Prior to administering naloxone to someone who appears to be overdosing, check for their responsiveness by lightly shaking their shoulder or leg, or pressing a pressure point such as the space below their eyebrows or their nail, according to Shinefeld. Then, if the person is still not responding, loudly say, “Hey, I'm going to Narcan you,” Shinefeld said. (Narcan is a brand name for naloxone.)
“Xylazine, to our knowledge, does not respond to naloxone, but the opioids that are almost always present with the xylazine will respond to it.”
Due to the spread of COVID and monkeypox, she said it’s best not to directly go mouth to mouth. A person can cup one hand into a tunnel shape and use that as a buffer if they don’t have CPR masks available. Philadelphia-based harm reduction group Savage Sisters has started carrying around portable oxygen tanks to assist with tranq overdoses in Kensington, a neighborhood that’s often described as an open-air drug market. “We could be waiting for about 18 minutes for somebody to show up,” said founder Sarah Laurel. “In that interim time rather than us doing rescue breathing, we want to administer oxygen.” The group also posts guides to reversing tranq overdoses online and does in-person training. Oxygen tanks are expensive and not readily accessible to most people, but Laurel said harm reduction workers in areas with large concentrations of people who use drugs may want to consider getting them. She also said first responders should bring them out of their ambulances when they arrive on scene.
“Historically, when people do come back, there's like a gasp of air. But in the age of tranq, people are still going to be sedated.”