For the final STIM step for confirming an overdose, why do I need to check if people are breathing at least one full breath every 6 seconds?

Sedatives like xylazine and medetomidine are increasingly common in Philly’s drug supply, especially with opioids. When people take these sedatives by themselves or with other drugs, it can produce symptoms that look very similar to an opioid overdose. For example, medetomidine causes blood vessels in the skin and internal organs to narrow, which can decreased blood flow in the body and make skin appear blue, purple, and/or grey. Additionally, harm reductionists working in Kensington have shared that people who have taken sedatives may be sedated and largely unresponsive for up to 8 hours, but will still be breathing regularly and are not overdosing. Because blue/purple/grey skin and unresponsiveness to stimuli are signs of opioid overdose as well, it’s important to time the person’s breathing to determine if they are actually overdosing and need Narcan or are just experiencing the effects of sedatives. If the person is breathing at least one full breath every six seconds, you should continue to monitor their breathing and NOT give them Narcan. If they are breathing once every 7+ seconds, breathing irregularly, or making choking/gurgling sounds, you should administer Narcan and begin rescue breaths.