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Editor's note: This is the second of a series of articles examining the fentanyl crisis that will appear in The Messenger this week.
For patients in terrible pain, properly administered fentanyl is a blessing.
But for those who take too much of it, or unwittingly consume it with illicit drugs, fentanyl can be a death sentence.
Their hope for survival rests in quick administration of an antidote commonly called Narcan.
Like fentanyl, Narcan, properly known as naloxone, has been around for a long time. It has become more of a household word in the last few years as the number of deaths across the nation caused by fentanyl or other opioids has increased. In response, the federal and state governments have tried to make Narcan more easily available. The Food and Drug Administration approved it for over the counter sales in April
It is available at local pharmacies and via a state program that will mail doses to those who request it..
The Fort Dodge police and fire departments are equipped with Narcan.
"The use of Narcan has increased," said Terry Evans, the emergency medical service supervisor for the Fire Department."I don't think we use it as prolifically as some other agencies, but it has increased."
Fentanyl is a synthetically made pain killer that is 100 times more powerful than morphine. In the clinical setting it is used to treat surgery patients and terminally ill patients. It blocks pain receptors in the brain, according to Lance Fischer, chief pharmacist at UnityPoint Health -- Trinity Regional Medical Center.
Narcan, he said, replaces fentanyl in the brain's pain receptors.
"It doesn't allow opiates or narcotics to bind to the cells of the body," Evans added.
Narcan is administered to someone suffering from an overdose or fentanyl poisoning by squirting it up their nose. Evans said Narcan is packaged in a kind of small spray bottle called an atomizer which turns the liquid medicine into a mist as it is squirted into the nose of a patient.
He said it is common to have to administer multiple doses to a patient.
The symptoms that tell paramedics that Narcan is needed include very low blood pressure, weak respiration and pupils in the eyes that are reduced to the size of pinpoints. Drug paraphernalia around the patient is also another sign Narcan is needed, according to Evans.
Although Narcan is being made more readily available for use by the general public, Evans said people should still call 911 after giving someone a dose because they will usually need additional care, he said.
Pharmacies across the state that have completed the necessary staff training can dispense Narcan under a standing order issued by the medical director of the state Department of Health and Human Services.
According to that department, these pharmacies in Fort Dodge are authorized to dispense Narcan:
• CVS, 2029 Fifth Ave. S.
• Daniel Pharmacy, 1114 Central Ave.
• Hy-Vee, 115 S. 29th St.
• Trinity Pharmacy, 802 Kenyon Road
• Walmart, 3036 First Ave. S.
The state also offers a Tele-Naloxone program, in which residents can ask to have Narcan mailed to them. The Tele-Naloxone number is 319-678-7825.