Opioid Overdose Risk Factors

Stay Safe. Know the risks. Carry Naloxone.

Risk factors

There are several factors that can increase a person’s risk of overdosing. They include:

  • Changes in tolerance from not using or using less. This happens after being in-patient, in jail, or following a period of less or no opioid use.
  • Changes in the drug supply.
  • Mixing opioids with respiratory depressants or “downers” such as alcohol or benzodiazepines (benzos).
  • Mixing opioids with stimulants, such as cocaine and methamphetamine.
  • Having chronic health conditions such as, HIV, Hepatitis C, lung disease, heart disease, or other health concerns.
  • History of past overdoses.

Prevent a fatal overdose

There are many harm reduction strategies for preventing overdoses from occurring or from becoming fatal:

  • Always carry naloxone (multiple doses if possible).
  • Whenever possible, use with someone else around.
    • Try to alternate using with those around you, so that one of you is still able to respond with naloxone if the other one overdoses.
    • If you are alone, call someone you trust before using, and ask them to either stay on the phone with you while you use or call you in 10 minutes to see if you’re OK. If you don’t answer, have them call 911 with your location.
    • If you are alone, call the Massachusetts Overdose Prevention Helping (Never Use Alone New England) at 1-800-972-0590 or use overdose monitoring devices and phone-based applications.
    • If you can’t call anyone, use in a semi-public location where someone will be able to find you if you overdose. Leave naloxone out and nearby, so that whoever finds you can use it on you.
  • Start low and go slow.
    • Every time you use a new bag or buy from a new dealer, do a small tester shot. Only do more after waiting a few minutes and seeing how your body reacts.
  • Avoid mixing opioids with other substances, such as alcohol and benzos.

Information on fentanyl

What is it?

Fentanyl is a strong synthetic opioid that is given intravenously in hospitals for anesthesia, rapid pain control, and sedation. It is also prescribed for the treatment of chronic pain, as a transdermal patch. Fentanyl is responsible for the surge in opioid-related deaths seen in MA since 2013, due to it being a potent and fast-acting drug.

Where has it been found?

Fentanyl is typically sold as is, or as heroin. It may also be present in other drugs such as cocaine and pressed pills without the user’s knowledge. For updated Fentanyl trends, see the MADDS website, which provides data on substances tested across MA.

What can I do about fentanyl?

If you use drugs, when you get a new supply, test them for fentanyl before using. You can get fentanyl test strips at many BSAS-funded Syringe Service programs or CNPP programs. Programs can order test strips for free at the MA Clearinghouse. Alternatively, you can bring a sample of the substance you are interested in testing to one of these locations, and Brandeis University’s drug checking program will test the sample for you.  Additionally, always use the harm reduction strategies outlined above to prevent a fatal overdose.

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