You’re at a park in Yakima or outside a Lower Valley business when you witness a drug overdose. What do you do? 

It’s not a far-fetched question. In 2024, there were 146 fatal drug overdoses in Yakima County. Many were either the result of fentanyl or fentanyl and another drug, Yakima County Coroner Marshall Slight has said.

Most overdose deaths in Washington involve fentanyl, according to the Friends For Life overdose prevention organization.

Anyone can get Narcan for free at multiple locations in Yakima County, carry it and administer it to block the effects of opioids on the brain.

Doing so can save a life. Here’s what a bystander can do:

Background

Fentanyl is a synthetic opioid that is about 50 times stronger than heroin and 100 times stronger than morphine, experts say. It is a major contributor to fatal and nonfatal overdoses in the United States, according to the Yakima Health District.

The illegal use of opioids has gotten more dangerous as fentanyl has become more prevalent. Fentanyl is a powerful synthetic opioid prescribed for pain and often sold on the street in fake form. Fake fentanyl pills and powder, sometimes mixed with other drugs and ingested unknowingly, have flooded Washington and the United States.

Naloxone is a safe medication that when given in time, reverses overdoses from opioids, including prescription opioid medications, heroin and fentanyl. It’s often known as Narcan, a common brand name, and comes as a nasal spray that anyone can use with a little guidance. It’s small and easy to carry in a purse or a bag, a vehicle glove compartment or center console.

Safe Yakima Valley’s ODMAP project, which began a year ago, involves software that tracks all drug overdoses where law enforcement or fire departments respond. Along with showing fatal overdoses, it shows how many people were saved from dying of an overdose. Narcan is playing a role, and making a difference.

Since the start of the year, the organization has tracked 788 fatal and nonfatal overdoses locally. There were 55 confirmed fatalities as of June 13, showing that Narcan use is making a difference. Some people received multiple doses of Narcan to reverse an overdose, said Alicia Stromme Tobin, executive director of Safe Yakima Valley.

Signs of an overdose

An opioid overdose may not be immediately obvious, or obvious at all. The person who is overdosing may look asleep. Try to wake the person. Look closely. The person overdosing may have shallow breathing, be breathing very slowly, or likely not at all. Typically there’s no breathing, said Katie Goodale, program manager for Safe Yakima Valley, said at a public Narcan training event in May.

The person’s skin may be pale or turning blue or gray, with blue or purple lips and fingernails. Overdose victims may look ashen or have cold and clammy skin. They may have slurred or no speech, or may vomit before losing consciousness.

If you think the person may be overdosing on opioids, never let the person “sleep it off.” Don’t leave the person who is overdosing.

Call 911 immediately and lay the person down, if necessary, to administer Narcan. Take one small predosed canister of Narcan, hold it with your index and middle fingers and thumb, insert the nozzle into either nostril and press the canister plunger all the way. Narcan starts working within two to three minutes.

Wait two to three minutes and if necessary, administer another dose and wait another two to three minutes. Narcan works by restoring breathing. Along with administering Narcan, Friends For Life recommends giving a rescue breath every five minutes until help arrives, 

“The goal is to keep them breathing until the EMTs come,” Goodale said. Be prepared for anger as the person goes into immediate withdrawal.

“They’re not going to be happy,” she said.

It’s important to know that the state’s Good Samaritan Law protects anyone who seeks medical assistance for a drug overdose against drug possession charges and protects anyone who administers any form of naxolone.

Where to get Narcan

Though naxolone is available as an intramuscular injection, the nasal spray generally referred to as Narcan is the simplest to use and the most widely available. Each canister holds one dose that is sprayed into one nostril. Doses usually come two to a box.

Yakima County has two locations where naxolone is available 24 hours a day, seven days a week. They are free vending machines outside Yakamart at 111 Fort Road in Toppenish, and outside Planned Parenthood at 1117 Tieton Drive in Yakima.

Opportunities Industrialization Center (OIC) at 717 Fruitvale Blvd. in Yakima has a free naxolone vending machine available during business hours, from 7 a.m. to 6 p.m. Monday through Friday. The Yakima Health District at 1210 Ahtanum Ridge Drive and Yakama Nation Public Community Health at 10 S. Alder St. in Toppenish have naloxone available during business hours and also distribute it during public events. Some substance abuse disorder treatment sites also distribute it free during business hours.

Astria hospitals in Sunnyside and Toppenish, along with all Astria clinics, have naxolone available for free in their lobbies.

Naloxone is available to anyone at a pharmacy without a prescription under a statewide standing order, according to the Yakima Health District. Medicaid and most health insurance plans cover part of or all the costs of naloxone. The county health district has more information on pharmacy locations at YakimaHealthDistrict.org/Overdose.

And in Washington, people without insurance can order free naloxone online and have it delivered to their home at phra.org/naloxone.

Safe and effective

Narcan reverses only opioid overdoses, Goodale said. It doesn’t treat or reverse the effects of other drugs or alcohol. It isn’t habit-forming and isn’t harmful, even when administered to someone who hasn’t taken opioids.

“It’s not dangerous at all,” Goodale said.

Safe Yakima Valley will provide training on how to use Narcan for any group, organization or agency, Goodale said. So will the Yakima Health District. Yakama Nation Public Community Health also provides trainings. Reach out for more information.

At the May community event where she and others spoke about Narcan and how to use it, she stressed again why it was so important to know all about Narcan and ensure it’s available if necessary.

“As of this morning, we had an overdose spike,” she said. “In the last 24 hours, 14 people suffered overdoses.”