Stay Safer

Learn how to stay safer if you use substances.

How to stay safer if you use substances

Only take pills that are prescribed to you, as prescribed.

Sometimes, people use substances to cope with pain, stress, anxiety, or other mental health issues. Or, people may use substances because they are curious and want to experiment. If you think medication could help you, talk to a health care professional. Don’t use or buy pills that are not prescribed to you, don’t use pills that do not come from a pharmacy, and do not take pills from friends or family, even if they say they are real. 

Many fake prescription pills contain fentanyl, which can cause an overdose.

Be cautious, use less, and don’t mix substances.

Because many drugs might contain unknown and potentially harmful amounts of fentanyl, it is important to be cautious. Fentanyl is 50 times stronger than heroin, and even very small amounts can be harmful.

People can overdose on fentanyl by injecting, snorting, or smoking it or by taking other drugs that contain fentanyl that was mixed in. Because fentanyl acts fast, injection carries a higher risk of overdose. No matter how you might use substances, go slowly and take time between doses. (source) Always test any drug using fentanyl test strips before using it.

Do not mix substances like fake prescription pills and other drugs like cocaine, heroin, or meth because they all could contain dangerous amounts of fentanyl, increasing your risk of an overdose. Avoid drinking alcohol while using any other drugs.

Test for fentanyl.

Test strips are a fast, inexpensive, and easy way to test if a drug has fentanyl in it. Test strips are made out of paper with a special coating that will react if it comes into contact with fentanyl. Test strips can help you find out if a drug has fentanyl in it, but they won’t show how much fentanyl is there, so it is still important to be cautious.

Test strips can help keep you safe, but they won’t guarantee that a drug is safe. If a test strip is negative, there may be a chance that the drug could have some fentanyl in it.

Learn how to use test strips here. Test strips are legal in Colorado. You can order test strips online or find them at syringe access programs. If you live in Denver, you can order test strips from the county here.

Never use alone.

Do not use substances alone if you can help it. Make sure someone is nearby and can respond if something goes wrong. Or, if you are in a group where everyone is using a substance, stagger your use to make sure that there is always someone alert and can spot the signs of an overdose, give naloxone, and call for help.

Not sure who you can reach out to? Never Use Alone is a non-judgmental hotline service that connects people with someone who can help keep them safe while they use substances. 

If you use substances, make sure you have naloxone with you in case you or someone you are with overdoses. Let others know where naloxone is kept, and make sure they know how to use it. If you experience an overdose, you will not be able to give yourself naloxone.

Be prepared to call for help.

If you think someone might be having an overdose, call 911 and stay with that person. You cannot get hurt by touching fentanyl or touching someone who has used fentanyl (source). If you have naloxone, use it. 

In Colorado, the 911 Good Samaritan law means you cannot get into trouble trying to help someone who might be having an overdose, even if you are using substances yourself and have small amounts of certain drugs and drug paraphernalia with you. Don’t hesitate to make the call, you can save a life. 

If you cannot call 911, give the person naloxone (if you have it) and put the person in the recovery position before you leave them to find someone who can call. If you can stay with or return to the person, do so. If you cannot stay with the person before help arrives, make sure that you leave all doors unlocked and open so the person can be found more easily.

Use naloxone.

Naloxone is a safe way to reverse an opioid overdose. Naloxone is legal in all 50 states, and anyone in Colorado can access, purchase, and use naloxone. Some pharmacies have naloxone in stock, and almost all can order it for you and get it to you within a couple of days. Many insurance plans, including Medicaid and Medicare, cover naloxone. Visit your local pharmacy and ask your pharmacist about naloxone.

Anyone who uses opioids or has them in their home should get naloxone and make sure they have it with them when they use substances. If you or someone you care about uses opioids, either with a prescription or without, or has an opioid use disorder, you can help them by talking to them about naloxone and having it at home, just in case. You can even carry naloxone with you if you encounter someone who might be overdosing.

Signs of an overdose

Know the signs of an overdose

A fentanyl overdose can happen unexpectedly and very fast, so it is important to act quickly. Remember that someone might accidentally take fentanyl that was mixed into other drugs. Signs of an overdose include:

  • Very small or tiny pupils.

  • Limp body.

  • Unable to talk.

  • Pale, gray, or bluish skin, lips, or nails.

  • Cold or clammy skin.

  • Breathing has slowed down or stopped.

  • Very sleepy or passing out.

  • Snoring, choking, or gurgling sounds.

  • Muscle spasms or locked, rigid arms and legs (source).

  • Rigid chest or ribs (source).

If you are with someone who might be having an overdose, here’s what to do:

  • Call 911. 

  • If you have naloxone, use it.

  • Stay with the person. Try to keep them awake and breathing. You may be able to perform CPR or rescue breathing. 

  • Lay the person on their side in the recovery position to help prevent choking. 

  • Wait until the emergency responders arrive. In Colorado, you are protected from liability and certain drug possession penalties by the 911 Good Samaritan Law if you provide help to someone you believe is experiencing an overdose and stay on the scene. 

If you cannot call 911, give the person naloxone (if you have it) and put the person in the recovery position before you leave them to find someone who can call. If you can stay with or return to the person, do so. If you cannot stay with the person before help arrives, make sure that you leave all doors unlocked and open so the person can be found more easily.

How to stop an overdose

How to use naloxone nasal spray

If you are helping someone with symptoms of an overdose, always call 911. Give them naloxone while you wait for help to arrive.

The most commonly used form of naloxone is a nasal spray, which means the medicine is given to the person up their nose. You will not hurt someone or cause them pain by giving them naloxone. You will not get hurt or be exposed to fentanyl by giving someone naloxone. Before giving someone naloxone, read the instructions on the package.

  1. Peel open the container.

  2. Put the nozzle into one of the person’s nostrils. It does not matter which one.

  3. Press the plunger to release the dose.

  4. Wait two to three minutes and stay with the person. Give them rescue breaths (two breaths every 5 seconds) while you wait for first responders to show up. If they do not respond, if their breathing has stopped, or if their breathing is very slow or difficult, you may need to give them another dose. If the individual has no pulse, breathing has stopped, and you are trained, you can administer CPR.

For more detailed information on how to give someone naloxone, watch these educational videos from Prescribe to Prevent.

Naloxone facts

  • Sometimes naloxone comes in as an injectable, but this is less commonly preferred by individuals who aren’t comfortable with syringes. Always follow the instructions on the package before you give someone naloxone. 

  • If you are unsure how to give someone naloxone, always refer to the instructions printed on the package.

  • If you experience an overdose, you will not be able to give yourself naloxone. Never use alone, and make sure the people you are with can call for help and know how to give you naloxone if needed.

  • If you aren’t sure if the person with overdose symptoms took fentanyl or any other type of opioid, it is still safe to give them naloxone. 

  • Expired naloxone is better than none (source).

  • Naloxone has no potential for misuse and is 100% safe.

  • Naloxone can wear off in about 20-90 minutes (source). It is important to call 911 so the person with overdose symptoms can receive any other medical care they might need. 

  • If you or someone you care about uses opioids or other drugs that may contain fentanyl, make sure you have a supply of naloxone and learn how to use it. Make sure the people you use with also know how to use naloxone. 

  • Talking to a pharmacist about naloxone, knowing how to use naloxone, or having naloxone does not mean you have a problem or that you have an opioid use disorder. Anyone in Colorado can buy, have, and use naloxone. 

  • If you are under 18, you can purchase, have, and use naloxone. 

  • Naloxone is the best and safest way to help someone who is experiencing overdose symptoms. Ice, cold showers, hitting the person, or giving them a salt shot are not helpful alternatives, and they may even cause more harm (source).

Where to get naloxone in Colorado

More than 500 pharmacies in Colorado, including major chains such as CVS, Walgreens, Walmart, Safeway/Albertsons, King Soopers, and City Market, sell naloxone.

You can find a map of pharmacies at StopTheClockColorado.org.

You can learn more about naloxone access at BringNaloxoneHome.org.

Many insurance plans, including Medicaid and Medicare, cover naloxone. Not every pharmacy outlet might have naloxone in stock all the time, but if you ask the pharmacy, they can order it for you or might direct you to a pharmacy with naloxone in stock. You also can call ahead to confirm that naloxone is in stock.

If pharmacy staff asks you for a prescription, tell them about Colorado’s standing order. They are posted online on the CDPHE’s website.

Pharmacists and pharmacy technicians should know about naloxone. If they don’t, tell them naloxone is the medication that reverses opioid overdoses. You can direct them to the FDA website.