Someone I Love Is Using Fentanyl. What Do I Do?

You probably came here in the middle of the night. Phone in one hand, tears in the other. You typed something into Google that you never thought you would have to type. I am sorry you are here, but you are not alone.

You may be here because your son is using fentanyl. Your daughter. Your partner. Your sibling. Your parent. Maybe they told you. Maybe you found foil, pills, needles, or something else that made your whole body go cold. Maybe they have already overdosed once or worse multiple times. Maybe you are scared the next call will be the one you cannot come back from.

I have lived your pain, multiple times with every relapse. I know your fear, anger and desperation. So let me be the voice that meets you at the kitchen table tonight, with no lecture and no shame.

Fentanyl is dangerous. You are not being dramatic.

But panic does not make you powerful. Shame does not make them safer. And waiting for some magical rock bottom can cost families time they do not have.

With fentanyl, rock bottom is often a grave.

That does not mean you can control whether they use. You cannot. I know that is a brutal sentence to read. But you need truth right now, not slogans. What you can do is build safety around the reality you are living in.

You can get naloxone. You can learn the signs of an overdose. You can stop making every conversation a war. You can offer connection without handing over cash. You can set limits that protect your home without stripping them of every lifeline. And there is a question, the one I built my whole framework around, that you can start asking right now:

If tomorrow brought the worst call, could I live with how I showed up today?

Hope is the thing you cannot rebuild after it is buried

Quick answer

Every parent I have talked to who lost a child to overdose has told me the same thing. They would take the worst day of their loved one's addiction back over losing hope forever. If you are still in the active part of this, you still have hope. You may not feel it. It is there.

I have been the nurse practitioner in the room when fentanyl walked in. I have also been the mother in another hospital, in another year, learning the same thing the families I now sit with are learning. So when I tell you that the fear you are carrying tonight is real, I am saying it from both chairs.

The worst part of addiction from the medical and mom side is when the person you love overdoses. We want to believe that moment will be their "rock bottom" but the disease of addiction is crueler than that.

You see, Logical reasoning does not exist in a brain that has been hijacked by addiction. Your job is not to wait for that brain to figure it out. Your job is to help them stay alive long enough that timing may eventually come together.

The eight pieces of the safety plan

Each of these is its own deep-dive post. Tonight, here is the high-level version.

1. Get naloxone in your house, tonight

Naloxone (brand name Narcan) reverses opioid overdose. Over the counter since March 2023. About 45 dollars retail. Free in most states. Keeping it in your house is not enabling. It is the same as keeping an EpiPen for a peanut allergy. Alive and mad is better than dead and loved.

Full video below with signs of an overdose and how to administer Naloxone.

https://youtu.be/8eUUf5ssH_4?si=JYbAadkQR673heD-

2. Lead with relationship, not rehab

Most people in active addiction already know they are hurting the people they love. Adding shame does not get you closer to them. It pushes them further. The four scripts I teach families: see the conversation post in this series.

3. Help without funding destruction

The question I used to ask was "how do I stop enabling?" I threw that out years ago. The question I use now is "how do I enable life while they are struggling?" Meeting basic human needs such as providing a meal, tent, helping them seek medical care isn't enabling drug use. Some parents and partners will pay for a cell phone (life line) because it allows them to sleep better at night. This is not the same as cash that becomes drugs. Full framework in the enable-life post.

4. Set boundaries that protect without abandoning

A boundary is meant to protect you, not punish or cause harm to the person in active addiction. It is a line you draw to protect your own life and others in the home. The Boundary Builder tool walks you through writing your own.

5. Know what you can (and cannot) do about treatment

In most states you cannot force an adult into treatment. A few states allow involuntary commitment under specific conditions (Florida Marchman Act, Kentucky and Ohio Casey's Law, Massachusetts Section 35). Even where it is allowed, outcomes are mixed. The deep dive on the legal landscape is in the force-rehab post coming soon.

6. Understand medication for opioid use disorder

Medication for opioid use disorder (MOUD), including buprenorphine (Suboxone, sublocade, brixadi) and methadone, is the gold standard for fentanyl/opioid recovery. Learn more about the different medications for opioid use disorder here

7. Stop Waiting for Them to Want help

You may be waiting a long ass time. It could be months or even years. You can't force someone to find sobriety. Instead, what you do is work on your coping, healing, creating appropriate boundaries.

8. Make space for your own part, when you are ready

My relationship with my daughter started to heal when I was able to own my part. Owning your part will look different for everyone. Families are often the product of generational trauma. No parent is perfect, and I do not blame myself for my daughters addiction but I do own the wounds that I may have caused that led to it. The wounds reframe in the OAR Compass framework explain more.

The question that holds it all together

Quick answer

After years of following rules that felt wrong, I narrowed the whole thing down to one question I now ask before every choice: if tomorrow brought the worst call, could I live with how I showed up today? Because at the end of the day we are all just doing what we can live with. That is the spine of this whole series. The route changes day by day. The question is what is steady.

Your peace does not need to match mine. Your boundaries do not need to look like a workbook. Maybe doing what you can live with means Sunday dinner even if they are not sober. Maybe it means saying no to a phone call. Maybe it is the opposite.

Choose connection over control. Boundaries over chaos. Love without abandoning yourself. And on the nights when you do not know what to do, ask the question.

You do not have to figure this out alone tonight.

I built three free tools for this exact moment. The Boundary Builder. The Treatment Navigator. The OAR Compass interactive tool for the harder repair work when you are ready. And my book, Do What You Can Live With, holds the whole framework.

Whatever you do tonight, please do not do nothing. Get naloxone. Send the text. Make the call. Ask the question. You are doing better than you think.

Frequently Asked Questions

What should I do if my loved one is using fentanyl?

Start with safety. Get naloxone in your house which can be found at local health departments for free usually, harm reduction organizations in your area, or even nextdistro website. You can purchase at local pharmacies and that will cost around $45. Then breath. I know you are devastated by the news, there will be time to lose your shit later. Learn the signs of an overdose (There are plenty of videos available online). Save the freakout for later. This is not the time to shame and unload all of your anger on them. Offer help that supports life, like food, medical care, a ride to the ER, and connection.

Should I call 911 if I think they overdosed?

Yes. If they are unconscious, barely breathing, blue or gray, limp, choking, gurgling, or you cannot wake them up, call 911 and give naloxone if available. Stay with them and roll them on their side. Most states have Good Samaritan laws that protect both of you. Just because they wake up after administering naloxone doesn't mean they won't stop breathing again. Thats why calling 911 is crucial.

Is naloxone enabling?

No. Naloxone is an emergency medication that reverses opioid overdose. It has zero effect on someone without opioids in their system, is not addictive, and does not make using safer. Keeping it in your house is preparation, not permission. It is wise to have more than one dose available, because you do not know what they took or how much.

Is Suboxone just trading one drug for another?

No. Buprenorphine (Suboxone) and methadone are first-line treatments for opioid use disorder recommended by SAMHSA, NIDA, and the American Society of Addiction Medicine. People on these medications are about half as likely to die from an overdose.