The term opioid refers broadly to all compounds related to opium, the drug derived from the opium poppy. Opioids can be natural products (e.g., morphine, codeine), semi-synthetic products (e.g., heroin, oxycodone, hydrocodone) or completely synthetic (e.g., fentanyl, methadone).

Opioids are prescribed by doctors to people to help manage severe pain. However, opioids are also used without a prescription by youth and adults. Whether used with or without a prescription, opioids can become addictive for people. Non-prescription use of opioids can include heroin, prescription opioids (e.g., oxycodone, hydrocodone, fentanyl, etc.), or opioids manufactured illegally (e.g., counterfeit oxycodone laced with fentanyl).

Opioid overdose is the accidental overdose or intentional self-poisoning by opioids is the most common cause of drug- related mortality in the United States. Synthetic opioids (primarily illicit fentanyl) appear to be the primary driver of the increase in opioid overdose deaths.

See Oregon’s April 2022 High Intensity Drug Trafficking Area (HIDTA) bulletin for more information.

Respiratory depression (shallow or absent breathing) is a hallmark sign of opioid overdose, potentially culminating in a stupor or unconsciousness, cyanosis (bluish or grayish discoloration around lips and nail beds), and lack of oxygenation to vital organs resulting in a heart attack and death. Opioid ingestion can be confirmed once the patient is alert, but naloxone treatment should begin before confirming if opioid overdose is suspected.

*It is important to note that if naloxone is mistakenly given to someone not actually experiencing an opioid overdose, it will not harm them. There is no potential for addiction or other misuse of naloxone.

 Know the signs of an opioid overdose:

• Pinpoint pupils
• Slow, shallow, or no breathing
• Gurgling or snoring
• Difficult to wake or can’t wake
• Extreme drowsiness
• Cold, clammy skin
• Gray or blue skin, fingernails, or lips

 Immediately call 9-1-1 if a person is found unconscious or an overdose is suspected. Even if the victim responds well to naloxone, opioids can stay in the body for several hours and respiratory depression can recur. Emergency Medical Services personnel are trained to manage opioid overdose and get the patient further care at the local hospital. 

Naloxone is a medication that works to rapidly reverse an opioid overdose when administered properly and at the right time. It is available as an injection or nasal spray. It is available generically or as various branded products (Narcan, Evzio, Zimhi, etc.).

Naloxone can very quickly restore normal breathing for a person whose breathing has slowed down or stopped because of an overdose of fentanyl, prescription opioids or heroin. Naloxone onset occurs within 2-3 minutes and can last for 30-90 minutes. Sometimes a second dose of naloxone is necessary if symptoms of overdose return.

Immediately call 9-1-1 if a person is found unconscious or an overdose is suspected. Even if the victim responds well to naloxone, opioids can stay in the body for several hours and respiratory depression can recur. Emergency Medical Services personnel are trained to manage opioid overdose and get the patient further care at the local hospital.

*Remember: if naloxone is mistakenly given to someone not actually experiencing an opioid overdose, it will not harm them. There is no potential for addiction or other misuse of naloxone.

Anyone who administers naloxone to save a life is protected from liability under Oregon law. Read the Good Samaritan Law (pdf).

 See Oregon Health Authority Frequently Asked Questions for naloxone for more information.

Youth need to know about the dangers of fentanyl. Schools, youth-serving organizations, and families should share the following messages with youth: 

1. Counterfeit pills laced with fentanyl are flooding the Pacific In just one year (2019-2020), Oregon saw a 74% increase in fentanyl-related deaths.
2. Do not take any pill that you do not directly get from your doctor or a Pills received from friends or purchased online or from social media are not safe.
3. Fentanyl is tasteless, odorless, and too small to see with the naked It’s extremely potent. An amount the size of two grains of sand is enough to cause a deadly overdose.
4. Fentanyl-laced pills appear identical to those prescribed by doctors. In Oregon, fentanyl is most commonly seen in blue, greenish, or pale colored counterfeit pills. There may be other colors. These pills may be marked as “M30.” Unless a pharmacist directly hands you a prescription pill, assume it is counterfeit and contains fentanyl.
5. There is no such thing as a “safe” source: pills are often laced with fentanyl long before they reach a direct Assume any pills obtained from social media, the internet, or a friend are counterfeit and contain fentanyl.
6. The blending of fentanyl in counterfeit pills is inconsistent and completely random, making every single dose a One dose may not contain fentanyl, while another does—even though both come from the same supply.
7. Naloxone is the only medication that can reverse an opioid
8. If someone is going to use, the best way to prevent a fatal overdose is to avoid using alone and to always have naloxone on If using alone and you overdose, you can’t call for help or administer naloxone to yourself.
9. The clearest sign of an overdose is if someone is unresponsive (won’t wake up). Other signs include:
   • Slow, shallow or no breathing -Cold or clammy skin
   • Pinpoint pupils -Difficult to wake, or can’t wake
   • Heavy gurgling or snoring sounds -Blue or gray skin, lips, or nails
10. An overdose is always a medical emergency. Call 911 immediately. Remember that the Good Samaritan Law protects witnesses and victims from being prosecuted for drug If you seek medical assistance in a drug-related overdose, you and the victim cannot be prosecuted for drug possession.

Administration of naloxone by school personnel is included in the existing LOSD Medication Administration policy. It requires designated school staff to complete naloxone training. School staff who are solely designated to provide naloxone, and are not administering other medications to students, are not required to complete the additional ODE Medication Administration training specific to individual student medications.  

• Visit the Oregon Health Authority Public Health Division for resources: www.oregon.gov/oha/ph/preventionwellness/substanceuse/opioids/pages/naloxone.aspx.
• Fake and Fatal: Fentanyl/counterfeit pill campaign and curriculum developed by the Beaverton School District
• Oregon Health Authority, Youth Substance Use Disorders: visit the webpage for treatment and recovery resources.
• Laced and Lethal: King County, Washington campaign designed to teach teens about the risk of buying pills and powders potentially laced with fentanyl.
• Song for Charlie: A family-run nonprofit charity dedicated to raising awareness about “fentapills.”
• SafeOregon Tip Line: Program created for Oregon students, families, school staff and community members, and law enforcement officers to report and respond to student safety threats.
• Oregon Youth Suicide Prevention Programs: Compiled list of youth suicide prevention resources and programming available.
• Families Helping Families resources for families dealing with addiction
• 8 Tips for Talking to Your Teen about Alcohol and Other Drugs created by Safety First.

• 8 Tips for Talking to Your Teen about Alcohol and Other Drugs created by Safety
• Youth Substance Use Disorders treatment and recovery resources from Oregon Health Authority
• Helping Families Help Resources, groups, trainings, and other support for families dealing with addiction
• Oregon Youth Suicide Prevention Programs