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Opioids and Overdose Prevention

Learn signs of overdose, how naloxone works, how to get help, find recommended publications, access data sources, and get additional resources.
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Help us spread the word about overdose prevention

Together with Clackamas County, we have created a toolkit of social media graphics and messages in multiple languages. Please consider downloading and sharing them on your own platforms. Get the toolkit. We also have a website with resources and easy to understand information in English (with translation widget) and Spanish.

Get help

If you or someone you care about is struggling with drug or alcohol use, there is help available through the Washington County Crisis Line at 503-291-9111. The line is answered 24 hours a day, seven days a week. The Hawthorn Walk-in Center is a confidential and free resource in Washington County. For other substance use treatment, Medication for Opioid Use Disorder (MOUD), and peer support, please see this page or OHA's Substance Use Disorder Services Directory.

If your child is struggling with drug or alcohol use, they can contact the Oregon YouthLine (text or call) at 1-877-968-8491 or text 'teen2teen' at 839863.

Washington County’s harm reduction program aims to protect the community and promote public safety by reducing potential harms from injection drug use such as the spread of infections like HIV and hepatitis C, syringe litter in communities, and overdose deaths. Visit the harm reduction program page to learn about local syringe exchange locations and services.

Overdose is a medical emergency!

If you or someone you know is using drugs, there is a risk for overdose. Assume anything not given by a pharmacy or your medical provider is fake and could contain a fatal dose of fentanyl or another potentially fatal drug. Know the signs of overdose, don't use alone, and use the overdose reversal drug naloxone.

Opioids and fentanyl can cause breathing to slow or stop. This decreases the amount of oxygen that reaches the brain. If not treated immediately, an overdose can result in organ failure and death. Overdoses can occur within a few minutes to over a couple hours.

Signs of an overdose:

  • Difficult or unable to wake up
  • Slow or no breathing
  • Bluish or pale lips and fingernails
  • Pale or clammy skin
  • Abnormal snoring or breathing sounds
  • Vomiting or foaming at the mouth

If someone is unconscious or has any of these signs, call 9-1-1 immediately.

Provider health alert, April 26, 2021

Reduce overdose risk

What you can do to reduce overdose risk if you or someone you know uses drugs:

  • Carry naloxone (name brand "Narcan"). Naloxone is a safe medicine that reverses the effects of opioids and can prevent death when someone overdoses. Oregon’s Good Samaritan Law protects from prosecution the person who administers naloxone and the person who is overdosing. Naloxone is available at local pharmacies. It is available over-the-counter OR with a doctor or pharmacist prescription. You can get discount coupons at If you are on the Oregon Health Plan, it is free to you. You may also be able to have naloxone mailed to you. Visit NEXT Distro's website for more information.
Watch this video for how to use nasal naloxone. Washington County has no affiliation with and is not endorsing the maker of this video.
  • Don’t use drugs when you are alone. Have someone with you so they can help if you overdose and lose consciousness.
  • Don’t trust your drug tolerance. Drug content and potency is not predictable, even within the same batch. Even people who have a high tolerance for opioids face an increased risk of death because of the inconsistency in the drug supply. Always go slow and do a test amount.
  • Avoid mixing drugs. This increases the overdose risk. Opioids, alcohol and benzodiazepines (e.g., Xanax, Valium) slow your breathing. Read more on CDC's website.

What are opioids?

Opioids are a group of medications prescribed for pain. They are highly addictive. Some examples of opioids are Oxycontin, Vicodin and Percocet. Prescription pain medicine can help treat severe and sudden pain, such as pain from a car accident or surgery. Opioids can also lead to addiction and death from accidental overdose. Heroin and fentanyl are opioids that are sold on the street and can be bought in pill or powder form.

Talk to your doctor about the risks of using opioids. Ask if there are other options to manage your pain. See this pain education toolkit for more information.  

It is not safe to use someone else's medication or to use prescriptions in any way other than how your doctor instructed.

What is fentanyl?

Two milligrams of fentanyl shown next to a penny

Pharmaceutical fentanyl is a powerful synthetic opioid prescribed for severe pain and anesthesia, but fentanyl is also illegally manufactured and distributed in the community. Fentanyl is tasteless and odorless. A tiny amount can kill. It can be sold in many colors and forms including pills, powder and chalk-like blocks.

Cheap, counterfeit substances containing fentanyl are thought to be fueling an increase in fatal drug overdoses across the Portland Metro region. It is very difficult to tell if they are counterfeit. Fentanyl is often mixed into fake pills made to look like prescription Oxycontin and Xanax that come from a pharmacy. Counterfeit pills are especially dangerous because people are often unaware that fentanyl is in them. People who buy these from the internet, social media, friends or dealers may unknowingly be getting fentanyl.  

Get the facts about fentanyl on the CDC's website.

Get rid of unneeded prescriptions

Getting rid of unused prescriptions can help prevent substance misuse and accidental poisoning. When medicine is in your house, keep it in a secure place. Get rid of old, extra or unused substances by taking them to a local drop-off site. Never flush drugs down the toilet or put them in the garbage.

Secondhand fentanyl exposure

There are no known local cases of a bystander or responder suffering serious health effects from breathing in secondhand meth or fentanyl smoke. There is very little risk to bystanders, people responding to overdose, or others who may be in an area where people are using drugs. Small amounts of fentanyl can be deadly when used directly as a drug, but breathing in secondhand fentanyl smoke or touching small amounts of fentanyl will not cause serious side effects. You cannot overdose from fentanyl by briefly touching it. Secondhand fentanyl smoke cannot get you high or cause an overdose. It is safe to help others who may have used fentanyl and are in distress.


What is xylazine?

Xylazine or “tranq” is an animal tranquilizer used by veterinarians that is sometimes added to recreational drugs, such as opioids or methamphetamine. It is not approved for use in humans. It cannot be easily identified by appearance alone. Xylazine has been found in our region, but it is not widespread at this time. However, you should be aware of the presence of xylazine in the community and the associated risks. In addition to causing deeper sedation, xylazine has also been associated with severe skin wounds. These wounds are often at the site of injection, but can be seen far from the site of drug use and may even happen in people who have smoked xylazine. Learn more about xylazine on CDC's website.

Provider health alert, April 19, 2023

Publications and FAQs

Fact sheets

Overdose Prevention FAQ (PDF 154.1 KB)


Data sources

Tri-County Overdose Data Brief
Spring 2024

Charts and graphs with data related to overdoses

Tri-County Overdose Data Brief
Fall 2023

Tri-County Overdose Data Brief - Fall 2023

Tri-County Overdose Data Brief
Spring 2023

Tri-County Overdose Data Brief - Spring 2023

Strategic Plans

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