No reason to not use Narcan

County nurses promote rescue inhaler's use to counteract Fentanyl overdoses

Belen Ward
Posted 5/12/23

With the number of opioid overdoses out of proportion in Adams County, nurses from the county health department  are hoping to train the public to administer Narcan

"One in eight opioid …

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No reason to not use Narcan

County nurses promote rescue inhaler's use to counteract Fentanyl overdoses


With the number of opioid overdoses out of proportion in Adams County, nurses from the county health department  are hoping to train the public to administer Narcan

"One in eight opioid overdoses in the State of Colorado in the last few years has occurred in Adams County, and in 2021 Adam County lost 187 to lifestyle opioid overdoses," said Ellen Velez, Adams County Health Department Harm Reduction associate manager.   "The one-in-eight is disproportionally high."

"To put this matter in perspective, this is impacting our community and we want to make sure that folks are aware, trained, and understand that anyone can obtain Narcan to save a life," Velez said.

No certification is required to administer Narcan to anyone within the community, family member, or friend to help save lives, she said.

"We are getting the word out around overdose prevention, " said Michelle Wilson, Adams County Health Department Reduction Department public nurse. "The public has access to Narcan – which reversal the overdose –  and to fentanyl testing strips. It's an epidemic happening everywhere and everybody needs to know about it."

Wilson recalled one Saturday summer afternoon in 2021. She stopped at a 711 on Colfax and Colorado. and found a long line of people for the restroom. The patrons said they'd been in line forever.

"I went to the desk and said 'You've got to let us in,'" Wilson said.

Wilson said once they opened the bathroom door they found a person who had overdosed. She used a dose of Narcan and called 911. First responders were there within three minutes and the person survived.

"For that reason, carrying Narcan came in handy to save a person," Wilson said.

Doesn't hurt

Wilson demonstrated to the media how to administer Narcan May 8 at the Adams County Health Department.

The emergency Narcan comes in a small pouch that contains two Narcan nasal sprays and step-by-step instructions.  Anyone can purchase Narcan over the counter without a prescription at any drug store, typically for $50 or less.

Wilson recommended against leaving Narcan in extreme conditions – neither too hot or too cold. The police and paramedics also carry Narcan in their vans and cars, but it's still okay to administer it.

Wilson said Narcan will not hurt if a person is simply passed out or has an unknown heart problem.

"Narcan will not hurt someone," she said. "It will only reverse an opioid overdose, not if you are drunk. It won't work on benzodiazepine, which is like Valium. It won't do anything to counteract any of those kinds of substance, it will only work for opioids.".

 But she cautioned would-be rescuers to check with the person before administering Narcan.

"If you come upon someone laying on the floor, or slumped in the chair and are not breathing or may be breathing, loudly and snorting," she said. "You should nudge them and ask if they are okay," Wilson said.

Wilson said if they are unconscious, they could be going into respiratory depression. If their fingernails or lips are turning purple or white,  they don't have enough oxygen. Pale skin and small pupils the size of a pinpoint are other indications.

"If they have snoring respirations shake them to wake up," she said. "If they don't wake up, rub their sternum very hard with your knuckles. It hurts, so if they are unconscious, they will wake up," Wilson said.

Also,  get them lying on the floor, and tip them to one side because sometimes people will vomit when they come to. If they're in respiratory depression and dying, they won't wake up.

"Once you lay them on one side, call 911 immediately," she said. "Take out the Narcan, and open both doses because you may need to use both doses. It looks very similar to nasal spray. You put the nozzle in a nostril and push the plunger on the bottom. You don't need to hold the other nostril down."

Wilson said Narcan is absorbed by the blood vessels in the nose. Wait three to five minutes and administer the second dose if they don't rouse. They shouldn't take long to wake up, she said.

"The reason for that is that Narcan competes with the opioid molecules in our brain, and it knocks the opioid molecules out of our respiratory system," she said.

Calling 911 is just as important as administering the dose.

"It's good for about 45 minutes. After 45 minutes, those opioid molecules can sort of float back over and cause people to be respiratory depressed again," Wilson said.

Narcan works to take people immediately out of being non-responsive to breathing, and it immediately throws them into withdrawal.

"People are going to be angry when waking up and very startled," Wilson said. "Like I said, they might throw up, so you must be prepared. If they're not breathing, you can do rescue breaths between that first and second dose until the first responders get there."

Cancer pain treatment

Fentanyl was invented in the 1990  to treat intractable severe, cancer pain.

"Then people started producing it illegally, mixing it with pain pills such as Tylenol with codeine," Wilson said. "It makes you sleepy or loopy."

Wilson said that now it is mixed with heroin. Most of the illicit drug supply is tainted with Fentanyl, she said.

"Typically, most of the Fentanyl comes from  Asia, but they produce it a lot in Mexico," she said. "It so comes up from Central and South America, and it comes over from the East Coast and probably the West Coast too."

Velez the younger population buys it at parties.

"We want everyone in Adams County to be educated and carry Narcan in case you come into a situation with an unresponsive young person. It's a very easy step that can be lifesaving," Velez said.

Fentanyl is potent and can be mixed with other drugs, including stimulants such as cocaine. Velez said five people died in Commerce City using cocaine mixed with Fentanyl in February 2022, not realizing what it was.

"We have to make sure that everyone is prepared, friends and family, or if you use drugs as well to help one of your friends, it could potentially save your life," Velez said.

People who administer Narcan in good faith are protected legally, she said. Wilson said there is a statute called the Colorado Good Samaritan Act for emergency care CRS §13-21-108, which protects persons giving emergency assistance from civil liability.

"After calling 911, I will not be held accountable, if I'm unsuccessful saving a life. They will not charge me for whatever I did because it was more important that I saved your life," Wilson said.

"It also encourages substance users to call 911 who are afraid to call because they have drugs in their backpacks; they won't be charged because they save lives."

Standing order

Velez said that the state has a standing order for Narcan distribution. They can educate and supply anyone in Adams County who wants to learn and have questions.

"We provide Narcan at no charge for anyone who wants it. The Colorado statute states that we could carry it in high schools and elementary schools, it obviously it has to go through the state school boards for the school districts but we have a standing order here with Adams County to distribute it," Velez said.

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