​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Using any drug can be risky. ​This is true of drugs that are sold over the counter, like aspirin, prescription drugs like antibiotics, or unregulated drugs like heroin or methamphetamine.

People who drive cars can reduce their risk of injury by wearing seatbelts. People who spend time outdoors can reduce their risk of injury by wearing sunscreen. People who use ​aspirin or antibiotics can reduce the risk of side effects by taking these medications with food.

The risk reduction ​strategies below are similar and shared with the goal of keeping people safe and reducing the risk of ​overdose​ for all ​Kentuckians.

Risk Reduction S​trategies For:​

  • ​Carry naloxone, the drug used to reverse opioid ​overdose.
  • Never use unregulated opioids alone.
    • If you’re using opioids, try to have someone there with you
      • who’s not using the same thing at the same time,
      • who has naloxone, knows how to use it, and can administer it if needed.
  • Keep in mind that unregulated drugs can vary in potency.
    • Counterfeit pills and products sold as heroin ​often contain fentanyl in inconsistent quantities. It can be very difficult to know what you’re getting and ​how strong it is.

    • Comparison of authentic vs counterfeit oxycodone pills Authentic vs counterfeit oxycodone​

      Comparison of authentic vs counterfeit xanax pills Authentic vs counterfeit Xanax​​​​​​​​​​

  • ​Start with the lowest dose. Go slowly.
  • Try to wait between using different types of drugs.
    • Using opioids with any of the following can increase ​the risk for overdose:
      • alcohol
      • sleeping pills
      • gabapentin (Neurontin)
      • benzodiazepines (Xanax, Valium, Klonopin)
      • any other opioid (link)
      • cocaine
      • methamphetamine
  • If using again after taking a break, use smaller amounts with extra caution.
    • If you have recently gone through opioid withdrawal, your tolerance for opioids is decreased. You can overdose very easily.
    • If you have recently been in treatment, recovery or have been recently incarcerated, you are especially at risk.

  • Carry naloxone, the drug used to reverse opioid ​overdose.
    • Tell someone where it is and how to use it.
  • If you’re using unregulated drugs, you may be using fentanyl.
    • Fentanyl may be added to counterfeit pills that look like Xanax, Percocet, or generic oxycodone with the stamp M-30

      Comparison of authentic vs counterfeit oxycodone pills Authentic vs counterfeit oxycodone​

      Comparison of authentic vs counterfeit xanax pills Authentic vs counterfeit Xanax​​​​​​​​​​

    • Fentanyl is sometimes found in other unregulated drugs such as cocaine or methamphetamine.
    • Overdose can occur by any route: swallowing, smoking, snorting, or injecting.
    • Use fentanyl test strips​​.
  • Your risk for overdose is extremely high if you use opioids accidentally.
    • If you don’t use opioids regularly, even small amounts can cause an overdose.
    • If you become unresponsive, it may not be obvious that an ​opioid overdose is occurring. This could delay administration of naloxone.

  • ​Carry naloxone, the drug used to reverse opioid overdose.
    • Rapid naloxone administration is key to reversing overdose.
      • If someone who received naloxone is breathing slowly, shallowly, or not at all rescue breathing is essential.
  • Fentanyl can be deadly to people who use drugs.
    • Although fentanyl is an extremely potent opioid, it must directly enter the body to cause an overdose.
      • ​Overdose occurs when people swallow, smoke, snort, or ​inject fentanyl.
  • Fentanyl is extremely unlikely to harm people who do not use drugs.
    • Powdered fentanyl does not remain suspended in the air and does not easily absorb through the skin.
    • The American College of Medical Toxicology (ACMT) and American Academy of Clinical Toxicology (AACT) state that "the risk of clinically significant exposure to emergency responders is extremely low."
      • Their recommendations for first responders are sufficient to protect you when ​responding to an overdose.
      • A CPR barrier mask is sufficient to prevent ​exposure when providing rescue breathing.

Download Risk Reduction Strategies, English  [PDF, 433KB]

​Download Risk Reduction Strategies, Spanish [PDF, 475KB]​​​

Download Fentanyl and Xylazine Test Strips Guide, English [PDF, 853KB]

Download Fentanyl and Xylazine Test Strips Guide, Spanish [PDF, KB]​​

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