Attention Synthetic opioids, including fentanyl, are added to many substances found outside a licensed pharmacy in the U.S. This is often without the knowledge of the buyer/consumer. Substances where fentanyl is being incorporated as an additive include cocaine, counterfeit prescription pills, MDMA, meth and heroin. When obtaining pills or other substances outside of a licensed pharmacy, you cannot be sure exactly what you are getting, even if the substances you receive look like legitimate medicines or come from a friend/someone you trust. Sometimes, these substances contain fentanyl in lethal doses. You can only overdose on fentanyl by ingesting it, not by just touching it. On this page, we approach drug use from a harm reduction standpoint. Harm reduction is “a set of practical strategies and ideas aimed at reducing the negative consequences associated with drug use” and “is also a movement for social justice built on respect for the rights of people who use drugs” (Principles of Harm Reduction). On this page, “drugs” refers to substances other than alcohol, cannabis, and caffeine (covered elsewhere), such as cocaine, MDMA, opioids, psychedelics, etc., or improper use of prescription medications (i.e., using without a prescription, more than is prescribed, a different way than prescribed, or obtained outside of a licensed pharmacy.) Learn more about: Safer drug use Signs of overdose/Need for medical attention Responding to suspected overdose Risks of interactions How risky is my drug use? Concern for a friend Knowing laws and policies On/Off-Campus Resources Safer Drug Use People should be aware of the potential downsides when deciding to use drugs as well as how to reduce those risks as much as possible. Risks include doing things you wouldn’t normally do, injury, driving under the influence, addiction, negative impacts on mental health, negative impacts on physical health, memory loss, and increased risk of suicide. Visit NIDA’s website to learn about risks from specific substances. If you are thinking about using any substance, consider the following strategies to reduce the risks of drug use: Start with a low dose and take it slow. It can take longer than you expect to feel the effects. Do not drive or operate any machinery. Use one drug at a time. Avoid mixing drugs and alcohol. Use fentanyl test strips. Follow all instructions carefully. These test strips reduce the risk that fentanyl is in your drugs but may not always eliminate it. Have naloxone on hand in case of opioid (including fentanyl) overdose. Be in a safe environment with people you trust. Have a sober person with you who knows what you’ve taken and can respond in an emergency. Decide how much you plan to use and stick to it. Avoid sharing paraphernalia (e.g., bongs, pipes, spoons, needles) which can transmit viruses and/or bacteria. Know the signs of overdose. Have a friend there to talk with if you feel anxious, depressed or other negative emotions. Have condoms or other barriers with you in case you decide to participate in any sexual activity. Be aware that consent cannot be given if incapacitated by drugs and/or alcohol (e.g., lacking cognitive ability to make or act on conscious decisions). It’s best to eat and drink water before using some substances. See more tips for specific substances. Signs of Overdose/Need for Medical Attention Mixing drugs is the most common cause of overdose but it can also be caused by taking larger amounts of a drug after taking a break/reducing tolerance. It can be difficult to tell if someone has overdosed on something. It is best to call 911 for medical attention when in doubt. Read more on University's policy related to seeking medical attention. Call 911 when one or more of these symptoms is present especially when an overdose is suspected: Loss of consciousness Unresponsive to outside stimulus Awake, but unable to talk Breathing is very slow and shallow, erratic, or has stopped Choking sounds, or a snore-like gurgling noise (gasps or gagging) Vomiting Body is very limp Skin is clammy Discoloration of lips or face (blue, pale or gray) Pulse (heartbeat) is slow, erratic, or not there at all If someone is making unfamiliar sounds while “sleeping” it is worth trying to wake them up. If you cannot wake them up, call 911. While waiting for emergency services, place the person in the First-Aid recovery position. Responding to Suspected Overdose Naloxone (Narcan® is the brand name), a medicine that rapidly reverses an opioid overdose. Naloxone has no effects on someone who does not have opioids in their system. It should be given when an overdose is suspected. If you administer naloxone to someone you suspect has overdosed, call 911 for continued emergency medical attention. Access to Naloxone Naloxone is available on campus via the Department of Public Safety in an emergency. Students may make an in-person or telehealth appointment with a Medical Services provider at University Health Services (by calling 609-258-3141 or selecting a "Primary and preventive care" appointment on the MyUHS online portal) to get a prescription for Naloxone. While only the person for whom the prescription is written can fill the prescription at a pharmacy, the naloxone may be administered to anyone in need of it. Education on administration of naloxone will be provided during the appointment. Free Opioid Harm Reduction kits (containing fentanyl test strips and naloxone) are available in McCosh Health Center's vestibule, which is accessible 24/7. In New Jersey, anyone over the age of 14 can acquire free naloxone anonymously at participating pharmacies, including at Wegmans of Princeton. The New Jersey Harm Reduction Coalition fulfills requests for naloxone in the state of New Jersey. New Jersey Department of Human Services offers instructions and training on emergency responder administration of naloxone. The Opioid Overdose Prevention Network (OOPN) offers free public (virtual) trainings six times per month in New Jersey. Training attendees who are 18 years of age and older will also receive a free naloxone kit (containing nasal spray) after attending the training. Risks of Interactions It’s safer to use only one drug at a time, including any prescription medications, alcohol, cannabis, nicotine, and caffeine. For information about interactions, visit these websites: Illicit drugs and alcohol interactions Polysubstance use Drug combinations How Risky is my Drug Use? If you are wondering how risky your drug use is, you can take one of these online, anonymous screenings: Screening for risky use of prescription drugs Concerning alcohol and other drug use test Concern for a friend Similar to with alcohol use, review some of these signs of concern. These tips for how to approach a friend may also be helpful. Knowing Laws and Policies The possession, use, sale or manufacture of substances legally classified as “controlled dangerous substances” by the State of New Jersey or by Federal law in the United States may result in law enforcement involvement, arrest, criminal penalties, and/or University disciplinary action. University policy prohibits the possession, use, sale or manufacture of controlled substances, without a prescription, in any amount on or in the vicinity of University property or while in the conduct of University business or University-sponsored activities away from the campus. You are obligated to seek help when someone needs medical attention due to drug use, according to University policy and in accordance with New Jersey’s Overdose Prevention Act (N.J.S.A. 24:6J-1 et seq.), also referred to as the Good Samaritan Law. These laws and policies offer some leniency with respect to violations which may come to light as a result of such calls, depending on the circumstances involved. On- and Off-Campus Resources On-Campus Recovery@ Recovery@ is a resource for students who are either in recovery from drugs and alcohol or who are in trouble from drugs and alcohol. It is an organic group started by students and two administrators who were and are in recovery. They gather once a month for dinner to discuss the particular challenges of recovery at Princeton University. All discussions are confidential. To obtain more information email a confidential email, [email protected]. CPS' AOD Treatment Team Off-Campus Corner House Narcotics Anonymous Nar-Anon