fentanyl alert!

Actions Requested

  • • Alert patients to changes in the drug supply and the resulting risk of overdose due to fentanyl.
  • • Educate caregivers and communities about the signs of an overdose.
  • • Educate patients, caregivers, and communities about naloxone.

Background

Preliminary data from the Washington State Department of Health indicate there were more overdose deaths in Washington in 2020 than in 2019. The number of overdose deaths due to fentanyl is particularly concerning. Preliminary data show:1 •

  • 828 overdose deaths in Washington in the first half of 2020, compared to 607 overdose deaths in first half of 2019.
  • Of those overdose deaths, 305 were attributed to fentanyl in the first half of 2020, while 137 were attributed to fentanyl in the first half of 2019.

A convergence of factors may be leading to an increased risk of drug overdose in Washington. Illicit fentanyl has been found in counterfeit pills made to look like prescription opioids, as well as in powders and other illicit drugs. The extended disillusionment phase2 of disaster for the COVID-19 pandemic may be an additional factor, since it is typically the disaster phase with the greatest behavioral health impacts.

Action Steps

  • Educate patients about changes in the drug supply and the risks for overdose due to fentanyl.
  • Make sure patients and their caregivers have access to and knowledge of naloxone.
  • Prescribe naloxone to anyone who uses illicit drugs.
    • Washington State Department of Health. (2020). Death certificates [Data file]. Retrieved on January 25, 2021.
    • For a description of each phase in the disaster timeline, refer to page 5 of the COVID-19 Behavioral Health Group Impact Reference Guide (https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/BHG-COVID19BehavioralHealthGroupImpactReferenceGuide.pdf).
    • Provider alert regarding increased concern of drug overdose – February 5, 2021 2
    • Prescribe or distribute naloxone to people who use opioids and have recently been incarcerated or have had a break in use.
    • Co-prescribe naloxone with an opioid prescription.
    • Provide resources for patients, their friends, and their family about how to use naloxone.
    • Counsel patients about how to create a safety plan with their friends, family, and caregivers in case of an overdose.
    • Inform patients and caregivers on Washington’s standing order to dispense naloxone.
  • Talk to patients who are in recovery from opioid use disorder (OUD) about the risk for recurrence of use and the benefits of effective treatment medications and naloxone.

Resources

For providers

For Caregivers and Communities