What is the “fentanyl fold”? How to treat opioid overdoses

It has become one of the most startling signs of California’s fentanyl crisis: seemingly zombified drug users slumped in uncomfortable positions.

Alternately called “the fentanyl fold” or “the fentanyl bend over”, videos and photos of people Rumors that the drug was being used spread on social media.

What is the ‘fentanyl fold‘?

If you’ve ever seen people who appear drunk, hunched over, or frozen in place on sidewalks or in parks, you may be seeing someone in the throes of opioid use.

But why do people look hunched over or move like zombies?

“It’s some degree of loss of consciousness and some degree of loss of muscle control,” Dr. Daniel Ciccarone, professor of addiction medicine at UCSF, told ABC7 San Francisco.

According to Ciccarone, the “fentanyl fold” effect can occur within two to three minutes of taking the drug.

And how long will this uncomfortable body position last?

“Fentanyl can be a short-acting medication or a long-acting medication. Some people are back on their feet in 45 minutes or an hour. For others, it can take longer,” Ciccarone said.

Fentanyl abuse isn’t the only opioid that can cause this uncomfortable bodily reaction, Ciccarone said. Any opioid can have the same effect on users.

How many people died from fentanyl poisoning in California and the United States?

According to the California Department of Health, fentanyl-related deaths began to increase around 2019. In the most recent comprehensive study from 2022, the CDPH estimated the number of opioid-related overdose deaths in California at nearly 6,000.

Nationally, figures from the Centers for Disease Control and Prevention show that 84,181 opioid overdose deaths occurred in 2022, compared to 81,083 in 2023.

What are the signs of a fentanyl overdose?

The CDPH advises people who suspect a friend or family member of opioid abuse to look for:

• Fall asleep or lose consciousness
• Does not respond to stimuli such as screaming, pinching or rubbing of the breastbone
• Slow, weak or no breathing
• Choking or gurgling noises
• Soft body
• Cold and/or clammy skin
• Skin discoloration (especially lips and nails)
• ​​​​Small, pinpoint-shaped pupils

The CDPH and doctors advise people who use opioids or who suspect their family or friends are abusing opioids to carry naloxone, a nasal spray medication that can reverse an opioid overdose.

Naloxone is safe and easy to use and works almost immediately, according to the CDPH. It is available over the counter, without a prescription, at pharmacies and other stores.