If you suspect that someone is experiencing an opioid overdose, always use naloxone (NARCAN®), call 911, and stay with them until help arrives.
Naloxone (NARCAN®) will have a direct effect on the opioid, like fentanyl or heroin. The most important reason to use naloxone (NARCAN®) is to restore normal breathing. When someone is experiencing an overdose, their breathing is very slow or shallow. Giving naloxone (NARCAN®) to a person experiencing an overdose will work to restore normal breathing.
Xylazine is not an opioid, so naloxone (NARCAN®) will not have a direct effect on the symptoms that xylazine causes. Xylazine can cause drowsiness, slow breathing, decrease blood pressure, and lower heart rate.
When you give naloxone (NARCAN®) to a person that has used an opioid mixed with xylazine, the most important thing to look for is normal breathing. Because the xylazine can cause heavy sedation, the person may remain unconscious, even though the naloxone (NARCAN®) is working on the opioid, and the person is breathing more normally. Because some opioids, like fentanyl, are stronger than others, it may take more than 1 dose of naloxone (NARCAN®) to restore breathing. After you give 1 dose of naloxone, monitor the person for changes in breathing. If breathing has not improved after 3-5 minutes, give a second dose of naloxone (NARCAN®) into the other nostril. Always call 911 so you have backup on the way to help save the person’s life!