HEADS-UP!

Some street drugs have been contaminated with the synthetic opioids Fentanyl and nitazenes

Buy a printed version of the opioid overdose resource in the Substance shop

Some street drugs have been contaminated with the synthetic opioids Fentanyl and nitazenes. These include heroin, illicit Oxycodone pills, Xanax powders, and synthetic cannabis (spice).

Fentanyl and nitazenes are much stronger than heroin and have led to an increase in deaths caaused by overdose.

If you’re a heroin user or use other opiate-type drugs, the advice in this leaflet will help you to reduce the chances of overdosing.

HOW TO SPOT IF SOMEONE IS SUFFERING FROM AN OPIATE OVERDOSE

The usual effects of heroin use, like drowsiness and slower breathing, can look similar to overdose, so it’s important to know the difference.

SOME SIGNS OF AN OPIATE OVERDOSE:

Shallow breathing
Breaths that are shorter and not as deep as normal.

Unresponsive
Not responding to someone’s voice or physical attempts to wake them up, such as shaking, pinching the back of their arms, or rubbing their chest bone with your knuckles.

Pinned pupils
The pupils of the eye become tiny.

Change in skin colour
Blue/purple lips and fingertips in light-skinned people.

In darker-skinned people, skin can appear greyish or duller than usual. In this instance, a colour change might be easier to detect on the inside of the lips, on the gums and under fingernails.

Limp body
Muscles become slack and the person may appear floppy.

Seizures
Synthetic opioids (such as fentanyl) can cause symptoms similar to seizures - such as muscle spasms, rigidity, and chest tightness - that complicate breathing.

Gurgling or snoring sounds
Snoring doesn’t always mean someone is asleep. Snoring and gurgling can mean someone is struggling to breathe.

Severe nausea and vomiting
Opioids can trigger the vomiting reflex, causing nausea and puking.

WHAT TO DO IF SOMEONE HAS OVERDOSED

Give them naloxone

If you use heroin - or any opiate-type drugs - or know someone who does, you should carry naloxone. This is a drug that can reverse the symptoms of an overdose. If you can, carry multiple doses as they may be needed if the overdose has been caused by drugs containing nitazene.

Even if you don’t use opioids, carry it, as nitazenes have been found in other drugs like illicit Xanax.

If you’re unsure if the cause of the overdose is heroin or another opioid, give them naloxone anyway. It won’t cause any harm.

A single dose of naloxone will begin to work in 2-5 minutes, and its effects will last between 20-40 minutes. If fentanyl or nitazenes are involved, you may need to give them more than one dose.

It’s more likely that overdose symptoms will return with nitazenes, so keep an eye on the person longer than you would if they had overdosed on heroin alone.

You only need to recover their breathing. They don’t necessarily need to regain consciousness.

Put them in the recovery position.

When they are breathing normally again, put them in the recovery position. This will help with their breathing and guard against inhaling their sick if they vomit.

Call 999

Remember that naloxone is not a substitute for emergency medical care. It’s a temporary measure that buys time until proper medical treatment can be given.

Call an ambulance as soon as you can. The police will not usually attend an overdose emergency. When the emergency services arrive, tell them what the person overdosing has taken – better still, give them a sample of what has been used.

Stay with them

Keep an eye on them. The effects of naloxone will wear off. You may need to give them more doses.

TIPS ON STAYING SAFER

Keep an eye on each other

Try not to use drugs alone. It’s always better to be with someone you trust so you can keep an eye on each other.

If you are with other people, make sure multiple naloxone kits are available. Don’t all use at the same time. Space out hits so somebody is alert and sober and can get medical help if anything goes wrong.

If you have to use drugs alone, tell someone and ask them to check up on you.

If you can’t do the above, consider using the BuddyUp phone app. It’s a confidential service that allows you to prepare an overdose rescue plan. BuddyUp is available via Android and iPhone.

Low and slow

Start with a small amount and wait to feel the peak effects before taking more.

If you’re using pills that haven’t been prescribed, try cutting them into smaller pieces.

If you can’t do that, crush the pill, dab a bit, and wait. This method works well for powdered or crystal drugs and can make pill use safer, too.
Don’t mix your drugs

Mixing drugs is more likely to cause an overdose. Try to use one drug at a time. If you are going to mix drugs, use less of each.

Check your drugs

There is no way to see if your drugs contain fentanyl or nitazene. Consider sending an anonymous substance sample to the WEDINOS Project for analysis. You don’t need to provide personal details other than your age, sex and the first part of your postcode.

Getting the results takes a few days, so take it easy. Use the low and slow method if you are going to take drugs in the meantime.

Fentanyl test strips, which are used to check for the presence of fentanyl in drugs, don’t detect nitazenes.

ADDITIONAL SUPPORT

HOW TO GET NALOXONE

England

Naloxone is available from all drug and alcohol services. Make sure you find out where you can get it locally.

Scotland

Scottish Families Affected by Alcohol and Drugs offers a ‘click & deliver’ naloxone service

W. sfad.org.uk/support-services/take-home-naloxone-application

Wales

If you live in Wales, Barod offers a naloxone ‘click & deliver’ service.

W. barod.cymru/naloxone-click-deliver-service