Opioid Use and Resources

In This Section

• How to lower the risk of opioid overdose
• Fentanyl
• Xylazine
• Drug Test Strips for Xylazine and Fentanyl
• Naloxone (Narcan®)
• Local services and support

 
How to lower the risk of opioid overdose

• Never use alone. Use with others and take turns.
• Before using drugs, ask someone you trust to check on you regularly.
• If you are alone call the Never Use Alone hotline. Dial 1-800-484-3731. An operator will stay with you while you use, and call emergency services if needed.
• Test your drugs. Use test strips to test your drugs for Xylazine and Fentanyl. Drugs with one of these cut in can kill you.
• Always carry naloxone (Narcan®) with you.
• Go slow by taking small amounts, especially if you haven’t used for a while.
• Wait before taking more. Wait long enough to feel the effects of the drugs you took before taking more.
• Avoid mixing with alcohol or other drugs, especially drugs that make you sleepy.
• There is no safe dose of opioids.

Fentanyl

Fentanyl is a highly addictive synthetic substance that is added into illicit street drugs to increase consumption. It is also highly associated with risk of overdose death. The Tompkins County Health Department has issued a Health Alert warning of the high risk of the presence of Fentanyl locally in street drugs.

Harmful side effects include 

• Sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression.

Signs of overdose include 

• Stupor, changes in pupillary size (pinpoint size pupils), cold and clammy skin, cyanosis (blue discoloration of the skin), coma and respiratory failure leading to death. 

Overdose prevention strategies 

• Never use alone
• Use fentanyl test strips as a precaution
• Carry Narcan and be trained in its use
• Seek treatment and support

 
Xylazine

Xylazine (also called “tranq” or “tranq dope”) is a powerful non-opioid sedative or tranquilizer that is increasingly being found in the US illegal drug supply and linked to overdose deaths. Due to its impact on the opioid crisis, fentanyl mixed (adulterated) with xylazine has been declared an emerging threat by the White House’s Office of National Drug Control Policy. In one study, xylazine was found in almost 80% of drug samples that contained opioids (Maryland, 2021-2022). In another, xylazine was found in 31% of heroin and/or fentanyl overdose deaths (Philadelphia, 2019). [Source: CDC]

Symptoms and health risks of xylazine

• Sedation, difficulty breathing, dangerously low blood pressure, slowed heart rate, wounds that can become infected, severe withdrawal symptoms, death.

Reduce the overdose and the harms of overdose 

• Never use alone.
• Provide rescue breaths, especially for people who have used xylazine since xylazine causes breathing to slow down. Harm reduction experts also suggest rolling individuals on their side, into the recovery position.
• Carry naloxone and learn how to use it. Because xylazine is often mixed with opioids like fentanyl, naloxone should be given in response to a suspected overdose to reverse any possible opioid effects. Importantly, naloxone will not reverse effects of xylazine. In the event of an overdose, call 911 for additional medical treatment.
• Reduce injection-related risks by using sterile injection equipment, rotating injection sites, allowing skin veins time to heal before another use, and taking drugs in other ways besides injection.
• Test drugs before using. There are commercially available test strips to test for the presence of xylazine in a sample of drugs. Test strips are available free of cost at a variety of local programs (see "Local services and support" section below).

 
Test Strips for fentanyl and xylazine

• Fentanyl and Xylazine Test Strips can tell you if your drugs contain the synthetic opioid Fentanyl or the non-opioid sedative Xylazine. Both are frequently found in street drugs. Xylazine is always cut in with fentanyl, so drugs that test positive for xylazine will also contain fentanyl.
• If used correctly, these test strips can help to prevent overdose deaths and, with other risk reduction practices, save your life.
• Fentanyl Test Strips are blue and marked with the letters “FYL”.
• Xylazine Test Strips are red and marked with the letters “XYL”.

 
 PDF version for how to use xylazine and fentanyl test strips. 

Naloxone (Narcan®)

Naloxone (Narcan®) is a medicine that can reverse the effects of an overdose from opioids, including fentanyl, heroin, and opioid-based pain killers. It is a tool that community members can use to prevent an overdose from becoming a death.

 
Carry Naloxone with you

A statewide pharmacy standing order allows anyone* to get naloxone (Narcan®) nasal spray at a pharmacy without a prescription in NYS. Ask for it at the pharmacy counter. Insurance covers up to $40 copay. If you don’t have insurance you can buy naloxone at the pharmacy or you can get it for free at one of the local community agencies listed below. Or dial 2-1-1 for additional assistance.

• TC Whole Health, 201 E. Green St., Ithaca 
• Alcohol & Drug Council, Ithaca
• Cayuga Addiction Recovery Services,
• REACH Medical
• Southern Tier AIDS Program.
• 211 Tompkins/ Cortland.
  • Dial 2-1-1 (or 1-877-211-8667) 24/7.
  • Text your Zip Code to TXT211 (898211). Available M-F 9 AM to 4 PM

*Dispensing to adolescents under age 18 is at the discretion of the pharmacist.

 
Project COPE (NYS OASAS)

Community Overdose Prevention Education: Project COPE website. 
Harm reduction tools and strategies to prevent overdose deaths and save lives in our community.

Local services and support

Emergency

• Call 911 immediately if you or someone you know is having a medical emergency.
• Suicide Prevention and Crisis Service, Crisis Line, 9-8-8, offers free and confidential crisis counseling, available 24/7.

 
Prevention

• Alcohol & Drug Council of Tompkins County is a non-profit agency which provides information, education, counseling and referral services for area residents and organizations. Home page, 607-274-6288
  • Opioid Overdose Prevention Training (Narcan), 607-274-6288. The Council is approved to provide this training and to dispense Naloxone to non-medical persons.  Naloxone is a prescription medicine that reverses an overdose by blocking heroin (or other opioids) in the brain for 30 to 90 minutes.
• Sharps Collection and Disposal Sites in Tompkins County
• Southern Tier AIDS Program (STAP): provides comprehensive HIV/AIDS services in the Southern Tier of NY. They provide the Opioid Overdose Prevention Program, which provides individuals with training, a Naloxone kit, and a prescription to be able to carry and dispense this potentially life-saving medication.
• Mental Health Association in Tompkins County, home page, was established in 1954, to address mental health needs in the Ithaca community.
  • The Jenkins Center for Hope and Recovery is a drop-in center for those who use or have used mental health services. The Jenkins Center provides a safe environment where mental health consumers can relax, have fun with peers, and share information and support.
• The New York State Office of Addiction Services and Supports hosts “Project COPE”, a website which promotes overdose prevention and harm reduction education in New York State. The goal of this initiative is to empower people to learn how to prevent overdoses and save lives in their community.
• Additional resources for prevention services: NYS AIDS Institute Provider Directory

 
Using

• Never Use Alone hotline. Dial 1-800-484-3731. An operator will stay with you while you use, and call emergency services if needed.
• Test strips for Fentanyl and test strips for xylazine are available for free at the Southern Tier AIDS Program, REACH Medical, Cayuga Addiction Recovery Services, and Tompkins County Whole Health's office at 201 E. Green St.
• Narcan, fentanyl testing strips and xylazine testing strips can be ordered free of cost and delivered to your home via NYS OASAS. Complete the order form online at: https://oasas.ny.gov/harm-reduction.
• Community-based support groups are available for individuals to help navigate your personal recovery, as well as for friends and families affected by their loved one’s substance use.

Treatment

• Medication Assisted Treatment (MAT)
• Alcohol and Drug Council offers a variety of counseling services and treatment options, including MAT. They also provide education programs for workploaces and referral services for area residents and organizations. 607-274-6288.
• Cayuga Addiction Recovery Services (CARS) offers intensive residential and out-patient treatment services, including MAT. CARS offers Open Access Monday thru Thursday from 8:30 a.m.–4:00 p.m. Clients need only to bring an insurance card, if they have one. 607-273-5500.
• REACH Medical provides medical and behavioral services, including MAT. The REACH Project is a non-profit operating as a low threshold, harm reduction medical practice in Ithaca. Reach Medical offers a wide range of services including: opioid replacement therapy, medical cannabis certification, Hep C treatment, primary care and behavioral services, in a stigma-free, inclusive setting. 607-273-7000. REACH Project Facebook page.
• NYS Office of Addiction Services & Support (OASAS): Treatment Finder

Recovery

• Ithaca Community Recovery, is a non-profit organization that provides a meeting and activity space for Ithaca’s recovering community. They host a variety of meetings, including Alcoholics Anonymous, Al-Anon Meetings, Narcotics Anonymous, and more. Go to their website for meeting schedules.
• Mental Health Association in Tompkins County was established in 1954 to address mental health needs in the Ithaca community.
  • The Jenkins Center for Hope and Recovery is a drop-in center for those who use or have used mental health services. The Jenkins Center provides a safe environment where mental health consumers can relax, have fun with peers, and share information and support.

Suicide Prevention

• Suicide Prevention and Crisis Service, offers free and confidential crisis counseling. The Crisis Line is available 24/7 at 9-8-8.
• Tompkins County Suicide Prevention Coalition.
• The Sophie Fund, Inc., a nonprofit charitable corporation established in 2017 to support mental health initiatives aiding young people in greater Ithaca and Tompkins County. It supports programs and projects; raises awareness and fights the stigma around mental illness and treatment; advances a “zero suicide” ethos in the community; and serves as a community advocate for young people struggling with mental illness. 

National

• SAMHSA National Helpline FindTreatment.SAMHSA.gov/, 1-800-662-4357 (HELP). The Helpline provides free and confidential information in English and Spanish for individuals and family members facing substance abuse and mental health issues. 24 hours a day, 7 days a week. The website also has a location finder for the nearest treatment services based on the zip code entered.
• SAMHSA Resources for Families Coping with Mental and Substance Use Disorders

 Need help finding help?   Dial 2-1-1 (877-211-8667) for supportive referrals.