One dose of naloxone can be the difference between a fatal overdose and survival.
That’s clear to Eliseo Flores, who’s used the lifesaving opioid overdose reversal drug to save multiple friends from succumbing to fentanyl and other drugs. The 21-year-old is now an advocate for naloxone accessibility, working with state health workers to reach other young adults at risk of overdose.
As rates of deadly fentanyl overdoses rise among young people, the Washington State Health Care Authority last month launched a campaign called Friends for Life, aimed at encouraging young adults and teens to carry naloxone, also known by the brand name Narcan, and educating them on when and how to use it.
Research shows naloxone is often administered by friends, according to the health agency, so the statewide campaign was inspired by the idea that more “friends” carrying naloxone could lead to fewer overdose deaths.
The health agency created a “toolkit of materials,” available to any organization or institution through its campaign website, and is working to cultivate partnerships with community-based organizations to reach higher-risk populations, said Jessica Blose, the agency’s state opioid treatment authority.
The second phase of the campaign, still in development, will focus on providing educational materials, tools and support to professionals and coalitions so they can speak with students and parents about fentanyl and naloxone.
Flores said it’s key to ensure the potentially lifesaving tips are presented in ways that are relatable to young people — something he said he believes the program achieves. Sober for nearly a year, he recounted substance use struggles that began at 18 after losing his best friend in a car crash and another friend to suicide.
“It only took one time to feel the full effects of it,” Flores said of his previous fentanyl use. “This made me feel what I wanted to feel at the time, which was absolutely nothing.”
People find ways to cope with their struggles in whatever way they can, he said. There aren’t many outlets or spaces accessible to people where they can feel the freedom to express their grief without shame.
Moreover, fentanyl is easy to get, especially for teenagers who use the drug socially, Flores said. It’s also overwhelmingly cheap, he said, with pills sometimes selling for less than $1 apiece.
Fentanyl is about 50 times stronger than heroin, according to the health authority, and its potency varies tremendously in the unregulated street supply, which compounds the dangers people with substance use disorders face.
In 2012, Public Health — Seattle & King County reported 12 fatal overdoses involving fentanyl. Just 10 years later, that number rose to 712, according to data from the health agency. So far this year, 328 people have died from fentanyl overdoses countywide.
The number of people in their 20s who have died of fentanyl overdoses countywide roughly tripled between 2019 and 2022, with 103 people of that age succumbing to it last year.
Fentanyl overdoses killed 10 people under 20 in 2019. And in each of the past three years, an average of roughly 20 people under 20 have died of such overdoses.
The majority of all fentanyl deaths are reported among white people, who comprise an estimated 64% of the county’s population, followed by Black and Hispanic people, according to Public Health data.
But the starkest increase is reported among American Indian and Alaska Natives, whose populations suffered 25 overdose deaths in 2021 and 43 in 2022, marking a 72% increase.
A surge in fentanyl use was immediately apparent to Christian Roller when he returned to his hometown of Kent from Florida in 2018.
“I couldn’t even recognize what happened to my town,” said Roller, 23, describing the influx of people living unhoused who were struggling with substance use disorders and the people he met while staying at shelters after being discharged from the military.
Roller has administered naloxone several times on strangers, he said, describing a grim experience of watching other people go about their business while someone is dying of an overdose.
“There’s a disconnect there where some people forget that’s someone’s daughter or son and that they deserve respect,” Roller said. “That could even be you, based off different situations in life.”
He emphasized a need to shift from stigmatizing drug use to seeking solutions. The Friends for Life campaign aims to do that and has the potential to further human connections, which ultimately is what can dictate whether someone lives or dies of an overdose, Roller said.
Fatherhood solidified for Roller the importance of deep care not only for family but strangers as well, he said.
“You shouldn’t walk past [someone overdosing] when you can do something to save their life,” he said.
Roller was drawn to the state initiative to help correct misinformation about fentanyl and educate young people about the drug’s dangers and the potentially lifesaving naloxone dose.
And, he pointed out, “Washington is a state where naloxone is quite easy to get.”
The Food and Drug Administration approved naloxone for over-the-counter sale March 29, and a standing order in Washington already made naloxone accessible without a prescription.
Residents should be able to pick up naloxone at their nearest pharmacy, though they can also use a naloxone locator tool on stopoverdose.org.
Flores said he personally didn’t quite grasp the consequences of consuming fentanyl the first time he tried the drug. “It led me down a really bad path,” he said.
But when he lost a third friend, this time to an overdose, he realized he wanted to make a change.
“The thought of my single mom and brother seeing me that way is what really made me want to sober up,” he said.
He said that it’s vital that efforts like Friends for Life offer a feeling of community, provide resources for young people using drugs socially or to cope with trauma, and teach them how to administer naloxone.
“I’ve been able to save a lot of lives with that,” he said, stressing the value of a campaign aimed at young people that doesn’t talk at them, but rather attempts to connect them with others with similar experiences.
“My story isn’t something I should be ashamed of. It actually gives me a way to help people.”
