SCREW

FENTANYL

Learn your options.

Swap It, Block It, Reverse It, Be Safer.

 SWAP IT

  • Even more than other opioids, fentanyl quickly puts you on a rollercoaster. Soon you’re using just to feel normal for a minute before either passing out or crashing down again. It’s an awful cycle. It also carries a huge risk of overdose (including brain injury from lack of oxygen) and death. Medicines like methadone and buprenorphine (Suboxone is just one brand of this) help people get stable. They keep your brain’s opioid receptors satisfied so you can get off the rollercoaster and just feel even again.

  • Methadone has been around for a very long time and works really well at giving people back control over their opioid use disorder. Basically, it’s a long acting opioid that helps cut your cravings. At the right dose, you use it once a day and are all set until the next morning. Different programs work differently, but usually you need to pick up your dose between once a day and once a week. If you do use on top of the methadone, you are still at risk of overdosing, though.

  • Buprenorphine is great! Basically, it gets you to feeling even and keeps you there. Like fentanyl, buprenorphine turns on your brain’s opioid receptors, but it can only do it so much. It’s also more powerful than fentanyl and other opioids in attaching to those receptors. The overall effect is that it quickly brings you to a moderate level from wherever you’re starting. So if you’re high on fentanyl, it will quickly drop you down to “normal” so you will feel like you’re withdrawing. However, if you’re withdrawing, it quickly makes you feel normal again.

    Two huge advantages. First, it’s easier to get because many primary care providers can prescribe it for you. And like any other medicine, you can get up to a month at a time. Second, if it’s in your system, it’s harder to overdose on fentanyl because it partially blocks the fentanyl.

    Suboxone is one particular brand of buprenorphine, and contains an additional medicine (naloxone) that prevents you from trying to inject it. There are other forms. Most you dissolve under your tongue, but there are also patches and monthly shots available.

    Any which way, it’s worth working closely with your prescriber so they can help you transition comfortably. This may involve helping you choose the right time to start or microdosing the medicine.

  • No. Just stop it. People who tell you that using medicine is “just trading addictions” are just wrong. There’s a difference between an addiction and a physical dependence, and that difference is chaos. When you’re chasing fentanyl or heroin or scoring whatever Percs you can find, that’s chaos. When you use a prescribed medicine to treat your body’s current dependence on opioids, so that you can get on with living your life, that’s just healthy. Diabetics don’t get shit for using insulin and people with glasses aren’t told to just “squint harder”. They’re using tools and medicine to be healthy. You deserve the same.

 BLOCK IT

  • Even out on the West Coast, where we thought we were safe from fentanyl for a while, it’s now in everything. Almost any drug you buy now may have fentanyl, whether you want it or not. If you plan to continue to use meth or other substances, you should at least protect yourself from overdose.

  • YES! Naltrexone (similar to naloxone or Narcan) is a medicine that blocks opioids. It comes in either daily pill or monthly shot versions. If you have it in your system, it can lower the risk of an opioid overdose. It’s not perfect, but it provides some protection. Because of the way it works in the brain, it can also cut cravings (like for alcohol or drugs) in some people, giving you back some control over your use. Ask your provider about this.

 BE SAFER

  • None of these approaches are perfect, but they may help you or someone in your life:

    1) Test your shit. Fentanyl test strips can detect whether your drugs have fentanyl in them.

    2) Use clean needles, syringes and works every time. Don’t share.

    3) Use with a buddy and take turns.

    4) Have naloxone (AKA Narcan) on hand.

    5) Always do a small test dose. Even if your dealer swears it’s the same, you should check yourself. You should know what to expect.

    6) Avoid using alcohol, benzos like Xanax, or other drugs at the same time because you increase your risk of overdose.

    7) Keep checking in with yourself. Just because you’re not ready to quit now, that doesn’t mean you’ll never be ready.

 REVERSE IT

  • Naloxone (aka Narcan) reverses opioids. In most places, your local public health department can get you a naloxone kit for free. This is usually either an injection kit, or more commonly, a nasal spray. If someone isn’t responding, call for help. Use rescue breathing and/or CPR as needed. If you think it might be an overdose, go ahead and give the naloxone. It absolutely can’t hurt them, and you might save their life.

    If you’re using the spray, don’t test it before putting it in their nose. It just has one spray’s worth and you don’t want to waste it. Just stick the nozzle in their nostril and spray.

  • Most places have a Good Samaritan law that protects people just trying to help. For example, WA State law protects you and the person overdosing from charges of drug possession. No one should be hassling you if you’re calling to save someone’s life.