Ending the Crisis: Mayo Clinic's Guide to Opioid Addiction and Safe Opioid Use

Dr. Holly Geyer, MD is an Addiction Medicine Specialist at Mayo Clinic in Scottsdale, Arizona and the physician lead of the MCA Opioid Stewardship Program. She chairs the ‘School Training Overdose Preparedness and Intelligence Taskforce’ (STOP-IT) and is widely published in high-impact scientific journals. She is the author of Ending the Crisis: Mayo Clinic's Guide to Opioid Addiction and Safe Opioid Use.

Understanding Harm Reduction

In Rhode Island, harm reduction is an evidence-based public health approach that aims to provide tools, services, and education to people who use substances. Organizations give free supplies like naloxone, fentanyl test strips, and sterile needles to protect people from infections and overdose. Staff are trained to take a non-stigmatizing, person-centered approach. Harm reduction happens in community locations and includes street outreach, home delivered services, vending machines, and walk-in sites.

Overdose Prevention and Safety Measures

In Rhode Island, more than 4 out of 5 fatal overdose deaths in 2024 occurred in private locations, like at home. It is important to always use with someone nearby who has naloxone in case you overdose. If you use drugs, have someone you trust check on you so they can help in the event of an overdose. If you are using in a group, be sure to stagger your use so someone is always alert and ready to call 911 and administer naloxone.

If you are alone, SafeSpot is a free, 24/7 hotline where you will be connected to an operator who can stay on the phone while you use drugs. They can activate an emergency safety plan that you can decide when you talk with the operator. You can call the SafeSpot hotline toll free at 800-972-0590.

How to Respond to an Overdose

If you think someone is overdosing, you need to act fast. Always call 911 first and administer naloxone every two minutes if you have it. Naloxone is safe to use and only works if a person has opioids in their body. 911 will instruct you on how to support their breathing. If they are still sedated but breathing is restored, place them in the recovery position. This will help them breathe while you wait for first responders to arrive.

The Good Samaritan Law provides certain legal protection when you call 911 when someone is overdosing, whether you have drugs on you or not.

The Risks of Polysubstance Use

Whether it is on purpose or not, mixing drugs (also known as polysubstance use) is never safe. When you combine drugs, the effects can be stronger, unpredictable, and can even be deadly. Try to avoid mixing depressants or downers, like benzodiazepines (known as benzos), opioids, and alcohol. In Rhode Island, an opioid called fentanyl and a sedative called xylazine are being mixed with other drugs. The dangers of mixed drug use can happen with any drug, including prescription drugs.

Available Harm Reduction Supplies

• Naloxone: A medicine that can reverse an overdose.
• Fentanyl Test Strips: Used to see if your drugs have been mixed with fentanyl.
• Sterile Supplies: Including needles, cookers, and cottons to protect against infections.
• Harm Reduction Vending Machines: Provide free supplies 24 hours a day, seven days a week.