Presented By: Mary Wheeler Street Outreach Coordinator CAB Health and Recovery Services Inc.,

1. OPIATES.Heroin. OC's. Oxys. Percs. Vics. Methadone. Fentanyl. Dope. Brown. Oxycontin. Smack. China White. Morphine. Dilaudid. Boy. Brown Sugar. Scag. White Lady. Demerol. Dollies. Methadose. Codeine. Junk. Presented By: Mary Wheeler Street Outreach Coordinator CAB Health and Recovery Services Inc., Lynn, MA

2. Massachusetts. On average 2 people a day die of an opiate overdose in Massachusetts. New England’s opiate use is 35% higher than the rest of the US. In 2008 a reported 644 people died from drug overdose. The Narcan program in MA has reversed over 500 overdoses. The 500 overdose reversals were primarily done by active drug users to other active drug users.

3. Opiates and Opioids are… • Fentanyl and Methadone are synthetic opioids (man-made) • Heroin, Percoset, Vicodin and Oxycontin are semi-synthetic opioids • Opiates and Opioids are used for primarily pain management • Used for people with chronic pain (ex. cancer or HIV/AIDS) • Easily and widely abused • Regular use leads to tolerance • People must take higher doses to feel effects • Severe withdrawals • Euphoria, warm, relaxed, dry mouth, pinned pupils, nausea/vomiting, suppresion of the nervous system, “rush”, “nod” • Opiates can be swallowed in pill form, drank in liquid form, smoked, snorted or injected

4. Other Drugs • Benzodiazepines (Xanax, Klonopin, Ativan, valium etc.,) • Clonidine • Neurontin • Cocaine • Alcohol • Marijuana • Meth, Ecstasy, Acid, Mushrooms, Special K, Inhalants • Adderall, Ritalin • Cough syrup and cough medicine • Motion sickness pills

5. What Can Happen? Disfigurement from long-time use. Severe health issues such as depression, anxiety, panic disorder, HIV/AIDS, Hepatitis A, B, C. Criminal record.

6. What Can Happen? Overdose related health issues. Fatal overdose of friends, family etc,.

7. What is an overdose? • Too much of a drug • Shuts down your bodies main functions • Heart • Lungs • Brain • Liver • Unconscious for a long period of time but not knowing how long • Black-out • Falling out on a hand, arm, leg etc., causing loss of circulation

8. Overdose Prevention • Abstinence • Don’t Mix • Be careful after a period of not using • Getting out of jail or drug treatment • Never use alone • Know what you are taking

9. What does an overdose look like? • Not breathing • Irregular breathing • Turning blue • Shaking • Sweating • Seizure • Can’t wake up • Can’t talk • Can’t hear • Not responding to pain

10. Responding to an overdose • Are you ok? • Check for breathing • Sternum or Sternal Rub • If no response call 9-1-1 • If they respond try to keep them talking • No food or water • Put them on their side in the recovery position • If they do not respond do rescue breathing • If you leave the scene make sure you have put them on their side

11. Are you ok?

12. Sternum Rub

13. Call 9-1-1

14. Moving the person

15. Rescue Breathing

16. Rescue Breathing

17. Naloxone - Narcan • Medication to reverse an OPIOID overdose • Blocks the drug for 20-90 minutes • Starts the person breathing • Works 100% if heart is beating • Does not work on other types of drugs

18. Recovery Position

19. Calling 9-1-1

20. What do you say? • You want Paramedics or Advanced Life Support • Calling 9-1-1 will alert medical, fire and police • Overdose is not a priority call, respiratory arrest is. • “Someone here has stopped breathing.” • “Someone here is in respiratory arrest.” • Give your address or location • They can walk you through the situation if you stay. • Or you can say, “I know what to do, see you soon.”

21. Why would someone leave? • Fear • Drugs on them • Guns/Weapons • Warrants • Don’t care • Don’t want people to know they use. • Section 8 • Children

22. When they arrive… • Stay calm • Get people out of the house that do not need to be there • Leave a door open so they can get in • If you are giving the person rescue breathing let the medical people take over • If you have given the person Narcan tell the medics • If you know what drugs have been taken tell the medical people

23. What NOT to say… • Body language • Stay calm, don’t make sudden moves • Keep your hands where they can be seen • What you say CAN be used against you, even if you are not arrested. • DO NOT RUN • DO NOT touch the officer • Don’t resist • Don’t argue, be polite • Do not say anything if you get arrested • Don’t give excuses or make up stories • Wait for a lawyer or parent • You are entitled to a free lawyer if you can’t afford one

24. Legal Consequences • Knowingly being present • Possession • School zone violation • Conspiracy to violate drug laws • Voluntary manslaughter (if someone dies) • Lying to police/giving a fake name • Probation/Parole Violation • “Known drug user”

25. Wrap-up and Questions • What does it feel like to see an overdose? • Who would you talk to if you see something like this? • Who would you talk to if you overdose or a family member overdoses? • Do you have any questions, comments or concerns?