Its my understanding that various things help reduce OD risk from fentanyl.
Testing kits. You can buy testing kits that’ll test your drugs for fentanyl and fentanyl analogues.
Easily available Narcan. Its OTC now so people can buy it at walmart and administer that until the EMTs arrive
Doing drugs in groups of people, so if you OD there are other people there to call for help.
not punishing people at the hospital so they are not scared to get medical help.
What I’m wondering is would pulse oximeters (the $20 kind you buy online) help with preventing OD death? In theory, if fentanyl causes death from respiratory depression that should cause your blood oxygen levels to drop. So if someone did a drug and someone thought they just fell asleep, a pulse oximeter will tell if they are just sleeping, or if their blood oxygen levels are dropping due to respiratory depression.
In theory, it seems like a good way to test if someone who has fallen asleep has fallen asleep because they are stoned, vs falling asleep because they have respiratory depression. But I don’t think I’ve seen these recommended in harm reduction guidelines.
Also I’ve read endless stories of people with diabetes being administered narcan by police when they aren’t having a OD. Wouldn’t a pulse oximeter narrow down if someone is unconscious due to respiratory depression from fentanyl due to unconscious from things like low blood sugar?
I wouldn’t trust something that critical to potentially cheap, inaccurate crap.
Check for consciousness.
If the person can’t be roused, CALL 911
They can guide you further if needed, you need help rolling ASAP
Nailbed/fingertips will be dark with low oxygen
Are they inaccurate though? That seems to be the price point for a lot of them nowadays. Also they don’t need to be 100% accurate. They just need to distinguish between an oxygen saturation of say 97% vs 80%. They don’t need to distinguish between 97% and 96%.
I’m aware that calling 911 is important. In my OP I mentioned how for harm reduction purposes, having an environment where people are not afraid to go to the hospital is good.
But it seemed like having pulse oximeters at home is also a good part of a harm reduction toolkit, along with having fentanyl test strips and narcan at home.
Of course if someone has sleep apnea, they are going to register low blood oxygen saturation even if they do not OD.
And if it says 97% when they’re at 80% and falling? Also, most of them display heart rate.
Narcan can be administered without harm if the person is not on drugs. Also, if Narcan is needed, there’s no time to run to the nearest store that might have it.
If a person was considering a pulse oximeter to know when to administer narcan, I would guess that person was part of a crowd which did opiates frequently. In that case, the person wouldn’t want to administer narcan if the passed out person was okay. The passed out person would not appreciate having narcan administered and pulling them out of their high every time. That group would want to know the difference between the passed out person is just high versus is OD-ing. Theoretically, it does seem like like a pulse oximeter could be a useful tool in that case. But using opiates is extremely dangerous. Relying on a pulse oximeter to determine when to administer narcan is going to be error prone. If you’re a person who is not familiar with opiate users and you came across someone you thought was OD-ing, you should just administer narcan. You wouldn’t want to make a judgement based on a pulse oximeter reading.
I agree, it is error prone. But the reality is people are going to use drugs, and lots of drugs are cut with fentanyl now. The issue is what can be done to reduce the risk of death from OD if people are going to use drugs potentially cut with fentanyl.
I guess I started this thread as a harm reduction thread. As I mentioned in the OP there are already several harm reduction techniques that help out.
Easily available narcan so you can buy it and keep it at home
Doing drugs in a group so someone else can call for help or administer narcan
testing kits to determine if drugs have fentanyl or fentanyl analogues before using them
A police and medical system that doesn’t harm and punish people for seeking medical treatment
These are all good, but I wondered if having a pulse oximeter at home would also be a good tool to have to check for hypoxia. But if you can detect hypoxia just by looking at someone’s fingernails, that may not be as necessary. However it’d still be good to have.
That’s in an emergency situation where you have no other means. If you have someone at home with breathing problems, get a good oximeter. You don’t want someone in your care to reach that stage. My late wife was on home oxygen her last few years and I bought the same model the home visit nurses carried.
The pulse oximeter would probably not be all that helpful.
I say this as someone who LOVES oximetry in emergency response (and I flatter myself I had a lot to do with getting them onto ambulances nationwide). I am a big supporter.
But there are so many things that can throw them off, and it won’t be a matter of reading 95% when it’s really 93%. It’s often more like reading 60% when it’s really in the 90s. They’re great tools, but they’re finicky.
Nor would I recommend waiting till the person’s fingernails (or lips, or mouth) are turning blue. Best to act earlier. Use the old “shake and shout.” Gently, of course. Don’t hurt anyone. But if they’re asleep in circumstances that worry you, or so deeply asleep you’re concerned, try to rouse them.
If the person doesn’t come awake enough to satisfy you, err on the side of giving the Narcan, or calling 911. Getting an opioide reversed with Narcan is reportedly a dreadful experience. But it’s better than dying.
