May 7 is National Fentanyl Awareness Day, a day for individuals to stand united against overdose and overdose deaths as a result of fentanyl.
Fentanyl is 50 to 100 times more potent than morphine. Due to its potency, very small amounts can damage the brain and lead to overdose or overdose death. In 2022, the Centers for Disease Control and Prevention reported that the American Indian and Alaska Native population had the highest drug overdose death rates in 2020 and 2021, at rates of 42.5 and 56.6 deaths per 100,000 persons, respectively. It represented a 33 percent increase in overdose deaths from 2020 through 2021.
Naloxone is a medication used as a first aid tool that can reverse an opioid overdose by blocking the opioid receptors in the brain and body. It can be given as a nasal spray or as an injection and can restore breathing in 2 to 3 minutes. Additional doses may be required if there is no response. Naloxone is provided in two ways: 1) as part of an overdose education and naloxone distribution program, and 2) through pharmacies. Learn more here.
Funding is available for tribes to purchase naloxone via grants (i.e. state opioid response, tribal opioid response, tribal opioid settlement, and more.) Unfortunately, there is stigma surrounding harm reduction activities, as well as fear, due to the lack of tribes having “Good Samaritan” laws in place that would allow them to administer harm reduction services. The Good Samaritan law varies by jurisdiction and provides immunity from liability to those who act in good faith during emergencies.
The IHS is making efforts to combat fentanyl related overdose and overdose deaths by expanding access to naloxone through the Naloxone Safety Net Pilot Program. A limited amount of naloxone is available to augment existing supplies due to unexpected shortfalls. The shipments are coordinated by IHS headquarters and delivered directly to approved IHS National Supply Service Center customers.
In September 2023, the IHS updated Indian Health Manual Part 3 Chapter 35, Dispensing of Naloxone to First Responders and Community Representatives, which expanded first responder definitions and reduced administrative burdens to naloxone access. The IHS also developed a Naloxone in Schools toolkit to expand access to overdose prevention efforts. The toolkit provides an example of training plans and materials and is available on the IHS website. Additionally, the IHS developed and released its “Naloxone Keeps the Circle Strong” campaign, which includes a 3-minute video on how to use naloxone, a flyer sharing the signs of an opioid overdose with links to IHS resources, a re-branded naloxone training for community members, and a naloxone conversation starter guide for front-line clinicians.
The IHS Division of Behavioral Health provides resources to tribal and urban Indian communities, including those below:
- Division of Behavioral Health | Indian Health Service (IHS)
- IHS Community Opioid Intervention Pilot Project (COIPP)
- Opioid Stewardship in the Indian Health Service
Additional resources on fentanyl:
