Jackson County Public Health is issuing an overdose alert for accidental overdoses related to illicit opioids, specifically fentanyl. This alert is being issued based on a sudden spike in emergency department admissions, EMS and law enforcement responses, and fatalities related to fentanyl during the week of April 2, 2023.
Illicitly manufactured fentanyl started to become more common in our community in 2018. In early 2021 illicitly manufactured fentanyl became the predominant illicit opioid sold and used in Jackson County. There has been an increase in illicitly manufactured fentanyl sold as counterfeit pills such as oxycontin or in a powder form, which can look like other drugs, such as cocaine and methamphetamine. Fentanyl can also be mixed with other illicit opioids, such as heroin.
Since February 2021, Jackson County has seen more overdoses related to fentanyl than in previous years. Emergency response personnel in Jackson County have continued to respond to overdoses related to fentanyl use at a record level.
The Medford Area Drug and Gang Enforcement Team (MADGE) reported that xylazine was present in a recent seizure of fentanyl. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), xylazine is increasingly being found in the illicit drug supply, often in combination with opioids like fentanyl. Xylazine is known as “tranq” or “tranq dope” in the illicit drug market. Xylazine can cause drowsiness, lethargy, and in rare instances, apnea, and death.
While xylazine is not an opioid, it is dangerous because it can depress breathing, blood pressure, heart rate, and body temperature to critical levels. Additionally, people who inject drugs containing xylazine can develop severe skin wounds and patches of dead and rotting tissue that easily become infected and, if left untreated, may lead to amputation. These wounds can develop in areas of the body away from the injection site and may become life-threatening. Xylazine is especially risky because it is not detected in routine toxicology tests, so people who use drugs may be exposed without knowing.
Officials are encouraging the medical community, other community partners, parents, family and friends, and people with an active substance use disorder to be aware of the increased overdoses and harms associated with opioids.
Using illicit opioids, such as heroin and fentanyl, increases the risk of overdosing. There is no safe way to use illicit opioids, but precautions can be taken that may help reduce the risks associated with illicit opioids. The street drug supply has always been unpredictable and inconsistent. Assume there is a risk of overdosing no matter what drug is used.
- Abstaining from drug use is the best way to eliminate the risk of overdosing. Ask the person about their willingness to begin medication-assisted treatment or drug treatment. A list of resources can be found on the Oregon Recovers website https://oregonrecovers.org/resources/. Call the SAMHSA’s National Helpline at 1-800- 662-HELP (4357). This is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
- It is critical to call 911 when someone is overdosing. If naloxone is used, the effects are temporary, and the person still needs medical attention. After the medication wears off, the person could fall back into a coma. Good Samaritan Law protects someone from being arrested or prosecuted for drug-related charges or parole/probation violations based on information provided to emergency responders. If someone overdoses on fentanyl, it may take more naloxone to reverse the overdose. It can take about 2-3 minutes for the naloxone to take effect. Naloxone doesn’t work on xylazine, but it will help if the opioid/fentanyl is making it hard for them to breathe.
- People who haven’t used opioids in a while are at an increased risk of overdosing. It is important to be aware of your tolerance and always use less.
- Have an overdose plan, make sure someone can get to you, and it is safest when you are with someone you trust. Use the 24/7 Never Use Alone Hotline: 1-800-484-3731 if you cannot have a safe person with you. • Always assume there is a risk of overdosing no matter what method someone uses for illicit opioids.
- BE PREPARED. GET NALOXONE. SAVE A LIFE. Even if you do have a substance use disorder but know someone who does, you will want to carry naloxone in case someone needs help. Oregon law allows people to carry and use naloxone on others. You can get naloxone through these avenues:
- Any pharmacist in Oregon can prescribe naloxone to you. You do not need a prescription in Oregon to access naloxone through a pharmacy.
- Anyone who can prescribe medication can send a prescription for naloxone to your pharmacy.
- People who utilize the Jackson County Syringe Exchange Program can receive free naloxone.
- Free naloxone is available through Max’s Mission and HIV Alliance.

Source: Jackson County Health