Reversing a Fentanyl Overdose | 60 minutes

This week, Bill Whitaker reported on 60 Minutes about fentanyl, the deadly synthetic opioid that has sparked the worst drug crisis the United States has ever seen.

Last year, more than 70,000 Americans died from a fentanyl overdose, according to the U.S. Centers for Disease Control and Prevention. That's more deaths than the U.S. military losses in the wars in Vietnam, Iraq and Afghanistan combined.

Drug cartels in Mexico have flooded the U.S. with fentanyl, often hiding it in counterfeit drugs designed to look like real prescription drugs, including OxyContin, Percocet, Xanax and Adderall. And fentanyl also shows up as an additive in street drugs like cocaine, heroin and methamphetamine.

This has led to an increased risk of accidental overdose, which is when someone inadvertently takes fentanyl without knowing it is there.

Parents Mike O'Kelley and Angela King know this only too well. Last year they lost their 20-year-old son Jack O'Kelley to an accidental fentanyl overdose.

“You hear about it, but you think, 'Oh, that only affects people on the streets, homeless people, drug addicts.' No. It's so insidious,” King said in an interview with Whitaker.

After their son's death, they found text messages between Jack and a drug dealer. Jack had supposedly bought Xanax, oxycodone and a gram of cocaine. But the death certificate states that fentanyl was the cause of death.

“He made a really bad decision,” King said. “Not one that should have taken his life.”

Fentanyl has devastated the community of San Diego, California. The legal border crossing at nearby San Ysidro has been used by Mexican drug cartels to smuggle fentanyl into the United States.

Whitaker and a team from 60 Minutes met with Dr. Steven Campman, the San Diego County Coroner, to better understand the impact of fentanyl on the city over the past decade.

“For years, there were five, 10, maybe up to 20 fentanyl deaths a year,” Dr. Campman said in an interview with Whitaker.

“But then, around 2016, the number of deaths started to rise, from just 20 to 30, then 80 and 150. And then within a few years it rose to 800.”

Dr. Campman told 60 Minutes that on any given day, including the day the 60 Minutes team was there, one in five bodies in the morgue was a person who had died of a fentanyl overdose.

Signs of a fentanyl overdose

60 Minutes asked Dr. Campman what a fentanyl overdose looks like and what happens to the body when an overdose occurs.

“Because it has a depressant effect on the central nervous system, it causes people to become drowsy… lose consciousness. Their breathing slows down and their heart rate slows down,” he explained.

Dr Campman said the typical death from fentanyl is “a sleepy, slow death” and the victim may fall into a coma for “short periods of time” up to a few hours.

Other signs of a fentanyl overdose include the inability to wake the person, according to the CDC; constricted, pinpoint pupils that do not respond to light; shallow breathing or difficulty breathing, such as gagging sounds, gurgling, or snoring in a person who cannot be awakened; and discolored skin, especially around the nails or lips.

Dr. Campman added that a rare subgroup of fentanyl overdose victims die more quickly due to “wooden chest syndrome,” in which they suddenly stop breathing.

“This leads to faster respiratory paralysis. So people die quickly. In any case, people lose consciousness pretty quickly.”

However, Dr. Campman also pointed out that a person who has overdosed on fentanyl can appear deceptively “healthy” even long after death.

Reversing a fentanyl overdose

Dr. Campman attributes the recent decline in fentanyl overdose deaths in San Diego County to the increased availability and accessibility of naloxone.

Narcan is a nasal spray that delivers the life-saving medication naloxone. When administered in a timely manner, naloxone can reverse an overdose of fentanyl or other opioids that would otherwise be fatal and save someone's life.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), if someone is showing signs of an opioid overdose, you should immediately give naloxone and then call 911.

To administer naloxone with Narcan, insert the spray nozzle into one nostril, spray the contents of the disposable device, and wait two to three minutes to observe the person to see if they begin to breathe normally or respond.

If the person continues to be unresponsive or normal breathing is not restored, he or she may need another or even multiple doses of Narcan.

Multiple doses are particularly common when the person has taken fentanyl intentionally or unintentionally.

A complicating factor in all of this, according to Dr. Campman, is that a pack of Narcan contains only two doses, and in some cases of fentanyl, many more are required.

“Even if someone was there and could get them a dose or two of Narcan, if they had a box … in many cases, people need four, six, eight or 10 doses of naloxone to reverse the effects,” he told Whitaker.

Dr. Campman said several bodies brought to his examining room were found with naloxone in the hand or near the scene of death.

“We see them dead with the … naloxone near their hand or even in their hand, and think they can save themselves. But they die too quickly. They lose consciousness too quickly.”

The CDC recommends that people who use opioids and are at increased risk of overdose should carry naloxone with them, keep it at home, and let others know they have it. “Because you cannot administer naloxone to yourself, let others know you have it in case you experience an opioid overdose.”

A warning for parents

Mike O' Kelley and Angela King, Jack O'Kelley's parents, told Whitaker their experience was a crash course in the dangers of fentanyl. They advise other parents to educate themselves.

“It's in every street drug right now, in small amounts. Unless it's prescribed by a doctor, you can't take it. It's like Russian roulette.”

If you or a loved one is struggling with opioid use, or you are looking for additional information and resources, such as free Narcan in some states, visit the CDC Stop Overdose website.

The above video was produced by Will Croxton. It was edited by Sarah Shafer Preacher.