Reducing Harm

Project Red Workshop

Fentanyl is a public health crisis that has landed on the doorsteps of unsuspecting families across America and in our own backyard here at MHCC.

Guest speaker Ellen Wirshup from Project RED reported that more than 70,000 persons are dying of opioid overdoses each year in the United States, and east Multnomah County is not immune.

During an educational workshop at Mt. Hood on Feb. 11, she gave a brief history of how she helped established Project RED, an overdose prevention and harm reduction program sponsored by the Alano Club of Portland. The program is dedicated to increasing the availability and accessibility of overdose prevention supplies, education and trainings.

Wirshup discussed how to reverse an opioid overdose by administering Narcan (Naloxone). Beyond that, she covered the basics, explaining how opioids affect the brain and talking about the challenges of opioid tolerance, withdrawal and increasing treatment options in Oregon.

Most of all, she emphasized that “the fog that surrounds the opioid epidemic is not impassable; there is hope for healing and recovery.”

As for Narcan use, Wirshup shared crucial details.

 First, we all (the public) have to recognize that during an overdose, opioids reduce alertness, the person (user) becomes unresponsive (nodding off) and breathing slows. Opioids work by attaching to receptors in the brainstem, triggering a large release of dopamine that creates an intense feeling of pleasure. During an overdose, a person could stop breathing entirely, causing death.

We can be the difference by administering Naloxone, a medication that rapidly reverses the overdose process and saves lives. To determine if someone is experiencing an overdose, Wirshup said to look for a bluish discoloration around the lining of the lips. Watch for pinpoint pupils and count the person’s breaths – 12 or fewer breaths in one minute a rule of thumb. She said a good mechanism for counting breaths is to hold your own: If you have to take a breath and the unresponsive person still has not – the person is likely overdosing (under six breaths per minute is life-threatening, causing the heart to slow and brain cells to begin to die).

The breathing can also appear labored, accompanied by snoring sounds or rasping. Seizures and hallucinations are also common. The best option is to administer Narcan if possible, by an inhaler, directly into the person‘s nose and calling 9-1-1. Tell the 9-1-1 operator your location, that the person is breathing slowly but is unresponsive and you need help.

After three minutes, the Narcan should start to take effect and the person’s breathing should return to normal. When the overdose begins to reverse, keep them awake and breathing (do not expect a “thank you;” the person might wake up and be angry). Lay them on their side to prevent choking and stay with them until emergency services arrive.

We are all on the front lines of this epidemic, with tragic consequences of fatal overdoses and violence surrounding the drug trade reported every day on the local news. Project RED raises awareness about the opioid crisis and what can be done here in our own backyard. 

Cherilyn Nederhiser