PORTLAND, Ore. (KOIN) – As the fentanyl crisis spreads across the United States, an Oregon doctor shared more about the state’s rise in fentanyl overdose deaths and how naloxone can stop it.
Substance use disorder specialist, Dr. Bradley Buchheit of Oregon Health & Science University, described concerns of fentanyl use among adolescents.
“In adolescents, it is normal for people to try different things, right? Try different foods, try different careers, see what they like,” Buchheit explains. “Part of that, occasionally for some people, is trying substances.”
While the United States has been dealing with an opioid crisis, Buchheit says “the difference with fentanyl being in the drug supply is you could try something once and it could be the last thing that you do.”
Describing fentanyl’s impact on the body, Buchheit explains “fentanyl is a full agonist opioid, which is medical jargon for when it binds to the opioid receptors in your brain – specifically the Mu opioid receptor, there’s a number of different opioid receptors but that’s the one that can really trigger respiratory depression and is also the same receptor that can cause euphoria and treat pain—when it binds to that receptor, it activates it.”
The opioid specialist furthered that once these receptors are activated with fentanyl, it can treat pain, or at higher doses, reduce the body’s drive to breathe.
“What fentanyl does, is it gets into your bloodstream, it crosses that blood-brain barrier and then it activates those receptors in your brain. And if you activate too many of those receptors, in essence, what it’s doing is it’s telling your brainstem to not continue that drive to take the next breath.”
Buchheit says the body starts to “overdose” as oxygen isn’t getting into the blood stream and the body starts to shut down, including the heart and brain, leading to death.
Depending on the fentanyl dose, this can happen in a matter of seconds to minutes, Buchheit says.
“If someone is using IV, seconds to minutes. If someone is taking it by mouth, probably more minutes to 30 minutes would be maximum, most likely. But it really depends on how you’re taking it,” Buchheit said.
As Oregon sees a rise in fentanyl overdose deaths, Buchhiet says everyone should carry overdose reversal drug naloxone, also known by brand name Narcan.
“Everyone should be carrying and know how to use naloxone and I think that the reason is, over the past few years within the state of Oregon, we’ve seen a dramatic change in our drug supply. We went from seeing black tar heroin in the drug supply to now almost all fentanyl – which is about 50 times as potent as morphine,” Buchheit says.
He adds that “people who were overdosing on heroin, it would take minutes or sometimes even hours for them to overdose. With fentanyl, it can be seconds to minutes and so we are seeing spikes in overdose deaths in Oregon and really a need to be able to quickly and effectively initiate the reversal drug naloxone, or Narcan.”
Whether a passerby administers naloxone or a family member, Buchheit emphasizes “I really think that everyone in the state should be carrying naloxone.”
“Naloxone is what we call an ‘opioid antagonist,’ so it binds to the same receptors that fentanyl, oxycodone, heroin bind to, but it has such a strong binding affinity at those receptors, that if another opioid is on that receptor, it will kick it off and it does not activate that receptor at all,” Buchheit explains.
Some signs someone may be overdosing include if they’re not breathing, have blue lips or pinpoint pupils, according to Buchheit.
To administer naloxone, Buchheit says to “peel, place, press.” Peel open the naloxone packaging, place the nasal spray nozzle in their nostril, then press the bottom of the medication.
Next, Buchheit says “if you feel comfortable, or have been trained in basic life support or advanced life support, then you could do rescue breathing and/or CPR and you would repeat this every two minutes until you got a response.”
Buchheit says, in Oregon, naloxone is available at most pharmacies — noting there may be a copay, but a prescription is not required.