Fentanyl is in the drug supply, all of it, and construction workers die of overdose at some of the highest rates of any industry. This is the whole response in six steps. Read it now, while nothing is wrong, so it's in your head when something is.
Shout their name. Rub your knuckles hard on their breastbone.
No response, or slow and strange breathing, means you move to step two immediately.
Give the exact location, say "someone is unresponsive and not breathing right," and put the phone on speaker so your hands are free.
On a jobsite: send one person to meet EMS at the gate. Big sites eat response time.
Washington's Good Samaritan overdose law (RCW 69.50.315) protects both the person who calls for help and the person overdosing from drug possession charges. Fear of the cops is the number one reason people don't call, and the law exists to remove that reason.
Peel the package, insert the nozzle in one nostril, press the plunger all the way. That's the whole procedure.
It only works on opioids, and it does nothing to someone who hasn't taken any, which is why you never need to be sure before using it.
If they're not breathing and you're trained: tilt the head back, lift the chin, one rescue breath every five seconds. No pulse and you're trained in CPR: start compressions.
Not trained? The 911 dispatcher will walk you through it. Stay on the line.
New device, other nostril. Fentanyl often takes more than one dose.
If they start breathing, roll them onto their side, top knee bent, so they can't choke. Keep watching them.
Naloxone wears off in 30 to 90 minutes and the overdose can come back. This is why they go with EMS even if they wake up angry about it. And they might; waking up in instant withdrawal is rough. That's the medicine working, not a reason to skip it.
We run overdose response as a short toolbox talk with a real facilitator guide, delivered in a lived-experience voice crews actually listen to. Fifteen minutes at the gang box covers everything on this page, and it's the training people remember at the worst possible moment, which is the only moment that counts. Bring it to your site.
This guide covers suspected opioid overdose response consistent with public health guidance. It is not medical training or medical advice. Get hands-on naloxone and CPR training where you can; it takes under an hour and it sticks.
Maybe you're learning this for someone else, and some part of it is about you too. That wondering is worth paying attention to, and it doesn't have to mean anything about anything. Curiosity is not a confession. I've been on both sides of it, and the math got easier once I stopped doing it alone. If you ever want to talk to someone who won't flinch, my door is open. No judgment, no agenda, no follow-up unless you want one.