Facts & FAQs | Friends for Life

Call 911 right away if you think
your friend is overdosing.

Washington state’s Good Samaritan laws protect you both from prosecution for drug possession.

Facts & FAQs

What you need to know about today’s drug supply

In Washington state and across the U.S., illicit fentanyl and other powerful additives are making the drug supply more unpredictable and dangerous. Most overdose deaths in Washington state now involve fentanyl. Here’s what you should know:

Fentanyl is a strong, fast-acting opioid, so overdoses can happen quickly.
Fentanyl can be added to fake prescription pills and other drugs or sold as a powder.
Even one pill or hit can be enough to cause a fatal overdose.
Naloxone, also known as Narcan, reverses opioid overdoses.
You don’t need any special training to carry or use naloxone.

Talk to your friends about the risks from the drug supply, so they can make informed choices about if and how they use. And carry naloxone with you, so you have what you need to reverse an opioid overdose.

FAQs

What is fentanyl?

Fentanyl is a synthetic opioid that is about 50 times stronger than heroin. Pharmaceutical-grade fentanyl is carefully manufactured, regulated, and used in hospital settings or by prescription to treat pain.

Illicit fentanyl, on the other hand, is made without any oversight and can vary in potency based on the maker or the batch. Besides being extremely strong, illicit fentanyl is also relatively inexpensive to get, making it attractive to drug dealers who add it to many other drugs to make them more potent.

What does fentanyl look like?

Illicit fentanyl does not have a unique color, taste, or smell to help identify it. Usually, it will be in a powder or pill form and may appear white, off-white, or brownish in color—similar to heroin, cocaine, or other pressed pills. It is not possible to tell by a pill or powder’s appearance, taste, or smell whether it contains fentanyl.

What other names do people use for fentanyl?

Fentanyl has several street names. Some common names to know are blues, fent, fenty, fetty, mexis, M-30s, or 30s.

Can you overdose by touching fentanyl?

Illicit fentanyl is dangerous, but medical experts agree that you cannot overdose simply by touching fentanyl. Overdoses happen when fentanyl is ingested in some way (swallowed, snorted, injected, etc.) and enters the bloodstream.

What else is in the drug supply?

Illicit fentanyl is not the only powerful substance found in today’s drug supply. In many places in the U.S. and Canada, other synthetic opioids and non-opioids are being added to or contaminating drugs. These additives can increase the risk of overdose and decrease the effectiveness of naloxone, which is one reason to always call 911 if you think your friend is overdosing. If naloxone won’t wake them up, they may need a different treatment, and they will need it quickly.

Synthetic opioids

Sufentanil – a synthetic opioid about 10 times stronger than fentanyl.
Carfentanil – a synthetic opioid about 100 times stronger than fentanyl.
Isotononitazene – a strong synthetic opioid sometimes referred to as ISO.

Non-opioids

Xylazine – a non-opioid veterinary tranquilizer not approved for human use.
Etizolam – a non-opioid drug similar to benzodiazepines, which depresses the central nervous system.

What does an opioid overdose look like?

An opioid overdose may look like your friend has just fallen asleep, so it’s important to know the subtle signs of an overdose. Your friend may be overdosing if:

They can’t wake up
They aren’t breathing or are breathing infrequently
Their skin is cold, blue, or gray

If you think your friend has overdosed, call 911 right away and give them naloxone. Washington state’s Good Samaritan law protects you both from prosecution for simple drug possession.

Learn more about the signs of an overdose and what you can do to help.

What is naloxone?

Naloxone, also known as Narcan, is a medication that reverses opioid overdoses and saves lives. It is available as a nasal spray or intramuscular injection.

Who can use naloxone?

Anyone! It’s simple, safe, and legal.

Simple – You do not need special training to give someone naloxone. Read the easy-to-follow instructions on the box or watch this video.
Safe – If you use naloxone on someone who has not taken opioids, it will not hurt them. If a person has taken opioids, naloxone may cause withdrawal symptoms in addition to reversing an overdose. The person may wake up experiencing body aches, fever, irritability, or nausea. Naloxone is not habit-forming.
Legal – Washington has a statewide standing order, which means anyone in the state can legally get, carry, and use naloxone. The standing order helps people with insurance access naloxone for low or no cost. Naloxone is also available to purchase over the counter at pharmacies like Rite-Aid, Walgreens, and CVS, with prices ranging from $40 to $50. Many communities also have resources that make naloxone available to residents for free.

Find a place near you to pick up naloxone.

How does naloxone work?

Naloxone blocks the effect of opioids and helps reverse an opioid overdose to wake someone up. Naloxone has no effect on someone who is not on opioids. It does not work to treat the effects of other drugs or alcohol.

Naloxone starts working right away. If you give naloxone to someone who is overdosing and do not see a response within 2 – 3 minutes, you need to give another dose. Naloxone wears off within 30 – 90 minutes. That’s why it's important to call for emergency medical back-up and not leave until help arrives. Your friend can begin to overdose again if the naloxone wears off before they receive medical support.

If you don’t call 911, stay with your friend in case the naloxone wears off and they overdose again. They might feel bad withdrawal symptoms. Let them know that if they use more opioids during this time, they will not reduce those withdrawal symptoms. They will only make it more likely that they overdose for a second time.

Carry naloxone so you’re always prepared.

Does naloxone work on fentanyl?

Yes, naloxone works on fentanyl. In fact, it is the best way we know of to reverse a fentanyl overdose. Because fentanyl is such a strong opioid, multiple doses of naloxone may be necessary to help reverse an overdose.

Naloxone only works to reverse the effects of opioids, so it will not work to reverse the effects of other drugs or alcohol. However, naloxone has no side effects, and you cannot hurt someone by giving them naloxone, even if they are not on opioids. That’s why you should always administer naloxone first if you are helping someone who is overdosing. It can’t hurt them, but it can save their life.

Besides naloxone, how else can I keep my friends safe?

Tips to keep you and your friends safe:

Assume drugs you get anywhere other than a pharmacy or dispensary contain fentanyl.
Use fentanyl testing strips (FTS) to check if the drugs you have contain fentanyl. Places to access testing strips:
Try to stick to a buddy system when taking drugs.
- Think of this the same way as a designated driver. That way, one person is always alert and can look for signs of overdose.
If you can’t use a buddy system, call Never Use Alone at 887-696-1996.
- This nationwide toll-free call center is available 24/7/365.
- Volunteers stay on the phone and alert emergency medical services in the event a caller becomes unresponsive.
Go low and slow.
- Start by taking a very small amount of a drug and give it time to see how the dose affects you.
Avoid mixing drugs or mixing drugs and alcohol.
- The chances of an overdose are higher when drugs are used in combination with one another or with alcohol.

Where can I learn more?

Here are a couple more resources about opioids, naloxone, and preventing overdoses for you to share with friends:

Addictions, Drug & Alcohol Institute (ADAI) – StopOverdose.org
Washington Department of Health (DOH) – Overdose Education and Naloxone Distribution Program
University of Washington Addictions, Drug & Alcohol Institute (ADAI) – adai.edu