CRS Harm Reduction & Overdose Prevention 2 — Questions and Answers
Question 1: A peer gives naloxone to a man who overdosed on fentanyl, and he starts breathing again. What is the main reason someone should stay with him for at least the next few hours?
- Naloxone makes it unsafe for him to be left alone with other medications
- Naloxone often causes a delayed allergic reaction
- Naloxone can wear off before the opioid does, so the overdose can come back (Correct answer)
- He will need a second dose of naloxone no matter what
Correct answer: Naloxone can wear off before the opioid does, so the overdose can come back
Naloxone lasts about 30–90 minutes, and long-acting or strong opioids can outlast it, so breathing can slow down again.
Question 2: Which group of signs most strongly points to an opioid overdose?
- Dilated pupils, fast heart rate, and high body temperature
- Agitation, paranoia, and chest pain
- Flushed skin, sweating, and tremors
- Pinpoint pupils, slow or stopped breathing, and unresponsiveness (Correct answer)
Correct answer: Pinpoint pupils, slow or stopped breathing, and unresponsiveness
The classic opioid overdose triad is pinpoint pupils, respiratory depression, and decreased consciousness.
Question 3: A participant tells a peer specialist he was released from jail yesterday after 90 days without using. What overdose risk should the peer talk about first?
- His tolerance has gone up, so he will need more to feel anything
- His tolerance has dropped, so his old dose could now be fatal (Correct answer)
- Overdose risk only matters if he switches to a new drug
- Jail time protects against overdose for about six months
Correct answer: His tolerance has dropped, so his old dose could now be fatal
Time without use lowers tolerance, which is why overdose risk is very high in the first weeks after release from incarceration or detox.
Question 4: In most U.S. states, what do Good Samaritan overdose laws generally do?
- Allow police to skip responding to overdose calls
- Protect drug sellers from prosecution if someone overdoses
- Give limited legal protection to people who call 911 for an overdose, often against minor possession charges (Correct answer)
- Require bystanders to give naloxone or face charges
Correct answer: Give limited legal protection to people who call 911 for an overdose, often against minor possession charges
These laws encourage people to call for help by protecting the caller and the victim from certain drug-related charges; the details differ by state.
Question 5: Which statement best reflects the harm reduction principle of 'meeting people where they are'?
- Only working with people who live near the program office
- Supporting any positive change a person chooses, even if it is not abstinence (Correct answer)
- Waiting to offer services until the person is ready to stop using completely
- Matching the person's drug use so they feel accepted
Correct answer: Supporting any positive change a person chooses, even if it is not abstinence
Harm reduction accepts a person's current situation and supports any step that cuts down on harm, without making abstinence a condition.
Question 6: A participant who smokes stimulants asks whether she needs naloxone, since she 'doesn't do opioids.' What is the best peer response?
- No—naloxone reverses stimulant overdoses, but she uses too little to need it
- Yes—but only if she also drinks alcohol
- Yes—the stimulant supply is often contaminated with fentanyl, so carrying naloxone is recommended (Correct answer)
- No—naloxone only matters for people who inject heroin
Correct answer: Yes—the stimulant supply is often contaminated with fentanyl, so carrying naloxone is recommended
Fentanyl is often found in cocaine and methamphetamine, so people who use stimulants are at risk of opioid overdose and should carry naloxone.
Question 7: When giving rescue breaths to an adult who is not breathing because of an opioid overdose, about how often should breaths be given?
- One breath every 30 seconds
- Ten quick breaths in a row, then stop
- Two breaths every minute
- One breath every 5 to 6 seconds (Correct answer)
Correct answer: One breath every 5 to 6 seconds
Adult rescue breathing is about one breath every 5–6 seconds (10–12 per minute) to keep oxygen flowing until the person breathes on their own.
