The Opioid Overdose Epidemic Affects Everyone—Having Narcan On Hand is An Impactful Way for The Service Industry To Help (and Potentially) Save Lives.
In the summer of 2022, Ellen Wirshup was working at a local bar in her hometown of Portland, Oregon, when she got the news that a long-time childhood friend had passed away from an overdose caused by Fentanyl.
Wirshup recounts the feeling of devastation, anger, and sadness—but also, as someone who partook herself, the luck of having become clean right before Fentanyl hit the west coast.
Since 2013, a third wave in the opioid overdose epidemic has increased to an all-time high, exacerbated by illicitly manufactured Fentanyl—a highly lethal synthetic opioid that is 50-100 times more potent than morphine.
In more recent years, deaths caused by drug poisoning increased by nearly 30% between 2019-2020, and in 2022 alone, fentanyl poisoning took a shocking 110,236 lives. As a result, drug poisoning has quickly become the leading cause of death by injury in the US between the ages of 25-44.
The service industry is not unfamiliar with substance abuse and misuse. The opioid overdose epidemic, more often than not, hits home—so Wirshup decided to do something about it.
“I remember sitting with my friend at the river, and I was just talking to them, ‘well, what if I just got a bunch of Narcan and brought it into bars and saw who wanted it'” Wirshup shared. “And that was what I did. I went to Alano Club of Portland, which is where I had gotten my Narcan previously, and someone handed me a case, and I just started walking to bars.”
Eventually, Wirshup’s mission turned into an official initiative known as Project Red under the Alano Club of Portland, a local organization offering accessible, cost-free, trauma-informed programming and mutual aid support to anyone in or seeking recovery from substance use and mental health disorders.
With Project Red, Wirshup aims to normalize the possession of Narcan in the service industry and build awareness in restaurants, bars, and other entertainment venues so that they can take action to help save the lives of coworkers and patrons.
“I chose bars, restaurants, strip clubs, coffee shops, entertainment venues because that was the industry that I worked in, but also a lot of the kind of folks that I lost were people who worked in the industry. And I know that it’s an industry where a lot of people struggle with substance dependency and substance misuse and abuse,” Wirshup said. “I also wanted to create space where if [someone] needed help or they needed access to [Narcan], they’d have an easier way to get a hold of it as opposed to, like, not so discreetly going out of their way to find it.”
Narcan, a nasal spray form of Naloxone, rapidly reverses an opioid overdose by attaching to opioid receptors and reversing and blocking the effects of other opioids.
“Narcan is cool in that it doesn’t do anything to you if you have other substances in your system,” Wirshup said. “It also works on any and all opioids, so that’s going to be any kind of pill, any man-made opiates, so fentanyl is one of them, and it works on any and all fentanyl analogs.”
Each box of Narcan contains two doses, and the process of administering the drug is relatively simple if you or a staff member encounter someone experiencing an overdose.
“Inside each one of these is one formula dose, so you don’t want to do any test plunges because you’ll waste all of the medicine,” Wirshup explained. “Stick in the nose until it touches your fingertips—plunge and wait three minutes.”
After administering the first dose, you likely won’t see immediate results, but you want to watch and see if the person’s breathing or skin tone is slowly returning to normal.
You might have to administer a second dose of Narcan, but waiting those three minutes is essential because you don’t want to panic dose, and more importantly, Narcan induces withdrawal, which will be very painful and uncomfortable.
“If you give a three-minute window, that’s enough time to see if there are any changes, now after three minutes, administer your second dose that’s in the box if you don’t notice anything,” Wirshup said. “That gives you about six minutes. The paramedics should hopefully be there by then—if not just administer rescue breathing.”
In addition to providing interested businesses with Narcan, Wirshup trains staff on how to notice signs of an overdose and take action, whether through administering Narcan or just performing rescue breathing.
“What happens when someone is experiencing an opioid overdose, or when someone puts opiates in their body, is that the body is becoming so relaxed that you’re not breathing fast enough, so your brain is not getting enough oxygen,” Wirshup explained. “So these signs that you’re checking for look a lot like signs of someone deprived of oxygen.
Signs of a Potential Opioid Overdose:
- Change in breathing.
Look for slow and shallow breathing, also known as a death rattle.
- Skin Discoloration.
Check the area around the mouth or underneath the nailbed for pale, ashy discoloration or blue, gray, and purple skin coloring.
Try to get the person’s attention by talking to them or carefully knocking on their collarbone or shoulder blade. If they don’t wake up, that is a sign of a potential overdose.
If you notice any of these signs—take action.
Direct someone to call 911 and administer Narcan if you have it on hand. If not, rescue breathing can work just as well until the paramedics arrive.
Restaurants that carry Narcan can help save lives and better prepare their staff to handle the stress of managing an opioid overdose on the clock. Still, Wirshup occasionally encounters businesses that support the idea but are hesitant to have Narcan in their establishments based on liability or enabling concerns.
While Good Samaritan Laws protect individuals administering Narcan, Wirshup encourages concerned businesses to speak with their lawyers and do their research to feel better about it—but don’t just do nothing.
The alternative could be death, which is a far worse outcome.
“It is so much better to have Narcan and never need to use it than be in a situation where you need it and don’t have it,” Wirshup said.
In a perfect world, no one would have to be in any life-saving situation—but it’s better to prepare yourself and your team to know how to step in and take action in a meaningful way.
For those interested in obtaining Narcan and administration training, you can reach out to Ellen through the Project Red website. You can order Narcan through the mail-based distribution program Next Distro if you’re outside Portland.
Additionally, if you’re outside Oregon, you can look into organizations in your area that are already doing this work or contact your local health authority to see how you can get involved and help normalize Narcan in the service industry.