive on the ground in front of us is in opioid overdose or not. We don’t have to know that, because it’s not going to hurt them,” Hamberger said.
The training took less than an hour. And although training isn’t a requirement and residents can just follow the instructions on the Narcan kit, training can help people feel more confident in this process, Hamberger said.
As a reporter, I often get calls or emails from community members who say, “Not me, not my family, not our community.” But on the flip side, I often hear from those who, like me, think it’s far better to be cautious than to deal with the consequences of not being prepared.
“Let’s talk about this more openly with each other, the need for Narcan and the risk of opioids all around so that we can be prepared,” Hamberger said. “It will make a huge difference.”
